P - 78668RE(�UEST FOR ELECTRICAL INSPECTION
1 3 3 2 3 0 8 &�w Minnesota Board of Electricity
o � a 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
r � �a�� �� (651) 642-0800 lTY/MRS 1-800-627-3529 -
www.electricity.state.mn.us
IdentiTy the work covered by this request:
�NEW ❑REMODEL ❑ADDITION ❑REPAIR
L 0 to 400 Am ere �$25 ''� "
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am re (� $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S em Device or ratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Outdoor Li htin Standard � S1
Traffic Si nal Standard (� $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortner / Power Su for S' ns / Outline ' htin �$5
9NE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$�
Additional Ins ection Tri s�$20
IrnesU ative Fee
Reins ion Fee � $20
TOTAL FEE
/�jr ��. (minimum total fee is $20
Li hd Retrof'd �$25 er Fixture
Center Pmot I' abon Boom �$40
Manufactured Home Park Lots �$25 � h��bY �e�
Recreational Vehicle Park Sites � $5 "01GH1N
Se arate Bondin Ins ecGon �$20
S ecial In bn �$30 er Hour �'"�7p
S ecial Ins ection �$.31 r Mile
THIS INSTOLLATION MAY BE �RDERED DISCONNECTI
that I inspected the electrical installalion
� a
o� me aeres �a: s
wre
/'ti 3
n��
�^�� �
I certify that I am the�CENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: