P - 80468' REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-381-457 � 1821 University Avenue Suite S-128, Saint Paul, Min�esota 55104 '— �
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us ' �
Identity the work covered by this request:
L11�EW ❑ REMODEL O ADDITION ❑ REPAIR
�
0 to 200 Am ere �$5
Above 200 Ampere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Ap aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNIn
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
Recreational
l-1
Mile
}CCEL ENERGY �AVER'� �WITCH
Transfortners over 10 KVA (� $20
Transformers / Power Supply for Signs I Outline Lighting (� $!
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service arrd/or Power Supply up to 500 Amperes, Ail
Circuits and Two Inspection Trips Each Dwelling Unit �$80
Additional Insnection Trins � �20
FOR INSPECTOR USE ONLY
I hereby certify that I inspected the
ROUGH IN
FINAL INSPECTIpN
TOTAL FEE
total fee is �201
DAiE
f �� ^ C
FOR OFFICE USE ONLY
IlilliNl�l�lllllllllillll�li �� �s��� ►
"1 381 4579�` �'�2
Request Date: Rough-in Inspection Required? OYes ❑ o Inspection Other Than Rough-in: eady Now ❑wll Call
ag�� You must call the inspector when ready! oate Ready:
I certiiy that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the eleckical work at:
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