P - 79335❑ REQUEST FOR ELECTRICAL 1NSPECTION
�����- 6 0 3 � 6121 UnrversBy A en�ueESu te S- 28, SaiM Paul, Minnesota 55104
� (651) 642-0800 TTY/MRS 1-800$27-3529 www.electricery.siate.mn.us
NEW ❑ REMODEL ❑ ADDI710N O REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
XCEL ENERGY SAVER'S SWiTCH
GENERAL FEES Outdoor Lighting Standard @$1
Above 8
;UITS 1 F
0 to 200
AfARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOITS
Each Svstem Device or Anoaratus a(� 5.50
Transformers u to 10 KVA $10
Transformers over 10 KVA _$ 20
Transformer / Power Supply for Sipns / Outline Liqhting @$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes ihe Service andlor Power Supply up to 500 Amperes, Ali
Circuits and Two Inspection Trips Each D�xelling Unit @$80
3 to 12 Units @$50 Per Unit (minimum total fee is $20) � $20.50
Each Additional Unit @$25 THis uepn Foa iru�crat usE anr
1 hereby Certiry tl�at I inspeCted the ekctrical installa6on described herein on the dales st�ed:
OTHER ADDITlONAL FEES ��G �,_ G I&��
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Request Dete: Rough-in Inspection Required? Q Yes Inspedan Other Than Rough-In: ��eady Now O Will Call
��20�,Q You must call the inspector when ready! Date Ready:
I certify tt�at { am tt�e C�.ICENSED CONTRACTOR � COMPANY ❑ OWNER and hereby request inspection of the electrical work at::
INS7RUCTIONS ON BAGK OF YELLO'W COPY BOARD Oi ELECTRICIN COPV EB�W W tA-11 tl.�. [wt