P - 80473. REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
. 1-381-453 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. sta te, mn. us
Identify the work covered by this request:
Q�VEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
to 800 Ampere �
AL4RM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNIT)
3 to 12 Units �$50 Per Unit
XCEL ENERGY �AVER'S SWITGH
Su lemental Fee � $20
Transfortners u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transfortners 1 Power Su for Si ns I Outline Li htin �$!
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, Atl
Circuits and Two Inspection Trips Each Dwelling Unft �$80
Additional Insoectlon Trios � $20
TOTAL FEE
totalfee is $20)
FOP INSPECTOP USE ONLY
DITIONAL FEES
=ixture
� $40
S��5 I hereby certify ihat I inspectetl Ne electncal installation tlescribed herein on tha detes slated:
eS �� � F� � ROUGH IN DATE
� �V
' HnIII FINAL INSPECTION i�j°� / DAiE
FOR OFFICE USE ONLY
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"1 381 4538'� ����
Request Date: Rough-in Inspection Required? ❑ Yes ❑ o Inspection Other Than Rough-in: Ready Now ❑ Will Call
Q$��� You must call the inspector when ready! Date Ready:
I certify that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecfion of the electrical work at: