P - 81861REQUEST FOR ELECTRICAL INSPECTION
'` Minnesota Board of Electricity
1-37�j-3Q$ � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 -
° (651) 642-0800 TTY/MRS 1-800-627-3529 -
www. electricity. s ta te. mn. us
Identiiy the work covered by this request:
CIMIEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
TIFAMILY
$25
�fit � $25 per Fixture
Irrigation Boom � $4(
f Home Park Lots � $
Vehicle Park Sites �
iding Inspec6on � $2�
�ction � $30 per Hour
XCEL EIVERGY �AVER'S BWITCH
Outdoor Lighting Standard � $1
-r Trattic Siqnal Standard � $5
Transfortners u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortners / Power Supply for Signs / Oudine Lighting �$;
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and(or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$SO
Additional Inspection Trips � $20
� nereby certiry mat �
ROUGHIN
TOTAL FEE
total fee is $20}
DATE
FOR OFFICE USE ONLY
� ����I ��� ��I�� IN� N��� ���� iN�l!!n �� ��l ��- �` �y !
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ Inspection Other Than Rough-in: eatly Now ❑ Will Call
You must cali the inspector when reedy! Date Ready:
I certiiy that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work ar