P - 79298❑ REQUEST FOR ELECTRICAL INSPECTION
��( 1�- 5 5 3 1 Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
, (651) 642-0800 TTY/MRS 1-B00-627-3529 www. electnctty.state. mn. us
fl NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
;�{CEL �n1�RGY SAUER'S �V}l!T�#�
GENERAL FEES Qutdoor Li htin S:andard $1
SERVICES / POWER SUPPLIES Traffic Si nal Standard $5
O to 400 Am re $25 Su lemental Fee $20
401 to 800 Am�ere na S50 Transformers up to 10 KVA @$10 ____
ALARM, COMMUNIGATION, REMOTE CONTROL
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus @$.50
ADDITIONS TO THE GENERAL
MULTIFAMILY DWELLWGS PER UNIT
3 to 12 Units @$50 Per Unit
E�h Additional Unit @ S25
07HER ADDITIONAL FEE:
�ighting Retrofit @ $.25 per Fixture
Cenfer Pivot Imaation Boom la� $40
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
CircuiGs and Two Inspection Trips Each Dwelling Unit @$80
Additional Inspection Trips (a) $20
Investiaative Fee
(minimum total fee is 520) � �1o,5u
� iH15 A0.EA Fqi INSPECTqi l/5E IXJIY
I hereby cer6fy that I inspected the electrical installation descrihed herein on the dates sta�d:
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Raquest Qate: Rough-in Inspection Required? ❑ Yes ��ho Inspection Other Than Rough-In: ❑Rbady Now LJ NNII Call
�9 f'20t� You must call the inspectw when ready! Date Ready: -
I certify that I am the Cb�ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspec6on of ihe e.lectriql work at:
INSTRUCTONS ON BAq( OF YELLOW COPY BOARD OF ELECTRICT' COPY E&00007A-14 8.1. 2W2