P - 79148REQUEST FOR ELECTRICAL INSPECTION
1����- 4 6 7�3 Minnesota Board of Electricity -
` 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� (651) 642-0800 TlY/MRS 1-800�27-3529 www.electriciry.state.mn.us
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Request Defe: Rough-in Inspection Required? es ❑ rb Inspection Other Than Rough-In: ❑Ready Now �I Wil� Ca��
I 2-8-04 You must cali the inspedor when ready! oa� R�ay: .
I certi(y that I am the � UCENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of U�e electrical work at:
,lob SRe Address (�reet, BoX w Route No.) Ciry Zip Code
235 Satellite Lane Fridley
Management corp. I( ) ( )
�Q�y �� Contracta ticense Number Masrer F�ecmaan a
Electric CA01110 ''�''�'"''�'
NE,pSpring Lake Paxk, MN 55432
3729
ON BACK OF YE BOARD OF ELECTRICITV COPY EB-W001M14 8.1. 2002