P - 80185REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-396-151 1 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. s ta te. mn. us
Identity the work covered by this request:
�EW ❑ REMODEL ❑ ADDITION ❑ REPAIR XCEL ENEROY SAVER�S SWITCH
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
iIFAMILY DWELLINGS (PER UNII�
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL
Recreational
Transfortners u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transfortners / Power Supply for Signs / Outline Lighting �$!
ONE 8 TWO FAMILY DWELLINGS, EACH UNfT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two tnspection Trips Each Dwelling Unit �$80
Addilional Insoection Trios � $20
FOR INSPECTOR U6E IXJLY
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FlNM1L INSPECTION
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TOTAL FEE
herein on the dates steted:
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FOR OFFICE USE ONLY
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Reque�t8��2 Fough-in Inspection Required? ❑ Yes L�'No Inspection Other Than Rough-in: l�Reatly Now ❑ WIII Call
You must call the inspector when ready! Date Ready:
I certify that I am the L� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the elecVical work at:
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Authorized ' nature (C�ractor, ompany or Owner Perfortning Installation) Phone
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E&00001A-13 7/1/2000 BOARD OF ELECTRICITi COPY INSTRUCTIONS ON BACK OF YELLOW COPY