P - 78509REQUEST FOR ELECTRICAL INSPECTION
1_ 3.J � 2 3 5 Minnesota Board of Electriciry
� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us �j
I ❑ NEW ❑ REMODEL
0 to 400 Am ere �$25
401 ro 800 Am ere �$50
Above 800 Am ere � $75
CIflCUITS / FEEDERS
0 to 200 Am re �$5 ,�-{
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE Cl
CIRCUITS, CIRCUITS OF LESS THAN 5�
Each em Device or A aralus �
ADDITIONS TO THE GE
MULTIFAMILY DWEILINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITION/
Li htin ReVofd �$25 r Fature
Center Pivot I' adon Boom �$40
Manufaclured Home Park Lots � $2,
Recreational Vehicle Park Sites � $!
S te Bondin Ins ction �$20
�.
Su lemental Fee � $20
Transform�rs u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li Mi �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin UnR �$80
Additional Insoection Trips � $20
that I
Fee
total fee is
described he2in on the detes
�,
S ial Ins �on �$30 r Hour � � V V Fl"""'�"0N """
S ial In tion �$.31 r Mile y�� z��
THIS INSTALLATION MAY BE ORDERED DISCONNECTED T COMPLETED WITHIN 18 MONTHS
Foa o�ce use aur ��, '�/� �
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Request Date: Rough-in InspecUOn Required? ❑ Yes Inspection Other Than Rough-in: dy ❑ Will Call
� O You must call the inspector when readyl Date Ready: �
I certiiy that I am the (�I ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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E&00001A-13 7l1/2000 � BOARD OF ELECTHICRY COPY INSTRUCTIONS ON BACK OF YELLOW COPY