P - 80070• REQUEST FOR ELECTRICAL INSPECTION � ��
Minnesota Board of Electriciry
- 1-382-153 � 1821 University Avenue Suite 5-128, Saint Paul, Mlnnesota 55104
(651)642�0800 TTYIMRS 1-800-627-3529
www. electricity. s ta te. mn. us �
. -""' ..!�`f FOR OFFICE USE ON�Y
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Mequest pats: Rough-in InspecAOn Requlretl? LJ Ves LJ No Inspection Other Than Rough-im LJ Ready Now LJ Wiil Call
1 ��gro� Vou must call �he inspeclor when ready! �ate Ready.
I cetlify ihat I am ihe LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of ihe eledrical work at:
E&00001A-13 ]/V2000 60AR0 OF ELECTRICI7Y COPY INSTpUCTIONS ON BACK OF VELLOW COPV