P - 81971� REQUEST FOR ELECTRICAL INSPECTION ,,
Minnesota Board of Electriciry
� 1-377-474 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 �
(651) 642-0800 7TY/MRS 1-800-627-3529
www. e%ctricity. sta te. mn. us
Identiiy the work covered by this request:
�NIEW O REMODEL ❑ ADDITION ❑ REPAIR
0 to 400 Ampere � $;
401 to 800 Ampere �
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or paratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNIT
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Liohtinq Retroiit f� $25 per Fixture t' r-, �, _
�
XCEL ENERGY SAVER'S SWITCH
to
ONE & TWO FAMILY DWELLINGS, EACH UNIT
InGudes the Service andlor Power Suppty up to 500 Amperes, AI1
CircuiGS and Two I�spection Trips Each Dwellir�g Unit �$86
Additional Inspection Trips � $20
Investi ative Fee
Reinspection Fee � 520
TOTAL FEE
(minimum total fee is $20)
WP INSGECTOFi USE QVLY
flOUGM IN
FINqL INSPECTION
herein on Me datea stated:
FOR OFFICE USE ONLY
i iii�i� i�i� a{ii iii� �iii� ii� � n� i� •
* 1 3774740* ��-3J`r� �%SZ5
Request Date: Rough-in Inspection Required? ❑ Yes O Inspection Other Than Fiough-in: eady Now ❑ Will Call
Q�g%Q� You must call the inspector when ready! Date Ready:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electncal work at: