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P - 80495REQUEST FOR ELECTRICAL INSPECTION 1 1�6 4 O G� Minnesota Board of Electricity � � �' 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 �. .. (651) 642-OS00 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us ��� Identify the work cavered by this request: ❑NEW REMODEL ❑ADDITION ❑REPAIR GENERAL FEES SERVICES / POWER SUPPLIES 0 to 400 Am ere �$25 401 to 800 Am re �$50 Above 800 Amcere � $75 Above 200 Am ere � $10 ALARM, COMMUNICATION, REMOTE CONTROL, CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Each S tem Device or A aratus �$.50 ADDITIONS TO THE GENERAL F Lightlng Retrofit � $.25 per Fi�ure Center Pivot Irrigation Boom � $4C Manufactured Home Park Lots � $ Recreational Vehicle Park Sites � Separate Bonding Inspection � $21 Soecial insoection � S30 oer Hour � /�5l �?7� C��� Outdoor Li htin Standard (� $1 Traffic Si nal Standard � $5 Su lemental Fee � $20 Transformers u to 10 KVA �$10 Transformers over 10 KVA � $20 Transfortner / Power Su tor Si ns I Outline Li htin �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT Includes the Service andlor Power Supply up to 500 Amperes, All Circuits and Two Inspection Trips Each Dwelling Unit �$8( Addilional Inspection Trips (� $20 Investiaative Fee FOR OFFICE l�E ONLY III lil IIIII #�111 IIIII IIIII IIIII lIIN IIIII IIII 1111 * 1� s a o z 7�� total fee is installaGon described herein on � -i7 --e ���98 ���so Rough-I�: ❑ Ready � ( f' You must call the inspector when readyl Date Ready: I certiiy that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: