P - 78934REQUEST FOR ELECTRICAL INSPECTION
1� 6 0 2- 013 3� Minnesota Board of Electricity -
1821 Universi��0�e�+ue� �uite S-128, Saint Paul, Minnesota 55104
(651)642-08qOJfa�''�S 1-800-627-3529 www.electricity.state.mn.us
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❑ NEW ❑ REMODEL ❑ ADDITION R PAIR Desc '-usi� e back of the ite�pqy ifn�ary work covered by this request:
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GENERAL F S Outdoor Liahfinp Standard � E1
SERVICES / POWER SUPPLIES
CIRCUITS OF LESS THAN 50 VOLTS
to 72 Units �$50 Per Unit
Retrofit
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16020133
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� cerUry tliat I am the
ONE & TWO FAMILY DWELIINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
TOTALFEE
(minimum toha► fee is $20) O?0 � �
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I hereby ceAify tl�at I inspecEed tAe electrical inslalation described herein on Ihe da�es sf�ed:
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eo�rtn oF �cTwcm corv
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TED WITHI MON7HS
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reque.st inspeetion of tl�e ele�icxl work at:
EB-00001M74 &1.200Q