P - 78808REQUEST FOR ELECTRICAL INSPECTION
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"r 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651)642-0800 m/MRS 1-800�27-3529 www.electriciry.state.mn.us
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You must call the inspecta when reedy!
CONTRACTOR
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Dele Ready:
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nspeCtion � tl�e electric�l work at:
Lioense Mumber
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INS7RUCTONS ON BACK OF YELLOW COPY BOARD OF ELECTRICITV CAPY E&00001M14 8.7. 2002