P - 75669REQUEST FOR F�LECTRICAL INSPECTION -�` �
�_ 8� �� � Minnesota Bbard of Electricity
1821 University Avenue Suite 5-128, Saint Paul, Iylinnesota 55104
(651) 642-0800 T'fY/MRS 1-800-627-3529 www.elecfricity.state.mn.tu
Describe -using the back oF the white copy 'rf necessary - the work covered by this request:
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GENERALFEES
SERVICES / POWER SUPPLIES
0 to 400 Ampere (d� $25
401 to 8l}0 Am re $50
Above 800 Am re $75
CIRCUITS / FEEDERS ��
0 to 20D Am re $5
Above 2(10 Am re @$10
ALARM, COMMUNICATION, REMOTE CANTROL
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each m Devi� or paratus @$.50
ADDRIONS TO THE GENERAL f
MULTIFAMILY DWEWNGS ER UN
3 to 12 Units @$50 Per Unit
Each Addfional Unit @ $25
oni�noomow� �es
LigMing Retrofit @ $.25 per Fudure
CeMer Pivot Irtivatlon Boom C� $40
Fee
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over
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Taro Insp�tion Trips Each Dwalling Unit @$BO
Additional Ins 'on Tri $ZO .
Invesd ative F�
Reins 'on Fe.e $20
TOTAL FEE
(minimum total fee is $20) i �
THISARFAFOR PL4ECfIMII.ff OMY
I hereby certlfy that I 6upeded tl�e ete�ical inatellaUon desa�ed herein on the dates sta6
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�THIS INSTALLATION MAY BE ORDERED DISC _ IF NOT COMPLETED WITHIN 12 MONTHS
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g nsp�U eq pectlon Other Than Rough-In: ❑ Ready Now ❑ WWilll Ca0
��//f'J / You must cell the inspector when readyi Date Ready:
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I certify that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY IId�OWNER and hereby request ins�cGon of the electrical wo�C at
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ELECTRICAL INSPECTIONS PERnnir No.
CORRECTION ORDER �nTE
Installer of Wiring
OwnedOccupant Job -
Property Address " ° Zip
The followtng items'are�"eviations from the accepted standards of construction at the above described
premises. Numbers after each ftem are applicable NaUonal Electrlcal Code Sectlons:
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�Iy;J NotlTy inspector for reinspectlon before covering wiring.
C;7 Re-Inspectlon will be made at Ume of next Inspection.
� Sign and return thls form to Inapector when corrections have been made but no later
than (Date:)
Signature of Instatler `
Robert Clauson
1586 E. Sextant Ave. Date of Compliance ��—�
Maplewood, MN 55109
Call 651-777-7885 for Reinspectfon - 7:00 - 8:30 a.m.
Monday - Friday except holidays.
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