P - 80557REQUEST FOR EIECTRIGAL INSPECTION
�� Minnesota Board of Electricity
1-380-338 � 1821 University Avenue Suite S-128, Saint Paul. Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-6273529
www.electricity.state.mn. us
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Da�e:
FOR OFFICE USE ONLY
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❑ Ves ❑ Inspection Other Than Rough-in: eatly Now O Will Call
ready! Date Reativ:
I certify ihat I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the elecMcal work at: