P - 79320REQUEST FOR ELECTRICAL WSPECTION
��` 7 7 3- 5 8 5 3� Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTYlMRS 1-800-627-3529 www.electricity.stqte.mn.us
P� NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
XCEL EhlERGY SAVER'S SVVITC�
/ POWER SUPPLIES
CIRCUITS OF LESS THAN 50 VOLTS
3 to 12 UniGs @$50 Pe
Each Additional Unit @
I(�� il 111 II�N{ I( IN ll itl H�I ll �1 II �1 II �I I�II
17��Sa.�3
Transformers uD to 10
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
I�cludes the Service andlw Power Supply up to 500 Amperes, AII
Circuits and Two InspecGon Trips Each Dwelling Unit �$80
Reins tion Fee $20
TOTALFEE
{minimum total fee is $20) $20.60
rws �nEa F«a naaECra+use «ar
I hereby certiry that I inspecled the ek�c6ical installation described herein on the dates stated:
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Request Date: Rough-in Inspection Required? ❑ Yes O'No Inspection Other Than Rough-In: ORpady Now O Will Call
pg�pj[� You must call the inspector when ready! oace rteady:
I ceRi(y that 1 am tt�e [�¢ICENSED CONTRACTOR ❑COMPANY ❑ 01NNER and hereby request inspecGon of the electricai work at:
INS7RUCTONS ON BACK OF YELLOIN COPY BOARD OF ELECTRICITY COPV EB�00001M1I 9.7.'LOOz