P - 79756REQUEST FOR ELECTRICAL INSPECTION
1� 4 0�- 3 71 �? Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� (651) 642-0800 TfY/MRS 1-800-627-3529 www.electricity.state.mn.us
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Roughin Inspection Required? ❑ Yes �❑ Na Inspection Other Than Rough-In: �Ready Now ❑ Will Call
You must call the inspeGw when ready! Date Ready:
ENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request inspection of the electr�al xrork at::
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Power Suppli�
�EW VALLEY HEATING &
5182 WEST BROAI�1�/AY
763-535-2000
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License Number
E&0OOO1M51 8.1. 200Q