P - 80455, REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
�-` 1-381-442 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-500-627-3529
www. ele ctrici ty, s ta te, mn. us
Identify the work covered by this request:
O�tlEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES I POWER SUPPLIES
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNtCATION, REMOTE CONTROL,
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus (� $.50
ADDITIONS TO THE GENERAL f
MULTIFAMILY DWELLINGS (PER UNI
3 to 12 Units @$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
li hiin Retrofit �$25 r Fixture
Center Pivot Irri ation Boom �$40
Manufactured Hane Park Lots � $25
Recreational Vehicle Park Sites � $5
Se rate Bondin In �$20 r�
S'al In ection �$30 r Fbur
e
Special InspecUon � $.31 oer Mile
}SGEL ENERGY SAVER'� SWITCH
Outdoor Lighting Standard C� $1
Traffic Sianal Standard � $5
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortners / Power Supply for Signs / Outline Lighting �$!
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 �$80
Additional Inspection Trips � $20
I hereby certiry that I
ROUGH IN
FINAL INSPECTION
Fee �
TOTAL FEE
total fee is $20)
DA7E
DATE
�4 _
FOR OFFlCE USE ONLY
I IIIIII IIIII IIIII IIIII III� �� �I �� I�I ���' /
"1 381 4421 '' �'��
Request Date: Rough-in Inspection Required? ❑ Yes ❑ Inspection Other Than Rough-in: eady Now ❑�II Call
�g%��i 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: