P - 815721-Cr56-754 ; a:
IdentiTy the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
0 to 400 Amoere �
CIRCUITS I FEEDERS
0 to 200 Amcere �
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or � aratus �$.50
ADDITIONS TO THE GENERAL f
MULTIFAMtLY DWELLINGS PER UNIT)
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Liahdna Retrofit � $.25 oer Fixture
le Park Sites f� ;
Inspection � $21
� $30 r Hour
REQUEST FOR ELECTRICAL INSPECTION
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
� � �� �
Outdoor Li htin Standard � $1
Traific Si nal Standard � $5
Su lemental Fee @ $20
Transformers uo to 10 KVA �$10
� Transfortner / Power Supply for Signs I Outline Lighting �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dweilin Unit �$8G
Additional Inspection Trips � $20
Investiaative Fee
USE
total fee is $20)'I„/l/ ,.
electricai installa6on described herein on the dates stated:
Special Inspeclion �$.31 per Mile � � �'Z�
THIS INSTALLATION MAY BE ORDERED DISCONNECTED ! COMPLETED WITHIN 18 MONTHS
�R OFRICE USE ONIY �„ (�
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� i O 5 6 7 5 4 3�E �Z
Req e�[ D / Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough-In: Ready Now 0 wll Call
1� .
You must call the inspector when reatlyl Date Ready:
I certify that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical wo�C at