P - 78450REQUEST FOR ELECTRICAL INSPECTION
' Minnesota Board of Electriciry
1+ 3 4 7- 3 4 9 �821 ����ers,�, A�e��e S��te S-,28, 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 IXREMODEL ❑ADDITION ❑REPAIR ���
0 to 400 Am ere � �"� /
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS I FEEDERS
0 to 200 Am re�
Above 200 Am re $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S tem Device or A lus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UN
3 to 12 Units �$50 Per Unit
Each A�litbnal Unit � $25
OTHER ADDffIONAL FEES
Li Min Retrofd �$25 r Fbcture
Center Pivot I' tlon Boom �$40
Manufactured Home Park Lots � $25
Recreational Vehicle Park Sites �
Se rate Bondin Ins ion �
Soecial Insoeclion � $30 cer Hour
Traffic Si nal StandaM � $5 �
Su IemeMal Fee (� $20
Transtortners u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su for S' ns / Outline Li hti �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Indudes the Service and/or Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Additional Ins ection Tri s�$20
InvesU ative Fce
Reinsoection Fee � $20
total fee sL$20) I(p��s I
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�rebvi ceAifv that I insoected tl�e electm:al installaGOn desaibed herein on 1he
FOR OFRCE USE ONLY �\� yf j,/
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Request Date: Rough-in Inspection Required7 Yes ❑ No Inspection Other Than Rough-In: ❑ Ready Now Will Catl
/`-� /S {/.,,) You must call the inspecMOr when ready! Date Ready:
I certify that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspeclion of the elechical work at: