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Ide�tify the work covered by this request:
❑ NEW ❑ REMODEL �ADDITION
GENERAL FI
SERVICES / POWER SUPPLIES
0 to 400 Am ere C� $25
401 to 800 Am�ere � $50
0 ro 200 Ampere �
Above 200 Amoere
:UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL F
TIFAMILY DWELLINGS (PER UNIT)
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
LigMing Retrofit � $25 per Fixture
Center Pivot Irrigation Boom � $40
Manufactured Home Park Lols � $25
Recreafional Vehicfe Pa�k Sftes � $5
arate Bondin Ins ection � $20
Special Inspection � $30 per Hour
Soecial Insoectbn � $.31 cer Mile
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity �
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-OS00 TTY/MRS 1-500-627-3529
www. electriciry. state. mn. us
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Outdoor Li htin Standard � $1
Traffic Si nal Standard � $5
Su emental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns I Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
GNALING Circuits and Two Inspection Trips Each Dwellin Unit �$80
Additional Ins ction Tri s�$20
Investi ative Fee
:S Reinsoection Fee � $20
total fee is
I hereby cerUN thflt I inspected the electrkal installa0on described herein on the dates slated:
NOT COMPL_ETED
FOR OFFlCE USE ONLY
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I certify that i am the �IICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: