P - 75832REQUEST FOR ELECTRICAL INSPECTION
1- 7 4 3- 7 9 9� Minnesota Board of ElecVidty
1821 Universiiy Avenue Suite S-128, Saird Paul, Minnesota 55104
(651}842-08001"TY/MRS1-800.62T-3529 www.elecbicity.state.mn.us
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Ie: Rough-In Inspection RequVed7 ❑ Y� � No In.spe�on Other Than Raigh-In: ❑Ready Now Wql Cell
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I cer�fy ihat I am the �J LICENSED CONTRACTOR 0 COW�ANY ❑ OWNER and he�eby request mspection oF Cre dectrical work at: