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REQUEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104-2993
(651) 642-0800 www.electricity.state.mn.us
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'X" above the work covered by fhis request Enter remarks irt this space and on the back of the white copy on/y.
NSP SAilER'S 3WiTCH
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
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OFFICE USE ONLY This r uest void 18 months from validation date rinted in this box.
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PLEASE PRINT OR TY
R���� Rough-In inspection required? O Yes O No Inspection Odier Than Rough-In: � Ready Now O WiN CaN
You must call the inspector when readyl Date Ready:
I, ❑ licensed contractor ❑ company ❑ owner hereby request inspection of the above electrical work at:
EB-00007A-12 5/1999 STATE BOARD COPY SEE INSTRUCTIONS ON BACK OF YELLOW COPY