P - 79449REQUEST FOR ELECTRICAL INSPECTION �
1�� 181 15 8 Minnesota Board of Electricity °'
-� � 1821 Universiry Avenue SuHe 5-128, Sainf Paul, Minnesot2 55104 ��
(651) 642-0800 TTYlMRS i•B00-627�529
www.electricery.state.mn.us .
FOIi OFFICE USE ONLY
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I certiy that I am ihe(� LICENSED CONTRACTOR
Job Adtlress (SY�eeL Box. or Route Na]
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0 COMPANY ❑ OWNER and hereby request inspection of the electrical work at
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Meiling AOtlresa (COntrac[or, Compeny or Owner Per(orming Installation)
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