P - 81858, REGIUEST FOR ELECTRICAL INSPECTION
..
. Minnesota Board of Electricity
. 1-375-394 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 ` �
• (651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. sta te. mn. us
Identify the work covered by ihis request:
qiOEW O REMODEL ❑ ADDITION ❑ REPAIR
GENERALFEES
SERVICES / POWER SUPPLIES
0 to 400 Ampere � $25
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or A paratus �$.50
ApDIT10NS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNI
3 to 12 Units �$50 Per Unit
Lighting Retrofit � $.25 per Fixture
Center Pivot Irrigatlon Boom � $4C
Manufactured Home Park Lots � $
fiecreatlonal Vehicle Park Sites �
Separate Bonding Inspection � $2i
Special Inspection � $30 per Hour
Eti�i I���?il
Su lemental Fee � $20
Transfortners u to 10 KVA �$10
Transfortners overl0 KVA � $20
Transfortners ! Power Su I for Si ns / OuUine Li hti �$!
ONE $ TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits arM Two Inspection Trips Each Dwelling Unit �$80
Additional Inspection Trips � $20
TOTAL FEE
total fee is $20)
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I hereby cerdy that I inspected the electrical insfalletlon deacribed herein on the dates slete
RIX/GH IN DATE
FINAL IN$7ECTION DqTE
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FOR OFFICE USE ONLY
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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 CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: