P - 81789REQUEST FOR ELECTRICAL INSPECTION
1� V`-F V- 3 0 6� 8121��n�'�ver � Aven�ue Sutte'S 28, Saint Paul, Minnesota 55104
(651) 642-0800 TiY/MRS 1-800-627-3529
, ' wwrv.electricity.state.mn.us " '
Identify the work covered by this request: rb SC
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❑NEW REMODEL ❑ADDITION AIR `�LS�- �
GENERAL FEES ' Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES TraHic Si nal Standard (� $5
d to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am re �$50 Transtormers u to 10 KVA �$10
Above 800 Amoere �$75 Transformers over 10 KVA 8$20
Above 200
RM, COMMUNICATION, REMOTE CONTROL, SIG
:UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL
Manufactured Home Park Lots
Recreational Vehicle Park Sites
Transfortner I Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each DweNing Unit (� $8(
Additional Inspection Trips � $20
lnvestigative Fee
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I hereM certifv Nat I
total tee is
desGibed herein on the
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FOR OFFICE UsE ONLY
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I certi(y that I am the ,�LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection oi the electrical work ar
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EB-00001 A-13
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OF ELEC7AICRY�COPY
INSTpUC�WN8 ON BACK OF YELLOW COPY