P - 81981.
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
` 1-377-489 � 1821 Universily Avenue Suite S-i28, Saint Paul, Minnesota 55104 �
(651) 642-�800 TTY(MRS 1-800-627-3529
www. e%ctricity. s ta te. mn. us
Identiiy the work covered by this request:
OMIEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CANTROL, SIGNALI(VG
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Apparatus �$.50
TIFAMILY DWELLINGS (PER
3 to 12 Units �$50 Per Unit
FEES
XGEL EIVERGY SAVER'S SWITGH
Outdoor Lighting Standard � $1
—� Traffic Sipnal Standard � $5
Transformers u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transforme�s / Power Supply for Signs ! Outline Lighting �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$86
Additional Inspection Trips � $20
Investi ative Fee
Reinspection Fee � $20
TOTAL FEE
(minimum total fee is $20)
ROUGH IN
FlN4L INSPECTION
on
DATE
DATE
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' FOR OFFICE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ Inspection Other Than Rough-in: eady Now ❑ Will Call
You must call the inspector whe� ready! Date Ready: I
I certity that I am the L� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: