P - 80022� REQUEST FOR ELECTRICAL INSPECTION
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Minnesota Board of Electricity
1-396-130 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity.state.mn. us
Identify the work covered by this request:
LYREW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere Q$10
ALARM, COMMUNICATION, REMOTE CONTROL, SIG
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A Qaratus �$.50
ADDITIONS TO THE GENERAL FEE;
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Li htin Retrofit �$.25 er Fxture
Center Pivot Irri ation 800m �$40
Manufactured Home Park Lots � $25
Recreatlonal Vehicle Park Sites � $5 �
Se rate Bondin Ins ectio� �$20
S cial Ins 'on �$30 er Hour
Special Inspection � $.31 per Mile
XCEL EhIEROY SAVER'S SWITCH
i ransrormers over iu Kvn �e �u
Transformers / Power Supply for Signs / Outline Lighting �
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to SOJ Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$E
Additional Inspection Triqs � $20
C
TOTAL FEE
total fee is $20)
ihat I inspected Me elec[ncal instelletbn described herein on the detes stated:
DATE
� 6 �3 a3
FOR OFFICE USE ONLY
1 I II II{ IHN IIIiI HIII IIIII illll IINf � h� Inl
* 1 3 9 6 1 3 0 5'' �� °�=S`�
Reque�l ��2 Rough-in Inspection Required? ❑ Yes [�rNa Inspection Other Than Rough-in: I�Ready Now ❑ WII Call
You must call the inspector when ready! Date Ready:
I certi(y that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELIOW COPY