P - 79433REQUEST FOR ELECTRICAL INSPECTION ,.,�
1 3 2 6 9 4 g „ Minnesota Board of Electricity
� � 1821 Universiry Avenue Suite S-128, Saint Paul, Minnesota 55104 ��'
. a a�� (651) 642-0800 TfY/MRS 1-800-6273529 J�C���
www.electriciry.state.mn.us j �'
� �NEW
0 to 400
❑AD�ITION
MAY
VOLTS
KVA �
ONE & TWO FFMILY DWELLINGS, FAI:H UIVI I
Includes the Service anNor Power Supply up ro WO Amperes, All
Cirwits and Two Insoection Trios Each �wellin9 UnA �$80
FOR OFFICE USE ONLY
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Reques� ate: Rough-in �PSpection Requiretl? ❑ Vas No
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total fee is
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QVou mus� callfie inspec�orw�en reatly! pate Reatly: \
I certity ihat I am ihe LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER aiM hereby request inspection of the electncal work at
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