P - 820011-108-400 �
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ldentity the work covered by this request:
❑ NEW ❑ REMODEL ❑ADDITION REPAIR
GENERAL FEE
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Amcere � $75
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity —
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us " '
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Outdoor Li htin Standard � $1
Traffic Si nal Standard � $5
� Sua�{ementa{ Fee � $20
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A ratus �$.50
ADDITIONS TO THE GENERAL FEES
OTHER ADDITIONAL FEES
RecreaHonal Vehicie
Gi
Transformers over 10 KVA � $20
Transtormer ! Power Suppfy for Signs / Outline lagMing �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppfy up to 500 Amperes, All
Circuits and Two Inspectio� Trips Eech Dwelii Unit �$8C
Additional Insoection Trios � $20
Fee �
total fee is
inslallation descritred herein on the daOes
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FOR OFFICE USE 01�Y
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Request Date: � Rough-in InspecGon Requiredl ❑ Yes No Inspection Other Than Rough-In: Ready Now ❑�II Call
You must call the inspector when readyl Date Ready:
I certify that I am the�l.ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecGon of ihe electricat work at
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