P - 80109REQUEST FOR ELECTRICAL INSPECTION
��f� � � � � � Minnesota Board of Electricity -
�. � �� 1821 University Avenue SuRe S-128, Saint Paul, Minnesota 5510A
� �� °; (651) 642-0800 TfY/MRS 1-800-827-3529
www. electricity. state. mn. us
Identity the work covered by this request: � ��� ��
NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES Outdoor Li htin Standard �$1
S RVICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am re �$25 Su lemental Fee �$20
401 to 800 Am ere �$50 Transformers u to 10 KVA �$10
Above 800 Am ere �$75 Transfortners over 10 KVA �$20
CIRCUITS ! FEEDERS Transformer I Power Su I for Si ! Outline Li ti �$5
0 to 200 Am re (� $5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere t� $10 Includes the Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwellin Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ection Tri �$20
Each S tem Device or retus �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reins ion Fee �$20
MULTIFAMILY DWELLINGS PER UN TOTAL FEE -
3 to 12 Units �$50 Per Unit (minimum total fee is $20)
Retrofit � $25 oer Fixture
� � D@f HOUf
eleGrical installadon
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ETED WITHIN 18 MONTHS
FOR OFFICE U8E ONLY
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Reques ate: Rough-in Inspection Fequired? es ❑ No Inspection Other Than Rough-In: ❑ Ready Now ❑ WII Call
� ���� You must call the inspector when ready! Date Ready:
I cert' That I am the ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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Authorized ' actor, Company or Owner Pertortning Installatio�)
E A-13 BOARD OF ELECTRICITY COPY
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