P - 79293. REQUEST FOR ELECTRICAL INSPECTfON ` ��
� Min�esota Board of Electricity -
�����- 5 4 6 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 •: � �
(651) 642-0800 ITY/MRS 1-800-627-3529 www. electricity.state. mn. us
NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
XCEL Eh1ERGY SAVER'S SWIT�H
SERVICES / PC
0 to 400 Ar
4011a 800
0 to 200
)MMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS OF LESS THAN 50 VOLTS
raffic
Fee @ $20
uD to 10 KVA
overl0 KVA�
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the SeNice andlor Power Supply up l0 500 Amperes, All
CircuiGs and Two InspecGon Trips Each Dwelling Unit @$60
MULTIfAMILY DWELLINGS PER UNIT TOTAL FEE I
3 to 12 Units @$50 Per Unit (minimum tofal fee is $20) $20,50
E2Ch Addition2l Unit @$25 rws naen voa vuaECron use wr
I hereby certiry that I inspected tlie electrical inslallaUOn described herein on the dates staBad:
OTHER ADDITIONAL FEES
Li htin Rehofit $.25 r Fixture
CeMer Pivot Irti ation Boom $40 R0�"'" wTE
Manufactured Home Park Lots $25
Recreati0nal Vehicle Park Sites $5 � "�"""�C70N °�TE
Se arate Bondin Ins 6on $20 lo /2 ��
S iallns tion $30 erHour E'w"EO"�a°''°°"EO oarE
'allns tion $.31 Mile
THIS INSTALLATION MAY BE ORDERED DfSCONNECTED IF NOT COMP�ETED WITHIN 12 MONTH�
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Request Date: Roughin Inspection Required? ❑ Yes Li No InspeUion Other Than Rough-in: L]Ready Now L1 VIlII Cell
�gJ2(j1 � You must call the inspector when ready! Date Ready
I certify that I am the C�4ICENSED CONTRACTOR ❑COMPANY ❑ OWNER and he�eby req�st inspection of tlie ele�Uic�l work at:
INSTRUCTWiS ON BACK OF YELLOW COPY BOARD OF ELECTRICITY CAPY . EB-00001M74 8.1. 2002