P - 78311REGlUEST FOR ELECTRICAL INSPECTION
1 � 4 7 3 6 3 Minnasota Board of Electricity
� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 T'fY/MRS 1-800-627-3529 -
www. electricity. state. mn. us
IdeMify the wo�k covered by this request:
❑ NEW � REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re �$25
401 to 800 Am re �$50
Above 800 Am re � $75 .
CIRCUITS / FEEDERS
0 to 200 Am � �
Above 200 Am re � $10
ALARM, CAMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or ratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWEWNGS PER UNI
3 to 12 UniGs � S50 Per Unit
OTHER ADDI
Lightirg ReVOfit �d $25 per Fu
CerHer Pivot Irrigation Boom �
Manufactured Home Park Lots
Traffic Signal Sfandard � $5
Supplemental Fee � $20
Transformers up to 10 KVA �
Transformers over 10 KVA �
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
CircuiGs and Two Inspection Tri Each Dwellin Unit �$8(
Additional Inspection Trips � $20
Investiaative Fee
total fee is $20) �a
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I hereb cerlily that I in fhe elecVical installation described herein�on the Qat siaes �'
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S 'al I 'on � $.31 r Mile ( � '—
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 1B MONTHS
- - - ` - FOR OFFICE USE ONLY ��- _l / �
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Request Date: Rough-in Inspectlon Required? ❑ Yes ❑ No InspecKion Other Than Rough-In: ❑ Ready Now Q Will Call
��7 L You must call the inspector when ready! Date Ready:
I ceAify that I am the �$ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: