P - 81857REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-375-397 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
• (651) 642-0800 TTY/MRS 1-500-627-3529
www. electricity. sta te. mn, us
Identity the work covered by this request:
OiOEW ❑ REMODEL 0 ADDITION ❑ REPAIR
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am re � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNIT
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Lightinq Retrofi[ � $25 per Fxture
� $30 per Hour
� $.31 per Mile
.LATION MA`
Transfortners u to 10 KVA �$10
Transfortners over 10 KVA � $20
Trensfortners / Power Supply for Signs / Outline Lighting �
pNE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$F
Additional Inspection Trips � $20
FCR INSPECTOR USE IXJLV
1 hereby certily that I inspected the electricel installetion
ROUGHIN
FlNq� INSGECTqN
TOTAL FEE
total fee is $20)
DATE
DA7E
�� 2 �
FOR OFFlCE USE ONLY
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* 1 3753975* ��,�
Request Date: Rough-in Inspection Required? ❑ Yes ❑ Inspection Other Than Rough-in: eady Now ❑ Will Call
You must call the inspector when ready! Date Ready:
I certify that I am the � LICENSED CONTR,4CTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: