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REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-OS00 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us
Identity the work covered by this request �
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❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SI
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
.TIFAMILY DWELLINGS (PER
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
FEES
FEES
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Traffic Signal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA (� $10
Transformers over 10 KVA (� $20
Transformer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Additional Ins ection Tri s�$20
Investi ative Fee
Reinsoection Fee � $20
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total fee is
Center Pivot Irti atlon Boom �$40
Manufac�ured Home Park Lots �$25 I hereby ' that I inspected the electrical installation descr�ed herein an the dates steted:
Recreational Vehicle Park Sites �$5 101°' �' �'�
Se rete Bor�di !rts ion � $20
S ecial Ins ection �$30 er Hour `'�'"LNSPC�"�' ��
S ial Ins ion (� $.31 r Mile °�� '�""�
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFICE USE ONLY
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Request te: Rough-in Inspection Required? ❑ Yes No Inspection Other Than Rough-In: Ready Now ❑ Will Call
V� You must call tlie inspecta when ready! Dete Ready:
I certify that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of tlie eiectrical work at: