P - 78832REQUEST FOR ELECTRICAL INSPECTION �
1 ��� 0� 0 tl Minnesota Board of Electriciry
� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TfY/MRS 1-800-627-3529
' www.electricity.state.mn.us
• � — . FOR OFFICE USE ONLY
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Requ te: Rough-in Inspection Required? ❑ Yes �No Inspectian OTher Than Raug -I
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��� � You must call the inspector when ready! \ Date Ready: ���Q Q
I certify that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and tiereby request inspection of the electrical work at