P - 79777� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-396-550 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-OS00 TTY/MRS 1-800-627-3529
www.electricity.state.mn. us
Identity the work crovered by this request:
ONEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
0 to 400
�
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
XCEL ENERQY SAVER'S SWITCH
Su lemental Fee � $20
Transfortners u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transformers / Power Su d for Si ns / Outline Li hNn �$!
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
Additional Inspection Trips � $20
FOR INSPECfOR USE C{JLV
TOTAL FEE
d fee is $201
Manufactured Home Park Lots �$25 I �ereby certify �hat I inspected the eleCtrical installation dascribed herein on ihe dates sta[eA:
Recrea6onal Vehicle Park Sites �$5 RWGH IN DATE
Se arate Bondin Ins ection �$20
S ial Ins ection �$30 r Hour FINAL INSPEC710N DATE
S ecial Ins ection �$.31 er Mile ^ Z' 7^� 3
__ _,tu�e �NCrna � e=�nN MAY BE OR���iED DISCQNl��SIEQ �F OT�O PLM� E�TE�D'�ITHIN 18 MONITHS
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� FOR OFFICE USE ONLY
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Reque Rough-In Inspection Required? p Yes o Inspeciion Other Than Rough-in: Ready Now ❑ Will Call
You must call the inspector when ready� Date Ready�
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electricai work ar
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