P - 80456e REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity �
1-381-440 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 _
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity.state.mn. us '
Identify the work covered by this request:
L.FItlEW ❑ REMODEL U ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Amoere � �50
0 to 200 Am ere �$5
Above 200 Am ere � $10
A�ARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or A�oaratus � 5.50
�
FEES
�fit � $25 per Fixture
Irrigation Boom � $4(
I Home Park Lots � $
Vehicle Park Sites �
iding Inspection � $2i
;ction � $30 per Hour
ii�l I�ii IIIII 11111 I�II II�I II�1 Il�i �� 1�1
* 1 3 8 1 4 4 0 5*
XGEL Eh1ERGY �AVER'� �WITGH
Su lemenial Fee � $20
Transformere u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformers / Power Su I for Si ns / OuBine Li htin �$!
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspectlon T�ps Each Dwelling Unft �$80
TOTAL FEE
total fee is $20)
FOF INSPECTOR USE IXJLY
I hereby certify that I inspected Me alectrical installetbn descnbetl herein on �he dates t
ROUGHIN DATE
FINAL INSPECTION � /�—�— � w� Q07E
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JNECTED IF AOT COMPLETED WITHI,�1 18 MONTH
FOR OFFlCE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough-in: Q Ready Now ❑ Will Call
�$��� You must call the inspector when ready! Date Ready:
I certify that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: