P - 78418REQUEST FOR ELECTRICAL INSPECTION �
1� 4�. 7- 917 � Minnesota Board of ElecVicity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
' (651) 642-0800 TTY/MRS 1-800-627-3529 www•electricity.state.mn.us
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Req �ey / Rough�n I�spection Required? �Yes � No Irupedion Other Than Rough-In: ❑Ready Now�YYNI C�I
/ pZ � You must cell ihe inspector when ready! Date Ready. ,
I cerUy that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of tlie electrical work at:
Job Ske Address (Street Box a Route No.) _ Cilv Z� Code
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x/ Camp�y Name Contractar License Number Master Electriaan ar Power Linited ednidan
Standard Electric Co., Inc. CA01715 `'�""m�`
�daress (camacmr, r w owner Pertaming mstaxabon)
2672 M+�p wood Dr. ,�,DO�� Mapl ewood MN 55109
%�, � 651-484-8044
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