P - 81883REQUEST FOR ELECTRICAL INSPECTION
1 � � � � � � � Minnesota Board of Electricity =��
� � � 1821 University Avenue Suite S-128, Saint Paui, Minnesota 55104
- �_� 'ra (651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.m . s
ntity the work covered by this request: � � G i n�, T�
NEW ❑ REMODEL pADDITION ❑ REPAIR � �� � � `�
GENERAL FEES Outdoor Li htin Standard �$1
RVICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am ere �$50 Transformers u to 10 KVA (� $10
Above 800 Amoere ��75 Trancfnrmarc nvar in �cvn �¢�n
0 to 200 Am ere �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unft
Each Additional Unit �$25 A r� �
ughting Retrofft � $25 per Fixture
CeNer Pivot Irrigation Boom � $4(
Manufactured Nome Park Lots � $
Recreational Vehide Park Sites �
Separate Bonding InspecUon � $2i
Special Inspection � $30 per Hour
Special Insoection � $.31 oer Mile
� Transformer / Power Supply for Signs I Outline Lighting �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Ins 'on Trips Each Dwellin Unit �$BC
Additional Inspection Trips � $20
InvesGaative Fee
total fee is $20) � �Li
that 1 insoected the electrical insfallation
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THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFICE USE ONLY
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Request Date: Rough-in Inspectlon Required7 ❑ Yes No Inspection Other Than Raigh-In: ❑ Ready Now � 1K�1 Cail
5 v"� { You must call the inspector when readyl Date Ready: �, a
I certi(y that I am the �( LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical wak at:
EB-00001A-13 7/7/2000 BOApD OF ELECTAICRY COPY INSTRUCTIONS ON BAq( OF YEILOW COPY