P - 80598= REQUEST FOR ELECTRICAL INSPECTION
Minnesota 8oard ot Electnciry
1-380-329 1❑ 1821 Universiry Avenue Suite S-128, Saint Paul, Minnesota 55104
(851) 642-0800 TTYlMRS 1-8�0-627-3529
www. electricity. state. mn. us
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FOR OFFIGE USE ONLY
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Uf�fl (IV� � Y°u mus[ call the inspec�or when reatly! I Date Reatly:
I ceAity that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of ihe elecMcal work at:
Job Atlaress (S�reet, Box, or Rou�e NaJ CiN Zio Code
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BOARD OF ELECTRIqTY COPV
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