P - 80147REQUEST FOR ELECTRICAL INSPECTION
_� 312 4 g 7 ��`� Minnesota Board of Electricity "�
� � � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
'��� ae (651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us �-� ' � '
Identify the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION
GENERAL F
SERVICES ( POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Amoere � $50
0 to 200 Amoere �
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL F
TIFAMILY DWELLINGS (PER UNI�
3 to 12 Units �$50 Per Unit
Each Additionai Unft � $25
OTHER ADDITIONAL FEES
Lighting Retrofit � $25 per Fxture
Cemer Pivot IrrigaSion Boom � $AO
Manufactured Home Park LoGS � $25
Recreational Vehicle Park Sites � �
Separate Bonding Inspection � $20
Soecial Insoection � $30 oer Hour
Outdoor Li htin Standard � $1 ` '
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit (� $8(
Additional InsDection Trips � $20
that
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF
FOR OFFlCE USE ONLY
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� Date: Rough-in Inspection Required? ❑ Yes o Inspe
ZYou must call the inspector when ready! Date
I certity that am the� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER
total fee is
des�xibed herein on the dates stated:
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n: Readv Now ❑ wll Cali
and hereby request inspection of the electrical work at