P - 79793REQUEST FOR ELECTRICAL lNSPECTION
1� 4 01 ���� � Minnesota Board of Electricity
r 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 lIYIMRS 1-800�27-3529 www.electricity.state.mn.us
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''�1� �: Roughrn tnspeclion Required? ❑ Yes ❑ No h�speetion p�her Than RougM y Now � Nfill Catl
/ O� �/7 • ppi You must call the inspecta when ready! Dete R�dy:
I cefify lhat I am the �CENSED CONTRACTOR ❑CONIPANY ❑ OWNER and hereby �equest inspeclion of tlie electrical watc at:
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Pl�se Provide Two (2) Pfiane Nwnber(8) hidudfng Area Code
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erue Number Master Elxtriaen a�l�mited echnia
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