P - 80567REQUEST FOR ELECTRICAL INSPECTION _
x Minnesota Board of Eleciricity
� 1-380-348 � 7821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 .
www.electricity.state.mn.us _
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" 1 3 8 0 3 4 8 1'
Rough-in Inspecti
VOU must call t�e
FOP OFFICE USE ONLY
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290�1 ��
❑ Yes ❑ Inspec[ion plher Than Rough-in: eatly Now � Will Call
i reatlyl Oate Reetiv:
I cetlify ihat I am ihe L� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and herehy request inspedion ot the electrical work at: