P - 79234REQUEST FOR ELECTRICAL INSPECTION
� � � S Q � � � � � Minnesota Board of Electricity -
v 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� (651) 642-0800 TTY/MRS 1-800-627-3529 www.electriciry.state.mn.us
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nequasc ua[e: Rough-in Inspection Required? LJ Yes LJ"No I Inspedion Other Than Rough-In: L1Ready Now U Will Call
�3��� You must call the inspectar when ready! Date Ready:
I certify that I am the OXICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of tl�e electrical work at:
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