P - 79244REQUEST FOR ELECTRICAL INSPECTION
�`�,� 0- 6 3 9� Minnesota Board of Electricity -
1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
` (651) 642-0800 TIY/MRS 1-800-627-3529 www.e[ectricity.state.mn.us
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Request Dffia Rough-in Inspection Required? ❑ Yes O'No Inspedion Other Than RougMn: OR�ady Now O YVNI Call
�7�Q� You must call the inspector when ready! Date Ready:
! certify tl�at I am the CDCICENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request inspection of ihe elecfical work at:
INSTRUCTON8 ON BACK OF YELLOW COPY BOARD OF ELECTRICITV COPV EB-0OOO1M14 8.7. 2002