P - 78404REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity �'�
�- 3 4 7���� � 1821 Universiry Avenue Suite S-128, Saint Paul, Minnesota 55104
, (651) 642-0800 TTY/MRS 1-800-627-3529
www.electriciry.stat8rrnn.us _
Itlentify the work covered by this
❑ NEW ❑ REMODEL �,A[
GEN
SERVICES / POWER SUPPLIE
C7
Above 800 Ampere
�UITS / FEEDERS
0 to 200 Amoere �
❑ REPAIR
Above 200 Ampere � $10
RM, COMMUNICATION, REMOTE CONTROL, SIGI
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
.TIFAMILY DWELLINGS (PER UNIT)
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Lighting Retrofit � $25 per FoRure
CeMer Pivot Irrigation Boom � $40
Manufadured Home Park Lots � $25 �
RecreaGonal Vehicle Park Sites � $5 �
Separate Bonding Inspection � $20
S ial Ins 'on �$30 r Hour
i,�v s�;: .� � ,
, Outdoor Li htin Standard � $t
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transfortners u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortner / Power Su for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelli Unit �$B(
Additional Ins ection Tri � $20
Investlaative Fee
total fee is
ictricat i�b d hereifi on
• �--• _ _, �
S ial Ins ec6on �$.31 r Mile `�, � G
_� THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MO HS
FOR OFFCE ONLY
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R�gue Date: Rough-in Inspectian Required? �es ❑ No Inspection Other Than Rough-In: ❑ Ready Now �CWill Call
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You must call the inspector whe� ready! Date Ready:
I certity that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY � OWNER and hereby request inspection of the electrical work at:
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