P - 79867REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electriciry �'"-`'°�
�!-'� 1`"��� r 7 O 9 '9 ,� 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
�A� � (651) 642-0800 TTY/MRS 1-800-627-3529
www. electriciry.state.mn. us
Identify the work covered by this request:
❑NEW ❑REMODEL ❑ADDITION �REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Amcere � $25
CIRCUITS / FEEDERS
0 to 200 Am re �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aaoaratus �$.50
OTHER ADDITIONAL FEES
� �I
� Hour
w c.iLO —�
i• Q
ting Standard � ;
Standard � $5
I Fee � $20
uo to 10 KVA �
� Transformer I Power Suppty tw Signs ( Outline Lighting �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes ihe Service andlor Power Suppty up to 500 Amperes, Ail
Circuits and Two Inspection Trips Each Dwelling Unit �$8(
Additional Ins ection Tri s�$20
Investi a6ve Fee
Reinsoection Fee � $20
1 herehv certitv that I insoected ihe
FOR OFFICE USE ONLY
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(minimum total fee is $20) �,�
Fi�'�i�� .
instaNatlon described herein on the dates smted:
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29648-'
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l�` f��V� I You must call the inspector when ready! ` I Date Re�:� 2��O � !
I certi(y that I am the � LICENSED CON'fRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the elecUical work at