P - 79626- REGIUEST FOR ELECTRICAL WSPECTION
�2 2 4 9 3 2 '���` Minnesota Board of Electricity �
� � ��a 1821 University Avenue Suite S-128, 5aint Paul, Minnesota 55104
P��`�„ (651) 642-OS00 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us
Identify the work covered by this request: �_ � � �
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❑NEW ❑REMODEL ❑ADDITION REPAIR "� � �^ r' �� v
GENERAL FEE Outdoor Li htln Standard $t
SERVICES ( POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am ere �$50 Transfortners u to 10 KVA �$10
Above 800 Am ere �$75 Transformers over 10 KVA �$20
CIRCUITS / FEEDERS Transformer I Power Su I for Si ns I Outline Li htin �$5
0 to 200 Am ere �$5 --� ONE � TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$10 Includes the Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING CircuiGs and Two Inspection Trips Each Dwelli Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ion Tri s�$20
Each S stem Device or A aratus �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reinspection Fee �$20
Each
OTHER ADDITIONAL FEES
Retrofit � $25 per fixture
'ivot Irriaation Boom � $40
Vehicle Park Sites � $5
id'mg Irrspection � $20 ( '
�ction � S30 oer Hour T�
total fee is
I herebvi certi(v that I inspecled the electrical installafion described herein on die detes stated:
FOR OFFICE USE ONLY
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R ue Date: � Rough-in Inspection Required? ❑ Yes , o Inspection Other Than Rough-In: Ready Now. Q�II Cell
� You must call the inspector when ready! Date Ready:
I ceRify that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspectlon of the electrical work at: