P - 79727REQUEST FOR ELECTRICAL INSPECTION
1�2 2 4 8,,,, 6 Minnesota Board of Electricity —
E'r � ��; 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
?° �e (651) 642-0800 TTY/MFiS 1-800-627-3529
� www.electriciry.stare.mn. us
Identity the work covered by this request:
❑NEW ❑REMODEL ❑ADDITION REPAIR ���U� an � Z�I�
GENERAL FEE
0 to 400 Am re (� $
401 to 800 Am ere �
Above 800 Am ere �
CIRCUITS i FEEDERS
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A ratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units ��.50 Per Unit
Lighting Retrofit � $25 per Fixture
Center Pivot Irriaation Boom � S4C
ing Inspection � $20
ion � $30 per Hour
ion � $.31 per Mile
'ALLATION MAY
Outdoor Li htin Standard � $1
Traffic Si nal Standard (� $5
Su lemental Fee � $20
Transiormers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortner / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$S(
Additional Ins ection Tri s�$20
Investi ative Fee
Reinscection Fee � $20
Nl�f— S''!i_�s.
total fee is
on the
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THS
FOR OFFlCE USE ONLY
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Requist Da�e' O� Rough-in Inspection Required? ❑ Yes No Inspection Other Than Rough-In: Ready Now � Wifl Call
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( You rtwst call ttre inspec[or wfien readyl Date Ready:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electr�al work at: