P - 79258REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-396-190 � 1821 University Avenue Suite S�128, SaiM Paul, Minnesofa 55104
(651) 642-0800 TTY/MRS i-800�627-3529
www. elecfricity. state. mn. us
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FOR OFFICE USE ONLY
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Feque�t g��A.2 Fouqh-in Inspeclion RequiredP ❑ Ves C�NO Inspectlon Other Than Rough-in: C�Reatly Now [7 WII Call
Vou must call �he inspector when reatly! Da�e Ready:
I cedity that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of ihe electrical work at: