P - 80170REQUEST FOR ELECTRICAL INSPECTION
1 ���.J - 7 5 5 Minnesota Board of Electricity '�
�fi 7821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
. (651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us
Identify the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION �REPAIR
GENERAL FE S
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am re C� $50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am re �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIG
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A ratus �$.50
ADDITIONS TO THE GENERAL FEES
Each Additional Unit � $25
OTHER ADDITIONAL
Lighd� Refmfit � $25 per Fucture
CeMer Pivot Irrigation Boom � $40
Manufactured Home Park Lots (� $25
Recreational Vehicle Park Sites � $5
Separate Bonding Inspection � $20
Soecial Insoection � $30 cer Hour
► ��� � "d -
Outdoor Li htin Standard � $1
Traffic Si nal Standard � $5
Su lemental Fee � $20
TransEormers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su for Si ns / Outline Li hti �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Additional Inspection Trips � $20
Investi ative Fee
Reinsoection Fee � $20
total fee is
I insoected the electrical installation des�xibed herein on the detes stabd:
FOR OFFICE USE OlILY
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Request Date; Rough-in Inspection Required? ❑ Yes No Inspection Otlier Trian Rough-In: dy Now � Will Call
g� �—O You must call the inspector when ready! Date Ready: �
I certity that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNEfl and hereby request inspection of the electrical work at