P - 81970� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity �
, 1-377-47$ � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-OS00 TTYlMRS 1-800-627-3529
www. e%ctricity.state.mn. us
IdenGfy the work covered by this request:
D�VEW ❑ REMODEL � ADDITION ❑ REPAIR
o to
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNI�
3 to 12 Units �$50 Per Uni[
� $25 per Fi�
aUOn Boom �
ime Park Lots
Mile
XCEL ENERGY SAVER'� SWITCH
Transfortners over 10 KVA � $20
Transformers / Power Supply for Si ns / Outline Liqhtin �$5
ONE & TWO FAMIIY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspeciion Trips Each Dwelling Unit �$80
Additional Inspecfion Trips � $20
Investigative Fee
Reinspection Fee � $20
TOTAL FEE
(minimum total fee is $201
� nereey certiry mat � inspeccee lne elec�rica� insta�lafion deacribea nerein on
ROUGH IN
FIMAIINSPECTION -
DATE
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FOR OFFICE USE ONLY
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* 1 3774732* ���J� `���
Request Date: Rough-in InspecHon Required? ❑ Yes ❑ Inspectian Other Than Rough-in: eady Now ❑ Will Call
46t29/C�1 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: