P - 79380� REQUEST FOR ELECTRICAL INSPECTION
�3 0 3 8 5 0 Minnesota 8oard of Elechiciry
r � 1827 Univereiry Avenue Suite S-728, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-500-6273529�� �
www.electricity.state.mn.us
Itlentiry the work covered by this request:
❑NEW ❑REMODEL ❑ADDITION ❑REPAIR �re,tA,� —
50
Transiormers over tu nvA � pCU
Trareformer ! Power Supply tor Signs 1 Outline LigMing �$5
ONE & TWO FAMILV DWELLINGS, EACH UNIT
Iricludes the Sernce anNor Power Supply up to 500 Amperes, A�I
Circuits and 5wo Insoec1lon Tnps Each DweBing Unil �$HC
iotat fee is
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(1iequest 0 � Pou9�-�� Inspxtion Requiretl? ❑ Yes o Inspaction 01her Than flouBM1�ln: ❑ Reatly Now ill Call
\O� �� Yoo most call ihe Inspecior when reatly! �Dale ReaRy: Z�1
I cenify that I am th�LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER a, her�by re�e inspedion of ihe eledrieal work at:
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�JOb Atldress �Siree�, Bax, or Ho�le No.� Ciry ,.., ,, Zip Cotle . 1
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P�one
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Master License
or UWTer r� allabonJ I I YYI��� ��� �� � I
BOAHO OF ELEClA1GITY COPY INSTRUCTION$ pN 80.CK Oi YEIIOW COPY