P - 80451, ' REQUEST FOR ELECTRICAL INSPECTION
. ....
- Minnesota Board of Electricity •.
' 1-381-445 � 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:
LfNEW ❑ REMODEL ❑ ADDITION O REPAIR
Above 800
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL I
MULTIFAMILY DWELLINGS (PER UNIT)
3 to 12 Units �$50 Per Unit
Each Additional UniT � $25
OTHER ADDITIONAL FEES
S �
� �
Hour
Mile
?CCEL ENERGY �AVER'S SWITGH
to
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling UnR �$!
Additional Inspection Trips � $20
FOR INSPECTOfI USE
ROUGH IN
FINAL INSI
ihat
TOTAL FEE
total fee is $20)
OATE
2 — /�' a
_� TNIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
� FOR OFFICE USE ONLY
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1 3 8 1 4 4 5 4 ��
Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough-in: Ready Now ❑ Will Call
�g�8ro� 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: