P - 79198REQUEST FOR ELECTRICAL INSPECTION
1�` �� V- 518 0 Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� (651) 642-0800 TfYlMRS 1-800-627-3529 www.electriciry.state.mn.us
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'��+�� Ue�: Rough-in Inspection Required? ❑ Yes O"I�o Inspedion Other Than Rough-In: ❑ dy Now ❑ VYII Call
07�� You must call the inspector when ready! Oate Ready:
I certify that I am ttie �ICENSED CONTRACTOR ❑ COMPANY 0 OWNER and hereby request inspection of the electrical work at:
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