P - 81860� REQUEST FOR ELECTRICAL INSPECTION
� Minnesota Board of Electricity
, �-$7�j-402 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651} 642-0800 TTY/MRS 1-800-627-3529
www.electricity. state.mn. us '
Identify the work covered by this request:
C]KIEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
401 to 800 Amoere �
� Above 200 Ampere �$10 �
ALARM, COMMUNlCATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A paratus �$.50
ADDITIONS TO THE GENERAL FEES
to 12 Units �
Mile
XCEL ENERGY �AVER'S SWITGH
over
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 �$SO
Additional Inspection Trips � $20
Investi ative Fee
Reinspection Fce � $20
TOTAL FEE
FOfl MSPECTOfl USE ONLY
1 hereby certily Mat I
flOUGH IN
FINAL INSPEC110N
the electricalinstelistion describetl herein on the detes :
DATE
DATE
7- 2"z
FOR OPFICE USE ONLY
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Request Date: Rough-in Inspection Required? ❑Yes ❑ Inspection Other Than Rough-in: eady Now ❑ Will Call
You must call the inspector when ready! Date Ready:
I certify that I am the � LICENSED CONTRACTOR 0 COMPANY ❑ OWNER and hereby request inspection of the electrical work at: