P - 80085REQUEST FOR ELEC7RICAL INSPECTION
1 2 7 9 5 8 8 � Minnesota Board of Electriciry -
- o ' 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
• � � „� (651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us
Identify the work covered by this request:
❑ NEW � REMODEL ❑ ADDITfON ❑ REPAIA
GENERAL FEES
SERVICES ! POWER SUPPLIES
0 to 400 Amcere � $25
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 2� Am ere �$5
Above 200 Am ere � $10
AIARM, COMMUNICATION, REMOTE CONTROL, SIG�
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S tem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Un'�ts �$50 Per Unit
Each Additional Unit � $25
Manufactured Home Park Lots
Recreational Vehicle Park Sit�
�� J �SGr � �� ��'
Outdoor Li htin Standard � $1
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su for Si ns / Outline Li hti (� $5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two {r�spection Trips Each Dwellin Unit �$&
Additional Ins ion Tri � $20
Investi ative Fee
Reins ion Fee � $20
TOTAL FEE
(minimum total fee is $20'
FOF INSPECTOR USE ONLV ' �� A
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described herein on tice �tes state
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I I Special Inspection �$.31 per Mile I I �—� `� �'� 7 �i-
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFICE USE ONLY
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Request qat�: �� Rough-in Inspection Required? Yes ❑ No Inspection Other Than Rough-In: �❑ Ready Now iil Call
« � You must call the inspector when readyl Date Ready:
{ certiiy that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY �J OWNER and hereby request inspeclion of the elecUical work at
E&00001A-13 7/1/2000 BOARD OF ELECTfiICRY COPY INSTRUC710N3 ON BACK OF YELLOW COPY