P - 81546REQUEST FOR ELECTRICAL INSPECTION
` � ' � � � � � � � Minnesota Board of Electricity
� � � � 1821 Universiry Avenue Suite S-128, Saint Paul, Minnesota 55104
�°� � (651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity.state.mn. us
IdentiTy the work covered by this request: —�
❑ NEW ❑ REMODEL ❑ADDITION �`REPAIR
GENERAL FEES � O�tJoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am ere �$50 Transformers u to 10 KVA �$10
Above 800 Am ere �$75 Transfortners over 10 KVA �$20
CIRCUITS / FEEDERS Transformer / Power Su I for Si ns I Outline Li htin (� $5
: 0 to 200 Am re�$5 �� �:° ;_"' ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re �$10 Includes the Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwellin Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ection Tri s�$20
Each S stem Device or A aratus �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reins ection Fee �$20
MULTIFAMILY DWELLINGS PER UNI TOTAL FEE
3 to 12 Units �$50 Per Unit (minimum total fee is $20) �� w�
Each Additi0n81 Unit �$25 FOR INSPECTOR USE ONLV
described herein on the dates siated:
Inspection � �1
� $30 cer Hour
_.___THIS INSTALLATION MAY BE ORDERED DISCON�IECTED IF_NOT COMPLETED WITHIN 18 MONTHS __
FOR OFFICE USE ONLY
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Request Date: Rough-in Inspection Required? ❑.Yes . No Inspection Other Than Rough-In: ❑ Reatly Now ❑ Will Call
�� ,� You must call the inspector when readyl Date Ready: � �
I certty that I am the IICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address (Street, Box, or Route No.) City Zip Code
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EB-00001A-13 � 7/1/2000 BOMD OF ELECTRICITY COPY INSTAUCTIONS ON BACK OF YELLOW COPY