P - 80954fu� REOUEST FOR ELECTRICAL INSPECTION �+� ��
,-r��t��ll IIII III I�I (II II I I IIII (( IIII 8121 Unlversity AvearRmf S-128'CSt. Paul, MN 55104 �,���-
* 0 2 1 6 3 8 4 8 s Phone (612) 642-0800
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Sign/Outline Lfg. Xfmr.
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: request. Enler remarks in fhis space ond on
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Requesf will not be occepied withoW �he mrrect fee:
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INSPECTOP'S USE ONLY
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Fee
Imestigafive Fee � - ` �—�
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
216 - 3 8 4 � OFFICE USE ONLY TMs reqmst void 18 manihs irom validanon date prinkd in this box.
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PLEASE PflINT OR TVPE
Reqoesf DoM Rough-in inzpedion required2 ❑ Yes �IJo Inspedion Olher Than kaugh-Im �[Ready Now � Will Coll
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I,_f� licensed contrador ❑ owner hereby request inspedion af the above elechi<al work ai:
up i�ame or rvo. I rtange
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