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P - 80188, REQUEST FOR ELECTRICAL INSPECTlON �, �' Minnesota Board of Electricity �-396-� 47 � t82f University Avenue Suite S-128, Saint Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us ' � ldentity the work crovered by this request: 0 NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR to CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS Each S stem Device or aratus �$.50 ADDITIONS TO THE GENERAL MULTIFAMILY DWELLINGS PER UNI� 3 to 12 Units ��50 Per Unit Home Park Lots � $ ehicle Park Sites � ; ling Inspection � $21 tion � $30 per Hour XCEL ENEROY SAVER'S SWITC�i Transtormers u to 10 KVA �$10 Transformers over 10 KVA � $20 Transformers I Power Supply for Signs / Outline Lighting � ONE & TWO FAMILY DWELLINGS, EACH UNIT Includes the Service and/or Power Supply up to 500 Amperes, All CircuRs and Two Inspection Trips Each Dwelling Unit �$F Addftional Inspection Trips � $20 FOF INSPECTOR USE ONLY I hereby certify that I inspectetl the electncal installation ROUGH IN FINAL INSPECTION . TOTAL FEE d fee is $201 onre �=1� FOR OFFlCE USE ONLY ( IIIIII II II + III � (�III IIIII ��III IIII� (� � � * 1 3961 479'` ��� . .s-� 0`�0 Reque Rough-in InspecNOn Required? ❑ Yes o Inspection Other Than Rough-in: Ready Now � WIII Call You must call the inspector when ready! Date Ready: I certiiy that I am the L� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY