P - 79242' REQUEST FOR ELECTRICAL INSPECTION
"� ,�, "] i O ,� � � % ❑ Minnesota Board of Electricity
, �� r r � � 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104 -
(651)642-OSOOlTY/MRS 1-800-627-3529 www.electrJcity.state.mn.us
NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Describe -usi� the back of the white copy if necessary - the work covered by this request:
XCEL ENERGY SAVEI�'S SWITCH
GENERALFEES
AIARM, COMMUNICATION, REMOTE CONTROL; SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
E�h Svstem Device or Aooaratus �$.50
to 12 Units @$50 Per Unit
ach Additional Unit @ $25
Traffic
Fee @ $20
up to 10 KVA
over 10 KVA
ONE $ TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each D�eiling Unit @$80
Reins tion Fee $2(t
TOTAL FEE 2O.�JO
(minimum total fee is $20)
iHISAREA FOR INSPECIOR USE ON.Y
I hereby ceNry that 1 inspec0ed the electrical inst�lation described herein on the da[es stated:
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Request Date: I Rough-in Inspection Required? ❑ Yes ❑�PIo I Inspedion Other Than Rou9h-In: OF�eady Now O Will Call
�7��� You must call the inspector when ready! Date Ready: �
I certify that I am the 07dICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecction of the electrical work at:
INBTRUCTONB Oq BACK OF VELLOW COPY BOARD OF ELEC7RICITV COPY EB-00001M14 8.1. 2002