P - 80036. REQUEST FOR ELECTRICAL INSPECTION
....
Minnesota Board of Electricity
1-393-796 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 :– ��
� (651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us ' �
Identiiy the work covered by this request:
❑�IEW ❑ REMODEL ❑ ADDITION ❑ REPAIR XCEL ENEROY SAVER'S SVIfiTCH
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am ere �$50 Transfortners u to 10 KVA �$10
Above 800 Am re �$75 Transfortners over 10 KVA �$20
CIRCUITS / FEEDERS Transformers / Power Su I for Si ns / Outline Li htin �$5
0 to 200 Am ere �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$10 Includes the Service and/or Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelling Unit �$80
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS Additional �nspection Trips �$20
Each S stem Device or A aratus �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reins ection Fee �$20
MULTIFAMILY DWELLINGS PER UNI TOTAL FEE
3 to 12 Units �$50 Per Unit (minimum total fee is $20
Fach Additinnal Ilnit @ �95 wnmsvecTOeuseon�r
LighUng Retrofit � $25 per Fxtuo
Center Pivot Irrigation Boom � $4
Manufactured Home Park Lots �
Recreational Vehicle Park Sites �
Separate Bonding Inspection � $;
Soecial Insoection � $30 oer Hou
t hereby certity that I
ROUGHI�
FINAL INSPECTION
the electrical instellation described herein on the dates
DAT
'�'7 . �
DATE
I I opeum u ispecuvn rr Y u i pei rvme • �' � �
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NO CT OMPLETED WITHIN 18 MONTHS
(`��--�–,.�»—,, —y_�—���f��—�„�„
FOR OFFICE USE ONLY
( IIIIII (II� �III (IIII �I�� (I�II IIIII � �� I�I ���
* 1 3937966* ��.50
Reque�� Rough-in Inspection Required? ❑Yes C�iNO Inspection Other Than Rough-in: �Ready Now ❑wll Call
You must call the inspector when ready! Date Ready:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address (St� aoX o,��TM�A N� � ari �'� ZP ��
VE
Section Township Range Fire No. County �a
Occupant Phone
C3RACE LUTHERAN CHUR�CFI
Power Supplier r� �
�L ENER�3Y �
Electrical Contrador / Company Name Contractor License Number Master License Number
HUNT EIEGTRIC CQRPOtiATIOM CA 00863
Mailing Address (Contractor, Company or Owner Performing Installation)
2300 TE�iITORIAL ttf}AO , SAINT PAI�., MN 55114
Authorized Si�(�ractor,�ompany.or Owner Performing Insfallation) Phone
asi a�a^�ii
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY