P - 80559REQUEST FOR ELECTRICAL WSPECTION �
Minnesota Board ot Eledncity
1-380-340 � 1821 Universiry Avenue Suite S-128, Saint Paul, Minnesota 55104
� (ssi� saz-oeoo mrt�as �-aoo-s��-aszs '
www. elecfricity.state.mn. us
I�I�I IIIII IIII) II) I IIII��IIII III �d 7� FOR OFFIC� ONLV Y�'U �
* 1 3803408 * 2����
Now
must call ihe inspector when reatly! � Oate
I cerifij that I am the C� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request insoection of ihe electrical work ar