P - 78903�-
REQUEST FOR ELECTRICAL INSPECTION
1—� 6 O� 7 0 5 � Minnesota Board of Electricity -
1821 University Avenu '�t8.$-128, Sairrt Paul, Minnesota 55104
(651)642-0800 -8 �27-352g www.¢[ectriciry.state.mrr.us
0 NEW ❑ RE L❑ A ITION ❑ REPAIR Descnbe��pg the bacl�Af th white copy 'rf nec ary - the work covered by this request:
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V�nVUI1J/fCCUCRJ Transformer/PowerSu forSi ns/OutlineLi hfin a5
0 to 2(10 Am re SS ONE 8 TWO FAMILY DWELUNGS, EACH UNIT
Above 200 Am E10 Includes ihe Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CANTROL, SIGNALING Circuits and Two Inspection Trips Exh Dwelling UnR @ S80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS n,i,r�n��� i„�.,e,.r,,., r.:.,.. ca e�n
Fee
LL��.w rCR VIYI I TOTAL FEE I
3 to 12 Units � E50 Per Unit (minimum total fee is $20) /��
EaCh Add�6onal Und � E25 rHSU�nFoarsrECraeusE
I hereby cerlify Mat I inspected Ihe dutrical insfaYation described herein on the da�s sfa6ed:
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16607053
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CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of tt�e electriral work at: