P - 79338REQUEST FOR ELECTRICAL INSPECTION
��` 1��- 6 0 6 0 Minnesota Board of Electricity -
1621 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� (651) 642-OB00 TTYlMRS 1-800-627-3529 www.electricity.state.mn.us
NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
XGEL ENERGY SAVER'S SWITCH
GENERAL FEES Outdoor Ligh6ng SiandaM @$1
0 to 200 Am re $5
Above 200 Am ere $10
AlARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or aratus $.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNIT
3 to 12 Units C� $50 Per Unit
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1 7 7 3 6 0 6 7
Transfortners u to 10 KVA $10
Transformers over 10 KVA $ 20
Transformer / Power SuDPIy for Signs I OuUine Lightina @$5
ONE 8� TWO FAMILY DWELLINGS, EACH UN1T
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspecilon Trips Each Dwelling Unit @$80
(minimum total fee is $20) � $20,5a
THIS NRFA FOR IIS CiOR USE OIlY
� hereby cerbry thffi I inspected Me electrical installa6on destri6ed hetCin an Ihe da�s stated:
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Request Date: Rough-in Inspeclion Required? ❑ Yes Inspection Other Than Rough-In: ady Now O Will Call
��('��f Q� You must call the inspector when readyl Date Ready.
I certiiy that I am the C�¢ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecction of the elecUical work at::
INSTRUCTONS ON BACK OF YELLOW COPY BOMD OF ELEC7RICIT' COPY . EB-00001M14 8.1. 2002