P - 79624REQUEST FOR ELECTRICAL INSPECTION
� s=� Minnesota Board of Electricity
1� 2 2 4 r J� 1 °�� 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
q 0 (651) 642-0800 TTY/MflS 1-800-627-3529
www. electricity. state. mn. us
Identify the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION REPAIR
GENERAL FE
0 to 400 Ampere � $
401 to 800 Am ere �
Above 800 Am ere �
CtRCUITS ! FEEDERS
CIRCUITS OF LESS THAN 50 VOLTS
vstem Device or Aooaratus � $.50
.TIFAMILY DWELLINGS (PER
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER AD[
Liahtina Retrofit � $25 oer F
Recreational Vehicle Park Sites �
Seoarate Bondina Insoection � $:
c
Outdoor Lighting Standard � I
Traffic Signal Standard � $5
Supplemental Fee � $20
Transformers up to 10 KVA �
Transformers over 10 KVA �
� Transformer / Power Supply for Signs / Outline Lighting �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$8(
Addifional Ins ection Tri s�$20
Investi ative Fee
Reinsoection Fee � $20
FOR OFFICE US� ONLY
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total fee is
linsoected the electricalinstallalion described herein anthe
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I certity that I am th�.�LICENSED COIVTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecfion of the electrical work at:
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