P - 76001REQUEST FOR ELECTRICAL INSPECTION
1� 7 8 7� O 7 4 � Minnesota Board of Electricity _' ;
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� (651) 642-0800 TTY/MRS 1-800-627-3529 www.edecfrzcity.state.mn.us
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___ GENERAL FEES Outdoor Lightinp Standard na. $1
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CIRCUITS OF LESS THAN 50 VOLTS
>ystem Device or Apparatus @ $.50
ADDITIONS TO THE GENERAL FEES
$50 Per Unft
Unit @ $25
OTHER AD
Traffic
Transformers u to 10 KVA $10
Transformers over 10 KVA @$ 20
Transformer I Power Supply for Signs / Outline Lightlng @$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unft @$80
Additional Insoecbon Trios (�a $20
TOTALFEE
total fee is $201
I inspected the elecMcal installa6on d�crib�l hereln an
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Se iate Bondi Ins , 'on $20 _ �'� �
S cial Ins 'on �$30 r Hour °��0'^��"m oA�
' I ecction $.31 per Mile
i___ flllST/aLLATION MAY BE ORDERED DISCONNECTED_IF NOT COMPLETED WITHIN 12 MONTHS
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u����r�� Rough-inlnspectionRequired? ❑Ye� �]No InspectionOtherThanRough-In: [�ReadyNowOWillCall
You must call the inspector when ready! Date Ready:
I cerMy fhat I am the C� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at
Job Si� Street Address CftYF � .._��
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(ConVactor or Owner Performing In
Utility Address
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Please Provide Two (2) Phone Numbers Inciuding
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ise Number Mester Electrician or Power Lim
i f3(1l�R.'1 License Number
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Please Provide Two (2) Phone Numbers Including
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