P - 77334REQUEST FOR ELECTRICAL INSPECTION ,� �'��
1'�� V 1- 310 6 Minnesota Board of Electricity �Q�S-����o f .`_
❑ 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 wx�w.electricitv.state.mn.us
Descnbe -using the back of the white copy if necessary - the work covered by this request:
EkCEL ENERGY SAVE�'S SW.T.TCH
GENERALFEES
JICES I POWER SUPPLIES
0 to 400 Ampere @ $25
401 to S00 Ampere @ $50
Above 800 Ampere @ $75
;UITS I FEEDERS
0 to 200 Am ere $5
Above 200 Am ere $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
MULTIFAMILY DWELLINGS PER UNIT
3 to 12 Units @$50 Per Unit
Each Additional Unit @ $25
OTHER ADDITIONAL FEES
Liahtina Retrofit (�a $.25 per Fixture
Tra�c Signal Standard
Supolemental Fee (� $
over 10 KVA @ $ 20
Power Suoolv for Siqns
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Additional Ins ection Tr�s @ $20
Investigative Fee
Reinsoectian Fee (�a $20
TOTAL FEE � `�
total fee is $20)
that I inspected the elecirical installation descnbed herein on ihe dates stated:
Se arate Bondin Ins ection $20 — —�� US
Special Inspection @$30 per Hour exaiaeo nenNOONeo onre
Special Inspection @ $.31 er Mile
THIS lNSTAILATiON MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12 MONTHS
i Iiil II III II i� II lii II III II NI II I� II BI II III (III
L7813106
'�. ����^. L� f��j Rough-in Inspection Required? ❑ Yes � No Inspection Other Than Rough-In: [�Ready Now ❑ Will Call
�_ __ __.__ _ You must call the inspector when ready! __ i Date Ready: ___
I ceRify that i am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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'��. Electrical Utifity ,, Electrical Utility Address
' XCEL ENERGY
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C�` UN 1'�CI°fL� I!t'gC CQRF'DFi�iTION � co�tre�to� ly�e�1'Se�l T��:�
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� MaiGng Address (Contractor, Company or Owner Performing Installation)
'�30� TE�,�;IT�JRIAL ROAD, S�INT F'f�UL, h1N 55114
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, qutho� Si na�ntractor or Owner Performing Installation) ��Ig� � royid
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Master Electrician or Power Limited Technician I
License Number
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