P - 80569REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board ot Electncity
1-380-350 � 1821 University Avenue Suite 5-128, Saint Paui, Minnesota 55104 �'
(651) 642�0800 TTYIMRS 1�800-6273529
www. electricity. state. mn. us .
IdeMify �he work wvered by this request:
OMIEW ❑ REMO�EL ❑ ADOITION
SIGNALWG
INNI {{NI NII III I{I{II��MI{�M�IN II
%CEL ENERGY SAVER'S SWITCH
UNIT
rta� i���soemaa me aiaano� m:unaro�
0 Amperes, All
:Iling Und � SBO
TOTALFEE 50
totalfee is $20)
:��mea narem � �ne aaes su�ee�.
FOH OFFICE USE ONLY
,r�q� ��43
a� So
I� 08/17/01 I �ou mus� cell �he Inspector when reaay! � Da�e Reatly:
I cetlify that I am the � LICENSED CONTRACTOR ❑ CAMPANY ❑ OWNER and hereby request inspection ot the electrical work at: