P - 81864REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
j-37rj-Q.Q3 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electriciry.state.mn.us ' �
Identity the work covered by this request:
070EW ❑ REMODEL ❑ ADDITION ❑ REPAIR
0 to 400 Am ere �$25
401 to 600 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or A paratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNIT)
3 to 12 Units C�1 $50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Lighting Retrofit � $25 per Fixture
Lots
iiWf
Transfortners u to 10 KVA � g10
Transfortners over 10 KVA � $20
Transformers / Power Supply for Signs / Outline Lighting �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes ihe Service a�dlor Power Supply up to 500 Amperes, All
Circuits and Two inspection Trips Each Dwelling UnR �$80
Additional Inspection Trips � $20
Investi ative Fee
Reinspection Fee � �20
TOTAL FEE
(minimum total fee is $20)
RWGH IN
FIW1L INSPECTION
herein an ihe datea slated:
DATE
DATE
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FOR OFFICE USE ONLY
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Fiequest 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 certi(y that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: