P - 79166' REQUEST FOR ELECTRICAL INSPECTION
1 ,� '7 � � � � � � � Minnesota Board of Electricity -
+ 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651)642-�800 TTYIMRS 1-800-627-3529 www.electriciry.state.mn.us
NEW Q REMODEL ❑ ADDITtON ❑ REPAIR Describe -using the back of the whife copy if necessary - ihe work eovered by this request:
XCEL ENERGY S�VER'S SWITCH
I POWER SUPPLIES
)MMUNICATION, REMOTE CONTROL, SIGNALIN�
CIRCUITS OF LESS THAN 50 VOLTS
3 to 12 Units @$50 Per Unit
Each Additional Unit Q $25
Fixture
INI II �I I{ I� ll III II I� � NI {I il{ 11 HI ��I I�
�A7579673 �
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Investi ative Fee
Reins tion Fee $20
TOTAL FEE
(minimum total fee is S2(I) 20.50
iH15 AREA FOR INSPECTOR USE ONY
I hereby cer6ry Nat I inspeGed the electrical instalt�on described herein on tlie d�s sfafed:
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C�i�337.�
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Request Date: Rough-in Inspaction Required? ❑ Yes L7 No Inspection Oth� Than Rough-In: C7Ready Now CJ Will Call
� ��'� ��� You must call the inspedcr when ready! Date Ready:
I certify that I am ttie �l LICENSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request mspection of tl�e electrical work aY.:
IN87RUCTONB ON BACK OF YELLOW COPY BOARD OF ELECTRICITV COPY EB-OOOOtA-14 8. t. 2002