P - 79847� T ` REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
� i 2� 3� O 6 5 � n 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
' (651) 642-OS00 TTY/MRS 1-800-6273529
www.electricity.state.mn.us '� '
IdentiTy the work cavered by this request:
❑ NEW REMODEL ❑ADDITION ❑ REPAIR T"1 �11✓' `''�" ��� ' `v"'� �
GENERAL FEES Outdoor Liahtina Standard (� $1
401 to 800 Am ere (� $50
Above 800 Am ere � $75
�UITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere (� $10
RM, COMMUNICATION, REMOTE CONTROL, SIGNALING
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
.TIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25 '
OTHER ADDITIONAL FEES
Li htin Retrofit �$25 r Fixture
Cemer Pivot Irri ation Boom �$40
Manufactured Home Park Lots �$25 I
Recrea6onal Vehicle Park 5ites � $5 `
S arate Bondin Ins �on � $20
Soeciat Insoection � $30 uer Hour _ , ♦ '
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su for Si ns / Outline Li htin �$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circui4s and Two Ins ection Trips Each Dwellin Unit �$8C
Additional Ins ection Tri s�$20
Investi ative Fee
Reinsoection Fee � 820
IF �
total fee is
c,
��LY-�`f I
3 MONTHS
FOR OFFICE USE ONLY
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Request ate: Rough-in Inspection Fiequired? ❑ Yes ❑ No Inspection Other Than Rough-tn: ❑ Ready Now � WA1 Cell
?j Z, You must call the inspector when readyl Date Ready:
I certify that I am the ❑ LICENSED CANTAACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the efectrical wak at