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IdentiTy the work covered by this request:
❑ NEW ❑ REMODEL pADDiTION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Amoere � $50
0 to 200 Ampere �
Above 200 Amoere
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. e lectricity. sta te. mn. us
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus (� $.50
ADDITIONS TO THE GENERAL FEES
.TIFAMILY DWELLINGS (PER UNI�
3 to 12 Units �$50 Per Unit
OTHER ADDITIONAL FEES
Li htin Retrom �$25 er Fixture
Center Pivot Irri ation Boom �$40
Manufacfured Home Park Lots �$25 i
Recreational Vehicle Park Sites � $5 `
rate Bondin Ins ection � $20
S ial Ins ection �$30 r Hour '
Soecial Insoection � $.31 oer Mile
Outdoor Liahtin4 Standard �
Transformers up to 10 KVA �$10
Transformers over 10 KVA � $20
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Includes the Service andlor Power Supply up to 500 Amperes, All
Circufts and Two Inspection Trips Each Dwelling Unit �$8(
Additional In ion Tri s�$20
Investi ative Fee
Reins ection Fee � $20
TOTAL FEE
(minimum total fee is $20
I inspected the electricel insialla6an descxibed herein on the date,s stated:
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
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Reque ate: � Rough-in Inspection Required? �,Yes ❑ No Inspeclion Other Than Rough-In: ady Now � Wil� Cafl
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You must call the inspeMOr when ready! Date Ready:
I certity that I am the �jCENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at;