P - 819881�-1�7-564 ��_
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Identify the work covered by this�qu�et:
%
❑NEW REMODEL ❑ADDITION ❑REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re �$25
401 to 800 Am ere �$50
Above 800 Am re � $75
IRCUITS / FEEDERS
0 to 200 Amoere � $5 >
REQUEST FOR ELECTRICAL INSPECTION
Mirmesota Board of Efectricity °�
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
RM, GOMMUNICATION, REMOTE CONTROL, SIGNALING
;UlTS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS 70 THE GENERAL FEES
TIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
'��''! O 0�
Su lemental Fee � $20
Transformers up to 10 KVA (� $10
Transtormers over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li htin @$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andloe Power Suppfy up to 500 Amperes, All
Circuits and Two Ins ection Trips Each Dweilin Unit �$8(
Additional Ins ection Tri s�$20
Investi ative Fee
Reinscection Fee � $20
a,�v
totaf fee is
Center Pivot Irri ation Boom �$40
Manufactured HOme PaAc Lots �$25 I he ' that I inspected Me electrical inslella6on descrbed herein on the det� stated:
Recreatlonal Vehicle Park Si[� �$5 1D1°"'" °"'�
Se arate Bondin Ins ion �$20
S ial Ins 'on �$30 r Hour �'""'�"`C"01 °"'�
ial Ins ' �$.31 Mile 6'r.3 — 0�
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITFIIN 18 MONTHS
FOR OFFICE USE ONIY
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Request Date: Rough-in Inspeclion Required? ❑ Yes o Inspection O[her Than Rough-In: ❑ Ready Now ill Call �
� (�� (� —( �+ � You must call the inspector when reedyl � Date Ready: �
I certify that I am the [�ICENSED CONTRACTOR ❑ COMPANY ❑ OWNEfl and hereby request inspection of the electrical work at: