P - 80462REQUEST FOR EIECTRICAL INSPECTIOfd
1 16 0 5 61 Minnesota Board of Electriciry
� � 1027 Universiry Avenue Suite 5-128, Saint Paul, Minnesota 55104
r (651) 642-0800 TTYlMRS 7-800-627-3529
www.edectriciiv.staie,mn.us �
�tlentify IDE wdrk caVeretl by this requtSC �', fj.�Q GL e� (,���ij7� �
❑AODITION
ONE 8 TWO FAMILY uWttLINliS, tn�n urvii
IrcluOes ihe Servlce anNor Power Supply up to 500 Amperes, All
THAN 50
—�_` � FOR OFFICE USE ONLY
II111111111111111III1111H��MN�111111111111 ,��$�� �! !�
I ,,,���.../// I �ou must call ihe inspec�or w�en readyl � Dam Feetly: �
I certily that I am the ILiUCENSED CONTRACTOR ❑ COMPANY ❑ OWNFR and hereby request inspection of the elactrical work at
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Job�s (Street, Box, or Route Ciry � Zip�� ��
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Sxtion Township Range ire No. Cou .� /
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