P - 80052REQUEST FOR ELECTRICAL INSPECTION .....
Minnesota Boartl of Electricity � •..
� 1-396-100 � 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
Identity the work covered by this request:
O1QEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re �$25
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Ap aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Li htin Retrofit �$25 per Fxture
Center Pivot Irri ation Boom �$40
Manufactured Home Park Lots � $2
Recreational Vehicle Park Sites �
Se arate Bondin Ins ection �$20
S ecial Ins 'on �$30 er Hour
Special Inspection � $.31 cer Mile
�
to 10
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspedion Trips Each Dwelling Unit �$80
Additional Insoection Trios � $20
ROUGHIN
FINAL IN3PECTION
TOTAL FEE
total fee is $20)
DATE
l z- �- �-� I
FOR OFFlCE USE ONLY
1I�I�IIIIIIIIII�III�IIIIIIIII���I� ��5�
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* 1 3 9 6 1 0 0 8* '
Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough-in: ❑ Ready Now ❑ Will Call
OBMBro� You musi call the inspector when ready! X Date Ready: X
I certify that I am the G� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address (Street, Bax, or Route No.) City Zip Code
75?6 4TH ST NE FRIDL.EY 554
Section Township Range Fire No. Caunty A�{A
Occupant � Phone
ZELENAK OREO M
Power Supplier Address
XC:EL EFIERGY
Electrical Contrador / Company Name Contractor License Number Master License Number
HUNT ELECTRIC �RATION CA 00883
Mailing Address (Contractor, Company or Owner Perfortning Installation)
�300 TERRITl7RfAL RQAD , SAINT PAUl., MN 55114
Authorized Signature (Contractor, Company or Owner Performing Installation) Phone
651 64�28/1
EB-OOOOtA-13 � 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY