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P - 780421-524-390 � •�' REQUEST FOR ELECTRICAL INSPECTION Minnesota Board of Electricity - 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-800-&27-3529 www.electricity.state.mn.us �► � � ` �vl� � IIIIIIIilllillill!lIIIIIII�►IIIIIIIBIII��1� I � 1524390� I�� � � 4 � ��� i ��c• /' � Rough-in Inspedion Required? ❑ Yes �NO Ins 7 � pedion Other Than Rough-In: ❑Ready Now II Call -. You must wll the inspector when ready! Date Ready: . . I cerMy that I am the O�CENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request inspecfion of the electrical work at::