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Identity the work covered by this request:
❑ NEW REMODEL ADDITION ❑ REPAIR
G NERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere (� $5
Above 800 Am ere � $7
,CIRCUITS / FEEDERS _.
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Apparatus �$.50
ADDITIONS TO THE GENERAL f
MULTIFAMILY DWELLINGS lPER UNITI
OTHER ADDITIONAL FEES
� $25 oer Fi�Aure
I Home Park Lots �
Vehicle Park Sites �
idina Insoection � Sf
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTYlMRS 1-800-627-3529
www. electriciry. state. mn. us
-7?7-
Outdoor Lighting Standard � $1
Traffic Signal Standard � $5
Supplemental Fee � $20
Transformers up to 10 KVA �$10
Transformers over 10 KVA � �20
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and�or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelli Unit �$8�
Additional Inspection Trips � $20
Investiaative Fee
total fee is
2��3Ja
that I inspected the electrical installatlon described herein on the dates
��-� � �- � �
TH15 INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTt
FOR OFFICE USE ONIY
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Request qate: , Rough-in Inspection Requi�ed? ❑ Yes No Inspection Other Than Rough-In: ❑ Ready Now ill �
(J Yaf must call the inspedor when ready! Date Ready: �
1 cerliTy that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: