P - 81886REQUEST FOR ELECTRICAL INSPECTION
` � � � � � � � a m Minnesota Board of Electricity —
� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� �; (651) 642-0800 TTY/MRS 1-800-6�7�529 � � �
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www.electricity.state.mn (J
Identify the work covered by this request: � �`rL��
❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES oor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traftic Si nal Standard �$5
0 to 400 Am re �$25 Su lemental Fee �$20
401 to 800 Am ere �$50 Transformers u to t0 KVA �$10
Above 800 Am ere �$75 Transformers over 10 KVA �$20
CIRCUITS / FEEDERS Transfortner ! Power Su for Si �s ! Outline Li i �$5
0 to 200 Am re �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$10 Includes the Service and/or Power Supply up to 500 AmQeres, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelling Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ion Tri s�$20
Each S stem Device or A aratus �$.50 Investiaative Fee
ADDITIONS TO THE GENERAL f
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONA EES
' hfi Retrofit � $25 r Fixture
Center Pivot Irri aGon Boom �$40
Manufactured Home Park Lots � $25
S i21 Ins 'on �$30 r Hour '�1R15PECf0N /
Special Inspection �$ 31 per Mile �C
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPI
FOR OFFlCE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than R
� �`O/ You must call the inspector when ready! Date Ready:
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tOtal fee is
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MO THS
I cerhTy that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER hereby request inspection of the elechical work at
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License
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WSTFIUCTIONS ON BACK OF YELLOW COPY