P - 816881��48-446 �paL�;i
IdentiTy the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION
GENERAL F
SERVICES / POWER SUPPLIES
0 to 400 Amoere � $25
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Bcard of Electricity =
1821 Universiry Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us " '
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CIRCUITS I FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIG'
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or aratus �$.50
ADDITIONS TO THE GENERAL FEES
OTHER ADDITIOt
Retrofit � $25 oer Fixture
� �0 p0f HOUf
:7
Transfortners u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortner / Power Supply for Signs / Outline LighGng �$5
ONE & 1W0 FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Suppiy up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unft �$8C
Additional Inspection Trips � $20
7lnvestiaatNe Fee
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I herebv certifv that I inspected the
tota! fee is
tlre �es s�d:
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AONTHS
FOR OFFICE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yes No Inspection Other Than Rough-In: ❑ Ready Now ❑ Wfll Call
"��'� � You must call ttie inspector when ready! Date Ready: �
I cerMy that I am the�LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: