P - 81974.
r REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-377-477 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTYlMRS 1-800-627-3529
www. electricity. sta te. mn. us
Identity the work covered by this request:
OMIEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
Above 200 Am ere � $1�
ALARM, COMMUNICATIQN, REMOTE CONTROL, SIGNALING
CIRCUITS. CIFiCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus �$.50
3 to 12 Units �$50 Per Unit
1 BOORI � $4
Park Lots �
Park Sites �
>pection � $:
xCEL EhIERGY �AVER'S SWITGH
Outdoor Li htin Standard � $1
TraHic Si nal Standard � $5
Su lemental Fee � $20
Trensformers u to 10 KVA �$10
Transtormers over 10 KVA � $20
Transformers / Power Su I for Si ns / Outline Li htin �$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Irxludes the Service andlor Power Supply up to 500 Amperes, Ail
Circuits and Two Inspection Tnps Each Dwelling Unit �$80
Additional Inspection Trips � $ZO
Investi ative Fee
Reins tion Fee � $20
TOTAL FEE
(minimum total fee is $20 '
FOF INSPECTOq US' ONLY
I hereCy certify that 1 insPec�ed the electrical Installatbn described nmein on the detes e
ROUGHIN OATE
FINqL INSPELRION - � UA1E
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Request Date: Rough-in Inspection Required? ❑Yes ❑ Inspection Other Than Rough-in: eady Now ❑wU Call
(y$%��� You must call the inspector when ready! Date Ready:
I certity that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at