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�' �' GENERAL I
;ES / POWER SUPPLIES
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCURS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Apparatus Q$.50
ADDRIONS TO THE GENERAL F
MULTIFAMILY DWELLINGS (PER UNITI
Park Lots
REQUEST FOR ELECTRICAL INSPECTION t
Minnesota Board of Electricity
1821 University Avenue Suite 5-128, Saint Paul, Minnesota 551U4
(651)642-0800TTY/MRS 1-800-627-3529 www.electricity.state.mn.us
�- the work covered by this requ�st:
:�0�. - 1F- C id•9st (� £ S ir� �� Z�f✓ s
Outdoor Liahtina Standard (�D $1
�ALLATION MAY BE ORDERED
�
N�I ��I Il�i lllll IIl� �III dl� Q� �� I�
19875608
Transfortners u to 10 KVA $90
Transformers over 10 KVA @$ 20
Transformer / Power Supply for Signs / Outline Lighting @$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 5�0 Amperag, AII
Circuits and Two Insp�tion Trips Each Dwelfmg Unit @$80
i
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TOTALFEE
total fee is $201
I inspaded the etedrical msfeVatlon desrn'hed hereln on tlre dates smted:
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You must call the insp�tor when readyl Date Ready.
I certify thati am the�ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER arM hereby �equest inspection of the electrical work at
Job Site Street Addr�s City
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