P - 80553REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Eledncity
1-380-334 � 1821 Universiry Avenue Suite 5-128, Saint Paul, Minnesota 55104 �'
(651) 642-0800 TTYIMRS 1-800-6273529
www.elechicity.state.mn. us
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I certity that I am the L� LICENSED CANTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecfion of the electrical work at: