P - 79752� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-396-558 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.eleCtricity.state.mn.us ' � �
Identity the work covered by this request:
ONEW O REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
Each Additional Unit �
Park Lots � $25
Park Sites � $5
spection � $20
XCEL ENEROY SAVER'S SWtTCH
Outdooi Lighting Standard � $1
� Traffic Sic7nal Standard � $5
Transformers u to 10 KVA �$10
Transformers over 70 KVA � $20
Transformers / Power Supply for Signs / Outline Lighting �$;
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, Ali
Circuits and Two Inspection Trips Each Dwelling Unit �$80
Additional Insoection Trins � $20
f-0R INSPECTOfl USE ONLY
I hereby ceAity t�at I inspected the elecirical
ROUGH IN
FINAL INSPECTION , �
FOR OFFICE USE ONLY
FEE
DATE
DATE
S�- 2�— �"3
I II�II I�II II�I I��II IIIII �II�I II� IIIII ��I � �� � •� V
* 1 3 9 6 5 5 8 7*
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fieque Rough•in Inspecdon Required? ❑ Yes No Inspection Other Than Rough-in: Ready Now ❑�II Call
You must call the inspector when ready! Date Ready:
I certity that I am the �I LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY