P - 78327_ _ _- -
RE(�UEST FOR ELECTRICAL INSPECTION -
�- 3 4 7- 413 � a2� Un� e ty A enue S tte,S 28, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us
Identify the work covered by this request:�� s ���t/� L�� � �� �GS- �i S,
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❑NEW REMODEL ❑ADDITION ❑REPAIR
GENERAL FEES � Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5 �
0 to 400 Am re �$25 Su lemeMal Fee �$20
401 to 800 Am ere �$50 ' Transformers u to 10 KVA �$10
Above 800 Ampere �$75 Transformers over 10 KVA �$20 .
CIRCUITS / FEEDERS Transformer I Power Su for Si ns / Outline Li hti �$5
0 to 200 Am re �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$10 Includes the Service andlor Power Supply up to 5� Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Tri s Each Dwellin Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS AddRional Ins 'on Tri s(� $20
Each S stem Device or A araius �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reins tion Fee �$20
MULTIFAMILY DWELLINGS PER UNI TOTAL FEE �
3 to �2 Unfts �$5o Per Unit (minimum total fee is $20) ��'"
Each Additional Unit � $25 `°"'"s��°" �E °"`v
OTHER ADDITIONAL FEES
li hG RetrofR (� $.25 per Fixture
Center Pivot Irri ation Boom �$40
Manufactured Home Park Lots �$2 I hereby certify that I inspected the e�eclrical installadon described herein on the dates stated:
Recreational Vehicle Park Sftes � P01GH "' o��
Se rate Bondin Ins ion �$20
S ecial I�s ection (� $30 er Hour �'"""�cT'°" opT�
S ial In ion �$.31 r Mile ��d��
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT PLETED WITFiIN 18 MONTHS
FOR OFFICE USE ONLY ����
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Request Date: Rough-in Inspection Required? ❑ Yes o Inspection Other Than Rough-In: ❑ Ready Now Will Call
— 2—� You must call the inspector when readyl Date Ready:
I certify that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: