P - 79323REQUEST FOR ELECTRICAL INSPECTION
�� 1 (�- 5 9 0 0 Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
1 (651) 642-0800 TTYIMRS 1-600-627-3529 www.electricity.slate.mn.us
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Request Date: Rough-in Inspection Required? ❑ Yes ❑�iVo Inspedion Other Than Rough-In: ❑�ady Now LJ Will Cal�
D�Qf Q� You must caN the inspector wTien ready! Date Ready:
I certify that I am the C�ICENSED CONTRACTOR ❑ COMPANY � OWNER and hereby request inspection of the elecfical work at::
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