P - 80009• REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
, 1-396-118 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. el ectricity. state. mn. us
Identity the work covered by this request:
0"NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR xCEL ENERQY SAVER�S SWITCH
0 to 400 Am ere �$25 Su lemental Fee �$20
401 l0 800 Am ere �$50 Transformers u to 10 KVA �$10
Above 800 Am re �$75 Transtortners over 10 KVA �$20
CIRCUITS / FEEDERS Transtortners / Power Su I for Si ns / Outline Li htin �
0 to 200 Am ere �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$10 Includes the Service and/or Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelling Unit �$E
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS Additional Insoection Trips �$20
I MULTIFAMILY
OTHER
TO7AL FEE
total fee is $201
FOH INSPECTOR USE ONLY
�$25 I hereby certlty that I inspected the electrical installadon described herein on Nre Aates =
� '�F r► �' flWGH IN DATE
�0
DUi FINAL INSPECTION � ' DATE
���R r lL-5'—
FOR OFFICE USE ONLY
IIIHII{�II�IIIIIIIIIIIIII�IIIHII��I�II{�I ��s
�
* 1 3961 1 80* ��
Reque�� Rough-in inspectlon Required? ❑ Yes C�No Inspection Other Than Raugh-in: �Ready Now ❑ Will Call
You must call the inspector when ready! Date Ready:
I cert'rfy that I am the L3S LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY