P - 80041REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity �''
.. 1-396-112 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electriciry. sta te. mn. us
Identity the work covered by this request:
❑"NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
to
� �0
� $.31
XCEL ENEROY SAVER'S SWITCH
Transformers u to 10 KVA �$10
7ransiortners over 10 KVA � $20
Transfortners / Power Supply for Signs / Outline Lighting �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and�or Power Supply up to 50� Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unft �$80
Additional Inspection Trips � $20
Investi ative Fee
Reinspection Fee (� $20
TOTAL FEE
(minimum total fee is $20)
FOH INSPELTOP USE ONLY
I herebvi cerHlv ihat 1
I FINAL INSPECTION
—' �
the aleGa ncal instelletion described nerein on me dates f
DATE
'-3o–dJ
FOR OFFlCE USE ONLY
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Reque���'2 Rough-in Inspection Required? ❑ Yes I�NO Inspection Other Than Rough-in: IRReady Now ❑ Wfll Call
You must call the inspector when ready! Date Ready:
I certify that I am the L� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address (St �Bt, Bo���,R'� NE C� FRIDL.EY Zip Code ���
l4�
Section Township n e Fire No. County A�p
�uFINKEL MAX EUf3ENE Pnooe
Power Supplier Address
xc� ��v
Electrical Contractor / Com ny Name Contractor License Number Master License Number
HUHtT ELEG�RIG CORPaRATIQN CA 00883
Mailing Address Contractor, Company or Owner Performin Installation)
2300 FtRiTORIAL ROAO , SAIM1C�PAU�, MM 55114
Authorized Si nature (C�ractor,�pa� r Owner Performing Installatlon) Phone
�51 64$-2D11
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY