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P - 795181-223-337 a �w � Identity the work covered by this request: ❑ NEW ❑ REMODEL ❑ ADDITION �REPAIR GENERAL FEES 0 to 400 Am re �$' 401 to 800 Am re � Above 800 Am ere � CIRCUITS / FEEDERS Above 200 Am ere � $10 ALARM, COMMUNICATION, REMOTE CONTROL, CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Each S stem Device or A aratus �$.50 ADDIT{ONS TO THE GENERAL F MULTIFAMILY DWELLINGS PER UNI 3 to 12 Units �$50 Per Unit ReVofit � S25 oer Fixture Park Sites � Mile REQUEST FOR ELECTRICAL INSPECTION Minnesota Board of Electriciry �° 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us '� ' �el.f�i�'t GQoo 0 Outdoor Liahtino Standard � $1 Supplememai Fee � $20 Transformers up to 10 KVA � Transfortners over 10 KVA � � Transformer / Power Supply for Signs / Outline Lighting �$5 ONE 8 TWO FAMILY DWELLINGS, EACH UNIT Includes the Service and/or Power Supply up to 500 Amperes, All Circuits and Two Inspection Trips Each Dwellin Unit �$8C Additional Inspection Trips � $20 Investiaative Fee J FOR OFFICE USE ONLY i ������ ����t �f�« �i��� i�f�� i���� ���« E���� �R�i �«� �4 1 Z 2 3 3 3 7 5�t total fee is y-zy-�3 � �� �,� ��,� You must call the inspector when ready! Date Ready: �� D� I cert that am the �, LiCENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: