P - 80561REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board oi Electncity
, 1-380-342 � 1821 Universiry Avenue Suile 5-128, Saint Paol, Minnesota 55104
(651) 642-0800 TTYIMRS 1-800-6273529
www.electriciry.siate.mn. us
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I certify ihat I am the f� LICENSED CONiRACTOR ❑ COMPANY ❑ OWNER and hereby request inspec[ion of ihe eledrical work at: