P - 82088E
' REQUEST FOR ELECTRICAL INSPECTION
�-859-815 03 Minnesota State Board of Electricity
1821 Universify Avenue Suite S-128, Saint Paul, Minnesota 55104-2993
+ (651) 642-0800 www.electricity.state.mn.us
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Contlitioner 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 on/y.
NSP SAVER'3 SWITCH
THIS INSTALLATION MAY BE ORDERED DISCONNEC7ED IF NOT COMPLETED WITHIN 18 MONTHS.
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w OFFICE USE ONLY This request void 18 months from validation date printed in this box.
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PLEASE PRINT OR TYPE
Request Date Rough-In inspection required? ❑ Yes ❑� Inspection Other Than Rough-In: C�ieady Now ❑ Will Call
You must call the inspector when ready! Date Ready:
I, �] licensed contractor ❑ company ❑ owner hereby request inspection of the above electrical work at: