P - 82024REG�UEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity —
1�� 1 1-13 5 � ` i821 University Avenue Suite S-128, Sain1 Paul, Minnesota 55104
�_°; (651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
IdentiTy the work covered by this request:
❑ NEW �REMODEL ❑ ADDITION ❑ REPAIR S �-°
GENERAL FEES
SERVICES I POWER SUPPLIES
0 to 400 Am re �$25
401 to 800 Am ere �$50
Above 800 Am re � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUfTS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus (� $.50
Jnits � $50 Per Unit
ditional Unit � $25
OTHER ADDITIONAL FEES
Retrofit � $25 per Fixture
'ivot Irtigation Boom � $40
lured Home Park Lots � $25
Mal Vehicle Park SRes � $5
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Treffic SiQnal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transformer / Power Su for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service arnilor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$8C
Rein ' Fee � $20
TOTAL FEE
(minimum total fee is $20) • �
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1 hereby certify thal I i tlie elecUical ir�lallatlon descn'Eed herein on tAe dates stated:
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FOR OFFlCE USE ONLY
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�(� J �� V � � You must call the inspector when readyl � Date Ready: �
i ceRi(y that I am the �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspectlon of the electrical work at