P - 80457t
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Eleciricity �'` �
`' 1-381-444 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TfY/MRS 1-800-627-3529
www. eleCtricity, sta te. mn, us
Identity the work covered by this request:
�f roEW ❑ REMODEL ❑ ADDITION O REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS I FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOITS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Ligh6nq Retrofit � $25 per Fixture
XCEL ENERGY SAVER'� �WITGH
Transfortners u to 10 KVA �1 $10
Transfortners over 10 KVA � $20
Transfortners ! Power Supply for Signs / Outline Lighling �$',
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 Untt �$80
Addifional Insoection Trios � $20
Fee
TOTAL FEE
total fee is $201
pnanutacturea rrome Nark Lots �$z5 1 hereby certify that I inspecled Ne electrical installation tlescribed herein on the tletea stateA:
Recreational Vehicle Park Sites �$5 �`' .J ROUGH W DATE
Separate Bondin Ins 'on � $20
S eCial Ins 'on �$30 er Hour FINAL INSPECTION on�
S ecial Ins ection �$.31 r MUe ��� 2—
_ THIS INSTALLATION MAY BE ORDERED DISCONNECTED fF COMPLETED WITHIN 18 MONTHS
— _ — _,_.�� —
FOR OFFICE USE ONLY
I IIIII) i�ll tll�l II�II II� ������I �%,/C� �f') •
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* 1 381 4447* v"
Request Date: Rough-in Inspedion Required? ❑ Yes ❑ No Inspection Other Than Rough-in: Ready Now ❑ Will Call
���� You must call the inspector when ready! Date Ready:
I certi(y that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: