P - 78510REQUEST FOR ELECTRICAL INSPECTION
1 � y� � O� Minnesota Board of Electricity
�• L� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 - _
www.electricity.state.mn.us
Identity th work covered by this request:
EW ❑REMODEL ❑ADDITION ❑REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 M 400 ere � $25
401 to 800 Am re �$50
Above 800 Am re � $75
CIRCUITS / FEEDERS
� 0 to 200 Amoere �$5 7�
D G.� �i � .�TI �d h o
Outdoor Li htin Standard (� $1
Traffic Si nal Standard � $5 =
Su err�ntal Fee � $20
Transfortners u to 70 KVA �$10
Trensformers over 10 KVA � $20
Transformer / Power Su for S' ns / OWine ' Min �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and�or Pawer Suppty up to 500 Amperes, All
GNALING Circuits and Two Inspection Trips Each Dwellin Unit �$8(
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Inaoection Trios �$20
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per UnR
Each Additional Und � $25
CeMer Pivot Irrigation Boom �
Manufactured Home Park Lots
�
Fee
ixsrECron usE or��v
total fee is $20) ��
I hereby ceAity that I ins ecled the electrical ir�tallaUOn described herein on ihe dates
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R� Date: Rough-in Inspection Required? Yes ❑ No Inspection Other Than Rough-In: ❑ Ready Now Will Caq
�'�Q You must call the inspector when ready! Date Ready:
I certiTy that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY �,OWNER and hereby request inspection of the electrical work at: