P - 79901REQUEST FOR ELECTRICAL INSPECTION
1� 2 6 4�� U� k� ��� Minnesota Board of Electricity "'`
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
��*�a (651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us � � �� " '
❑ NEW R
SERVICES / Pi
0 to 400 A
ao, ro eoo
Above B00
IRCUITS / FE
0 to 200 A
covered by this request:
MODEL ❑ADDITION ❑REPAIR
�
0
rJ l.il wI/'1.15v � 1 ��/( �� 6�' 1� U�
Outdoor Li htin Standard � $1
Traffic Si nal Standard � $5
Su lemental Fee (� $20
Transiormers u to 10 KVA �$10
Transfortners over 10 KVA C� $20
Transformer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
�GNALING Circuits and Two Ins ction Trips Each Dwelfin Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Insuection 7rios �$20
Each S stem Device a A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNiT1
Center Pivot
�
� $30 cer Hour
Reins ection Fee � $20
TOTAL fEE
(minimum total fee is $20)
FOH INSPECTOR USE ONLY
I he ' that I inspected the el�clrical instaflation described herein on ttie dates stated:
now� w wh
Fxu mse�cnan onh
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FOR OFFlCE USE ONLY
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Requ t Date: ' I Rough-in Inspecfion Required? ❑ Ves No Inspection Otlier Than Rough-In: ❑ Ready Now II Calf
�� v L�`� v You must call the inspectw when readyl � Oate Ready:
I certify that I am the LICENSED CONTRACTOR ❑ CdMPANY ❑ OWNER and hereby request inspection of ri�e electrical work at:
EB-0OOOtA-13 7/7/2000 � BOApD OF ELECTAICRY COPY INSTNlIC710NS ON BACK OF YELLOW COPY