P - 79241REQUEST FOR ELECTRICAL INSPECTION
`�� Z� O� C� C a Minnesota Board of Electricity -
� V 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
NEW O REMODEL ❑ nooirXCEL ENERGYSCS�AVEng �� � k�Te�H"te copy if necessary - the work covered by this request:
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GENERALFEES
0 to 400 Am ere $25
401 to 800 Ampere @ $50
Above 800 Ampere �a? $75
CIRCUITS / FEEDERS
0 to 200 Ampere @ $5
Above 200 Ampere @$70
AIARM, COMMUNICATION, REMOTE CONTROI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
3 to 12 Units @$50 Per Unit
Each Addifional Unit @ $25
FEES
Transformers over 10 KVA $ 20
Transformer 1 Power Supply for Signs / OuUine Lighting @$5
ONE & TWO FAMILY DWELLINGS, EACH UNiT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Reins tion Fee $20
TOTAL FEE ZO.SO
(minimum total fee is $20)
THIS AREA FOR INSPECiOR USE MqY
I hereby certify that I inspected the electrical inst�lation described herein on the dates sta@d:
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ Inspec[ian Other Than Rough-In: ❑ y Now O N�1 CaB
�T�� You must call the inspector when readyl Date Ready:
I certify tl�at I am the �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby �equest inspection of 1he elecUical work at:
INSiRUCTON$ ON BpCK OF YELLOW GOPY BOpRD OF ELECTRICT' CAPY E&0OOO1M14 B.Y. 2002