P - 79178� REQUEST FOR ELECTRICAL INSPECTION -
�.� '7 [ '7 _ 9 7 9 � Minnesota Board of Electricity , °
/ J f 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 -
(651)642-0800TTY/MRS 1-800-627-3529 www.electriciry.state.mn.us
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aues� ua�e: Rough-in Inspection Required? U Yes L] Np I Irupection Othar Than Rough-In: �Ready Now
� � i� �QQ� Vou must cail the inspector when r¢ady! Date Ready:
I certify that I am the �1 LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
INSTRUCTIONS ON BAGK OF YELLOW GOPY BOARD OF ELECTRICITY COPY EB-OOOp1A.14 8.1. 2002