P - 81815REGlUEST FOR ELECTRICAL WSPECTION
1 `� - Minnesota Board of Electricity -
• 1. � 10 3�� O� �`` 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55704
� -
- ��°���e (651) 642-0800 TTY/MRS t-800-627-3529
www.electricity.state.mn.us �!,/��
Identity the wo covered by this request:
❑ NEW REMODEL ADDITION p REPAIR
G ERAL FEES
SE ES / POWER SUPPLIES
to 400 Am re � $25
401 to S00 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am re �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Apparatus �$.50
Unit � $25
OTHER ADDITIONAL FEES
Vehide Park SRes �
iding Inspection � $t
�ction � $30 oer Hou
Ouldoor Li htin Standard � $1
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li hti �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, All
Circuits and Two Inspecdon Trips Each Dwellin Unft �$8(
Additional Inspecfion Trips � $20
Investiaative Fee
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I herebvi certiN tliat I insoected the
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT I
FOR OFRCE U8E ONLY
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total fee is
installatlon described herein on the dates sta�
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o�re
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ETED WITHIN 18 MONTHS
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Request Date: Rough-in Inspection Required? Yes ❑ No Inspecdon ONrer Than Rough-In: ❑ Ready Now Will Call
.(i�/ You must call the inspector n reatlyl Date Ready:
I certi(y that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work ah
Job Address (Street, x,.pr Route No.) .„ City , i Zp Code
Number
� Mailing Address (CoMractor, Company or
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