P - 78508REQUEST FOR ELECTRICAL INSPECTION
1 � � � � � � � � �� � m Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
�. (651) 642-0800 TTY/MRS 1-800-627-3529 '
www.electricity.state.mn.us _ �
Identity the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION �AEPAIR /
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re �$25
401 to S00 Am re �$50
Above S00 Am re � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere (� $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
' CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each stem Device w ratus �$.50
ADDITIONS TO THE GENERAL FEES
Each Addidonal Unif � $25
OTHER ADDITIONAL FEE
Lighting Retroflt � $25 per Fixture
Center Pivot Irrigation Boom � $40
Manufactured Home Park Lots � $2F� „
Recreational Vehicle Park Sites � �, . �
Separate Bonding Inspection � $20
Special Inspection � $30 per Hour
Special Inspection � $.31 per Mile
THIS INSTALLATION MAY BE
Traffic Si nal Standard � $5
Su � lemental Fee � $20
Transformers u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transformer / Power Su for Si �/ Outline Li ti �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes ihe Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Ins ion Trips Each Dwelling Unit �$8C
Additional Inspection Trips � $20
Investiaabve Fee
ron
total fee is
that I insoected the elechical installation described herein on tl�e �t� st�d:
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WITHIN 18 MONTHS
FOR OFFlCE USE ONLY pf ��'//�
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Request Date: Rough-in Inspection Required? ❑ Yes lo Inspeclion Other Than Rough-In: (�Ready Now ❑ Wfll Call
'� � You must call the inspector when readyl Date Ready:
I cert'rfy that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work et