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P - 80575RE�UEST FOR ELECTRICAL INSPECTION _ Minnesota Board ot Elepricity 1=380-356 � 1821 Univereiry Avenue Suite 5-128, Saint Paul, Minnesoia 55104 �(651) 642-0800 TTV/MRS 1-800-627-3529 www. electricirystate. mn. us FOq OFFICE USE ONLY I IIIIII �AI N�I IIIII �lII�IIR�IIII (I�I ��ya' �� 4 9� sa naugo-m inspedlon Requiretl? LJ Ves ❑ qb I Inspemion O�her Than Rough-in: eetly Now Vou must cell Ilie inspec�or when reatlyl Date Reativ j I certi that I am the y Q fy L� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereb re uest inspection oi ihe elecMral work ar