P - 78503_; REQUEST FOR ELECTRICAL INSPECTION
� 1 3 4 7 3 7 � ' Minnesota Board of Electricity
� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 =
www. electricity. state. mn. us
Identity the wark covered by this request:
❑NEW REMODEL ❑ADDITION ❑REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Am re�$25
401 ro 800 Am ere �$50
Above 800 Am re � $75
CIFiCUITS / FEEDERS
0 to 200 Am re �$5 (o
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or ratus �$.50
ADDITIONS TO THE GENERAL FEE
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unft
Each Addftional Unit � $25
Lighting Retrofit � $25 per Fixture
Center Pivot Irtigadon Boom � $4(
Manufactured Home Park Lots (� $
Recreatanal Vehicle Park Sites �
'� �(u"R.� ��"
Outdoor Li htin Standard f� $t
Tra�c Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
7ransformer / Power Su for Si ns / Outline Li hti �$5
30 ONE � TWO FAMILY DWELLINGS, EACH UNIT
Indudes the Service and/or Power Supply up to 500 Amperes, All
ING Circuits and Two Inspectbn Trips Each Dwelli Unit �$8(
Additional Insoedion Trios � $20
Reins ection Fee � $20
TOTAL FEE
(minimum total fee is $20) ��.5°
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I he cerdty that I inspec4ed tlie ebc9rical ir�stallaeon described herein on the �tes s�ted:
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S ial Ins ection �$30 r Hour "'� "�"01 � �a�T�.,r6
S ecial Ins ection �$.31 r Mile �r—.�^'`�
THIS INSTALLATION MAY BE ORDERED� ONNECTED I�C IYI�PLETED WITHIN 18 MONTHS
FOR OFFlCE USE ONIY � C
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Request Date: Rough-in Inspection Required? Yes ❑ No Inspectian Other Than Rough-In: ❑ Ready Now Will Call
� � Z F— � 1 You must call llie inspector when ready! Date Ready: ��
I certify that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY �'OWNER and hereby request inspection of ihe electrical work ah