P - 81959REQUEST FOR ELECTRICAL INSPECTION
�1 Minnesota Board of Electricity
1�� a: i- 3 5 0 r ep 1g21 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us �, LZ� '' '
Identify the work covered by this request: �
❑ NEW ❑ REMODEL ❑ ADDITION ❑ R PAIR � � � � G�.�'d�d
GENERAI FEES Ouldoor Li htin Standard �$1
SERVICES ( POWER SUPPLIES TraNic Si nal Standard �$5
0 to 400 Am ere �$25 Sup lemental Fee �$20
401 to B00 Am ere �$50 Transfortners u to 1� KVA �$10
Above 800 Am re �$75 Transformers over 10 KVA �$20
CIRCUITS ! FEEDERS Transformer I Power Su 1 for Si ns / Outline Li htin �$5
0 to 200 Am ere �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$10 Includes the Service and/or Power Suppty up to 5W Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspectfon Trips Each Dwelli Unit �
CIFCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ection Tri s�$20
Each S stem Device or ratus �$.50 investi ative Fee �
ADDITIONS TO THE GENER,4L FEES Reins ecfion Fee �$20
MULTIFAMILY DWELLINGS PER UNI TOTAL
3 to 12 Units �$50 Per Unit (minimum total fee is $20)
Each Additional Unit � $25 � ��� �E �Y
Manufactured Home Park Lots � 9
Recreational Vehicle Park Sites �
Separate Bonding I�pection � $2
Special Inspection � $30 per Hour
Soeciai Insnection � $.31 cer Mile
installation described here� at the
FOR OFFICE USE ONLY
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Request Date: RougMin Inspection Required? Yes ❑ No InspeCtlon Other Than Rough-In: eady Novr 0 WN{ Call
�' �f � Q/ You must call the inspector when readyl Date Ready:
I ceAify that I am the �iCENSED CONTRAC�QF� �]�OMQANY ❑ OWNER and hereby request inspectio� of the electrical work at:
Township
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Range
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License
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Compam+ or Owne orming Installation)
BOARD OF ELECTHICRY COPY
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