P - 79895REQUEST FOR ELECTRICAL INSPECTION
1 ��� � I � Minnesota Board of Electricity
� � � �� 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
`� �� (651) 642-0800 TTY/MRS -500-627-3529
- v �.
www.electricity.st� ��,r .�.i s �' �
Itlentity the wark covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
0 to 400 Ampere � $:
401 to 800 Ampere �
Above 800 Ampere �
�UITS I FEEDERS
0 to 200 Amcere � $
ALARM, COMMUNICATION, REMOTE G(
CIRCUITS, CIRCUITS OF LESS THAN Si
Each S stem Device or A aratus �
ADDITIONS TO THE GE
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Li htin Retro�t �$25 r fixture
Centei Pivot Irrigadon Boom � $4C
Manufactured Home Park Lots � $
Recreational Vehicle Park Sites �
Separate Bonding fnspection � $2I
Soecial Insoection � $30 cer Hour
SIGNALING
. / � � 4F �[,C��/
0 door Li htin Standard �$1
Traffic Si nal Standard � $5 __._____
S�plemental Fee � $20
Transformers u to 10 KVA (� $10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li htin �$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 5� Amperes, All
Gircuits and Two Inspection Trips Each DweIG UnR �$80
Additional Ins ection Tri s�$20
Investiaative Fee
I herebv cer6ify that I inspected the
_ _._ _ _ FOR OFFICi USE OfLLY
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total iee is
herein on the detes stated:
296��
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Now O Win Call
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� a ��� You must call the inspector when readyl Date Ready:
I certify that I am th�t1�ENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical wak at: