P - 81845' � � REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
�� 1-375-406 � 1821 Universiry Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-OS00 TT`PVMRS 1-800-627-8529
www, e%ctricity.state.mn. us '
Identity the work covered by this request:
O�AEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERALFEES
SERVICES 7 POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 80� Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere C� $t0
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or A paratus �$.50
ADDITIONS TO THE GENERAL FEES
AAULTIFAMILY DWELLINGS (PER UNIT)
3 to 12 Units �$50 Per Unit
I Home Park lots �
Vehicle Park Sites �
� $.31 per Mile
ENERGY SAVER'S �WITCH
Transfortners over 10 KVA � $20
Transformers / Power Supply for Signs / Outline Lighting �$:
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$80
Additional Insoection Trios � $20
0
TOTAL FEE
total fee is $20)
1 hereby certily ihat I in5pecteE Me electncal installetion tlescribed herein on ihe dateS stet9d:
ROUGHIN OATE
�7 �-a� �
FOR OFFICE USE O.NLY
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Request Date: Rough-in Inspection Required? ❑ Yes L7 Inspection Other Than Rough-in: eady Now ❑ Will Call
You must call the inspector when ready! Date Ready:
I certity that I am the [� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: