P - 81744REQUEST FOR ELECTRICAL INSPECTION
���� � � � � � � Minnesota Board of Electricity
� ��= 1521 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� "� (651) 642-0800 TTY/MRS 1-800-627-3529
www. e lectri city. state. mn. us
Identity the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
1 0 to 400 Amoere �$25
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A ratus (� $.50
ADDITIONS TO THE GENERAL F
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Li htin Retrofit �$25 er Fixture
Center Pivot Irri ation Boom (� $40
Manufadured Home Park Lots � �25
Outdoor Li htin Standard � $1
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transiormer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unft �$8(
Additional inspection Trips � $20
Investiaative Fee
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total fee is $20) ISb .
described herein on the dates stated:
S 'al Ins ' � $30 er Hour "'"""""s"""°' �"� """ �
Special Inspection �$.31 per Mile ( r- � 2°-`�
THIS INSTALLATION MAY BE ORDERED �SCONNECTED IF NOT COMPLETE HIN 18 MONTHS
FOR OFflCE USE ONLY
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Request Date: Rough-in Inspectfon Required? ❑ Yes Inspectan OC�er Than Raigh-In: ❑ Ready Now ❑ Will Call
'- You must call the inspector �en ready! Date Ready:
I certi(y that I am the �NCENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work al: