P - 80192� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of EleciricAy
1-382-155 � 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
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www. elecfricity.state.mn.us .
Itlentity p�e rrork coveretl by t�is request
❑�IEW ] REMO�EL ❑ A�DITION ❑ REPAIR
I Innf Inn Ilifl n111 nlll I�II III� III� nN Inf
" 1 3 8 2 1 5 5 8*
XCEL ENERGY SAVER'5 SWITCH
ONE 8 TWO FAMILV DWELLINGS EACH UNIT
IncW7es ihe Service anNOr Power Supply up �o 500 Amperes, All
Clrcuite antl Two InsO��'ion Trips Faeh DwellinA Unit �$80
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TOTAL FEE
(minimum total tee Is $20)
yamae me a�mi�i ��wa�a aas�mea na�a� on mz aazss E
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IOT COMPLETED WITHIN 18 M NTH
FOR OFFlCE USE ONLV
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iHequest Date: Rough-in Inspection Fequiretl? ❑ ve� ❑NO Inspection Other Than Fough-in' Reaay Now pwill Call
��rogro+ Vou must oall Ilie inspeclo� when reatly� D 1 R tly-
I certify that I am the UCENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of ihe elecMcal work at: