P - 79549REQUEST FOR ELECTRICAL WSPECTION
� � � � �� � � t � Minnesota Board of Electricity
� � � 1821 University Avenue Suite S-128, 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 ❑REMODEL ❑ADDITION ❑REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re �$25
401 to S00 Am ere �$50
Above S00 Am re (� $75
CIRCUITS / FEEDERS
to 200 Am ere � $5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEE
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units (� $50 Per Unit
FEES
Lighting Retrofit � $25 per Fixture
Center Pivot Irrigation Boom � $4(
Manufactured Home Park Lots � 9
Recrea6onal Vehide Park Sites �
Separate Bonding Inspection � $2i
Soecial Insoection � $30 oer Hour
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Traific Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
� Transformers over 10 KVA � $20
Transformer I Power Su for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Additionai Insoection Trios � $20
ispection Fee � $20
ron use or��v.
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�rtilv that I insoected the eleclrical
total fee is
he2in on the dates stated:
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THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT CUMPLETED WITMIN 18 MONTHS
FOR OFFICE U8E ONLY
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Requ st ate: Rough-in Inspection Required? ❑ Yes o Inspection Other Than Rou -In: eady Now ❑�II Call
You must call the inspector when readyl Date Ready: � 02
I certify that I am the� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: