P - 78996REQUEST FOR ELECTRICAL INSPECTION
�- 6� 7 4 5 3� Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TfY/MRS 1-800�27-3529 www.electriciry.state.mn.us
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% f'� /� You must call the inspecla when ready! Date Ready. .
I ceAify lhat I am the �ICENSED CONTRACTOR ❑ CONIPANY ❑ OWNER and hereby �equest inspection of ihe electrical work at:
� �ns�nucnw�s w� ewcR OF �ELLOW COP1/ BOARD OF ELEC7RICRV COPV EB-0OOO1M7� 8.1. 2002