P - 80594REQUEST FOR ELECTRICAL INSPECTION
' Minnesota Board of Elecfricify �
-` 1-$$Q-$Q6 � 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104 i
•_' (651) 642-0800 TTY/MRS 1-800-627-3529
�.._.
www. electricity.sfate.mn.us
nGN ihe work coverCtl bv ihis reauesl:
XCEL ENERGY SAVER'S SWITCH
ONE 8 TWO FAMILY DWELLINGS, FACH UNIi
Inclutles iha Service and�or Power Supply up to 500 Amperes, All
GircuiLS aM Two Ins�eCtion Trips Each Dwellino Unit �$!
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.FOq OFFICE USE ONLY
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I ceAify ihat I am the c1 LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection o! ihe electrical work at:
Job Atltlress (S[reeq Box, or Route No.) Ciy „� „_�_
$CCI10f1
Fange
Pno�e
OF ELECiqICITY COPY
AMUKA