P - 788991' 6 2�1- �� 5 � REQUEST FOR ELECry RICAL INSPECTION
Minnesota Board of Electrici
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-08Q0 TTY/MRS 1-800�27-3529 www.electricitv.state.mnuc
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'�"""" ""e. Roughi� Inspection Required? ❑ Yes Inspecpon pther Than Raugh-In:�esdy Wqy ❑ yyHl Call
� �1`1 —�`l You must cail fhe inspector when ready! Date Ready
I certify that I am the �CENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request inspection of tl�e electrical work at:
E&000p1Mt1 � 8.1:2002