P - 80479t
� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity ' •,
�� 1-381-448 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 '� ?
� (651) 642-0800 TTY/MRS 1-800-627-3529 �
www. electricity. state. mn. us
IIdentity the work covered by this request:
O"IOEW ❑ REMODEL O ADDITION ❑ REPAIR xCEL ENERGY SAVER�� .�'lWITCH
0 to 400 Ampere � $:
401 to 800 Ampere �
Above 800 Amoere �
ALARM, GOMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNI'�
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
Transfortners over 10 KVA � $20
Transfortners / Powe� Supply for Signs / OuUine Ligh6ng �
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, AII
Circuits and Two Inspection Trips Each Dwelling Unit �$E
Additional Inspection Trips � $20
Investiaative Fee
FOIi INSPECTOF USE ONIY
TOTAL FEE
total fee is $20)
� $25 r Fixture
lation Boom � $40
ime Park Lots �$25 I hereby carlity that I inspectetl Me elechical installa0on described herein on tlie detes stete
iicle Park Sites �$5 ROUC.H IN DFTE
Ins @ee�ction � $20
�I) �.WU f HOUf FINAL INSPEGTION DATE
n� R s� �p. Mi�a g'Z 2-
FOR OFFICE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough•in: ❑ Ready Now ❑ wll Call
Q$���� You must call the inspector when ready! Date Ready:
I certi(y that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: