P - 80073REQUEST FOR ELECTRICAL INSPECTION
1� 318 � 1� J �� $121 Urover ity A en�ue Su terlS 28, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. e lectricity. state. mn. us
IdentiTy the work covered by this request:
❑ NEW ❑ REMODEL ❑ADDITION ❑ REPAIR I � �
GENERAL FEES Outd Li hting Standard �$1
0 to 400 Ampere � $25
401 to S00 Ampere � $50
Above 800 Ampere � $75
�UITS / FEEDERS
0 to 200 Ampere � $5
Above 200 Ampere � $10
RM, COMMUNICATION, REMOTE CONTROL, SIGI
CUITS, CiRCUfTS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
.TIFAMILY DWELLINGS (PER UNI�
3 to 12 Units (� $50 Per Unft
Each Additional Unft � $25
OTHER ADDITIONAL FEES
Liuhtina Retrofd � $25 ner Fixture
e Park Sites
Ins 'on f�
� $30 oer F
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transiormers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for S� ns / Outline Li hhfi �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Indudes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Ins ion Tri s Each Dwelling Unit �$8(
Additional Insoection Trios � $20
Fee �
total fee is
an ttre daeas �ated:
i� �
FOR OFFICE USE ONLY
y t�i��� ����i E���i i���� ii��t �i�if ii��� ir�t� �ii� �f�� Q��
�4 1 3 1 8 7 i 9 Q�E IC3"" �` .$Q
Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough Now ❑ Will Call
��/� O� You must call the inspector when ready! Date Ready:
I certliy that I am the �rC�ENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electricai work at: