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- 0-858-379 1[]
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REQUEST FOR ELECTRICAL INSPECTION
Minnesota State 8oard of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104-2993
(651) 642-0800 www.e/ectricity.sfate.mn.us
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Commercial Intlustrial Farm Remod RE
A' r Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elect. Heat Temp. Service
'X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only.
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Calculate Inspection Fee - This Inspection Reauest will not be acceated without the correct fee.
Mobile Home Park Stall 0 to 200
Street Ltg. / Traffic Sig. Abpvq 2
Transformer/Generator �
Sign / Outline ltp. 3�nr.
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$WIIfN111fl� FPGt/r �
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R'8 U�E �Y
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I inspected lha
0 to 100 Ai
Above 100
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I InV�EdiVe Fee Final p� `� /��
THIS INSTALLATION MAY BE ORDERED ONNECTED IF NOT COMPLETED WIT ONl
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UFfIC� USE ONLY This request void 18 months from validation date printed in this box.
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*08583791* J�3�
PLEASE PRINT OR
Rough-In inspection requiretl? � Yes o Inspection Other Than Rough-Ir
You must call the inspector when ready! Date Ready: '(
I, '[�licensed contractor ❑ company ❑ owner hereb re uest ins `
Y q pection of the above electrical work at:
EB-00001A-12 5/1999
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SEE INSTRUCTIONS ON BACK OF YE�1 nw r.nov