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P - 786141,-305-947 Identify the work covered by this request: ❑ NEW ❑ REMODEL ❑ ADDITION 9.to 400 Ampere � $ 401 to 800 Ampere � Above 800 Amoere � � Above 200 Ampere f� $10 ALARM, COMMUNICATION, REMOTE � CIRCUITS, CIRCUITS OF LESS THAN Each System Device or Apparatus ADDITIONS TO THE G MULTIFAMILY DWELLINGS PER UNIT 3 to 12 UniGs �$50 Per Unit Each Additro�al Unit � $25 OTHER ADDITIOP Li htln Retrofk �$25 er Fucture Center Pbot Irri ation Boom �$4U Manufactured Home Park Lots � $ Recreational Vehicle Park Sites � : � A�ilile REQUEST FOR ELECTRICAL INSPECTION Minnesota Board of Electricity �. 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-800-627-3529 = www.electricity.state.mn.us SC �-V iC� C�-:�4�1 C'iG� Outdoor Li htin Standard � $1 Traific Si nal Standard � $5 Su lemental Fee � $20 Transtortners u to 10 KVA (� $10 Transformers over 10 KVA � $20 Trensformer / Power Su for Si ns / Outline ' htin �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT Includes the Service and/or Power Supply up to 500 Amperes, All GNALING CircuBs and Two Ins ection Trips Each Dwellin Unft �$80 Additional Ins ection Tri � $20 Investiaative Fee total fee is that I inspeded the electrical installation described herein on the detes stated: %�G.� FOR OFFICE USE ONLY I flllil IIIII IIIII fllli lllil IIIIIIIIII liil� lifl IIII �E 1 3 O 5� 4 7 Z' � �� �� �ate: Rough-in Inspectlon Required? ❑ Yes Inspection Other Than Rou h-In� ❑ Ready Now ill Call 3I o3 9 � You must call the inspector when ready! Date Ready: I certify that,l am the �CICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work ai: