P - 79920REQUEST FOR ELECTRICAL INSPECTION E..
,. ` Minnesota Board of Electricity
1-396-140 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-500-627-3529
www. electricity. s ta te. mn. us
Identify the wark covered by this request:
VREW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
REMOTE CONTROL, SIGNALING
CIRCUITS
FEES
MULTIFAMILY DWELLINGS (PER UNIT
3 to 12 Units �$50 Per Unit
Each Addtional Unit � $25
OTHER ADDITIO
Li hUn Retrofit �$25 r Fi�Rure
Center Pivot Irri tion Boom �$4(
Manufactured Home Park Lots � $
Recrea6onal Vehicle Park Sites �
XCEL ENERQY SAVER'S SWITGH
Transformers over 10 KVA � $20
Transformers / Power Supply for Signs / OuHine Lighting �$5
ONE 8 TWO FAMILY OWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$80
Additional Inspection Trips � $20
Investi ative Fee
Reinspection Fee � $20
TOTAL FEE
(minimum total fee is $20)
wA iNSaECTOn use ornr
1 hereby certdy that I
RWGH IN
FlNAI INSPEC�ION
the electncal instellation deacribed herein on the ds�9s s181ed:
11FlE
S ecial Ins ection �$.31 r Mile - " �—� ' �v�J
THI$ IN�TALI oT��1N MAY BE ORD�RE DIS�9__ _
I' `FOR OFFICE USE ONLY ' `
I I�II� IIIII II�II ����I IIIII III�t �
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* 1 3 9 6 1 4 0 4* L��� o�� �
Reque�Gafa,.�,,,. Rough-in InspecUon R uired? �
Of IDltJL eQ ❑Yes �IJo Inspection Other Than Rough-in: G�Ready Now ❑�II Call
You must caN the inspector when ready! Date Ready:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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