P - 81890�-040-379 '� �
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Identify the work covered by this request:
�NEW ❑ REMODEL ❑ ADDITION O REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re C� $25
401 to S00 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
to 200 a e � $5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or A�aratus �$.50
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Liahtina Retroffi � $25 oer Fixture
Inspection � $21
(� $30 cer Hour
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity _
1821 University Avenue Suite S-728, Saint Paui, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity.state. mn. us
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Outdoor Li9htin9 Standard � $t
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for S' ns / Outline ' Min �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Ins ection Trips Each Dwellin Unit �$SO
Additional Ins eclion Tri s�$20
Investi ative Fee
Reinsoection Fee � $20
V'�
total fee is
I insoec[ed the elec:trical inshdllabon des�x�bed
FOR OFFICE USE ONLY
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R�est Qa� : D� Rough-in Inspection Required? �Yes ❑ No Inspecdon Other Than Rough-In: ❑ Ready Now Will Cal�
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� You must cafl the inspector when readyl Date Ready:
I certify that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspeciion of the elechical work aC
EB•00001A-13 7/1/' �N BOARD OF ELECTRICRY COPY INSTqUCT10N3 ON BACK OF YELLOW COPY