P - 78925REQUEST FOR ELECTRICAL INSPECTION
1� 6 5� 1- 0 8 9� Minnesota Board of ElecVicity -
1821 University Avenue Suite S-128 ' Paul, Minnesota 55104
'� (651) 642-0800 TTY/MRS 1-8 Zk�9 �ww.electricitystate.mn.us
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❑ NEW ❑ REMODEL DITION � REPAIR Describe -using the b�k of the ' essary - the work covered by this request:
0 to 400 N
401 to 800
ALARM, COMMUNICATION, REMOTE CONTROL
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svslem Device w Aouaratus �d 5.50
3 to 12 Units
Each Additio
S�;
On �
oer Fbur
IIII IIII�IIIII IIIII ��III IIIII IIIII I�III11� I�
16510893
! � -V
Transformers u to 10 KVA S10
Transfotmers over 10 KVA �$ 20
Transfortner / Power SuDDh �r Sgns / Outline LighUng � SS
ONE 8 TWO FAMILY DWEW NGS, EACH UNIT
Indudes the Service andlor Power Supply up to 500 Amp�es, All
Grcuits and Two Inspection Trips Each Dwelling Unil � Z80
( TOTAL FEE I �Oi'�, �
minimum tohal fee is $20 � C.,�
n�s u�n we �svECiae usE aav
� hErebY ceNry tliat I insped¢d tlie elxtical i�lafpn daaibed Iwein on tlie dales sfal�d:
i'�,R Or�Pt:� tS=�c �S�tLY
�39�
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Roughin InsPection Required7 Yes No �r�sPedion Other Th� RaugMn: y Now 0 WiM Cdl
You must call the inspector wh� r�dy� �� �r
NSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspeclion of ttie electrical worlc at:
IN87RUCl10NS ON
E&OODD7MN &1.Z002