P - 78968c REQUEST FOR ELECTRICAL INSPECTION
1� V�6 6- 2 9 5 � Minnesota Board of ElecVicity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 �
� (651) 642-08Q0 TTY/MRS 1-800-627-3529 www.electriciry.state.mn.us
❑ NEW ❑ REMODEL ❑ ADDI7 N❑ REPAIR Descri -using the k of the ite copy if necessary - the work covered by this request:
GEN L FEES Out or Li htin Standard $1
SERVICES / POWER SUPPLIES Traffic Siqnal Standard (�a $5
0 to 400 Ar
401 to 800
1MMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS OF LESS THAN 50 VOLTS
iystem Device or Apparatus @ $.50
ADDITIONS TO THE �ENERAL FEES
to 12 Units �$50 Per Unit
Center Pivot Irtigation Boom �
Manufactured Hane Park Lots i
Recreational Vehicle Park Sites
. _
Transformers u to 10 KVA $10
Transformers over 10 KVA @$ 20
Transformer I Power Supply for Signs I Outline Lighfing @$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspec6on Trips Each Dwelling Unit �$80
Additional Inspection Trips p $20
Investigative Fee
Reinscec6on Fee C1a $20
(minimum total fee is $20) � (� o
THIS �REA FqY INSPECTOR USE ONLV
�reby certify that I inspected the electrical inst�lation described lierein on tAe dates st�e0:
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Rough-in Inspection Required Y 0 No Inspeqion p�her 7F�n Rough-In: ❑Ready Npw V1NII Call
You must call the inspector when ready! Date Read :
Y
NSED CONTRACTOR ❑COMPANY ❑ OWNER and hereby request inspection of tl�e elechical work at;
etf-u0007M14 8.1.2002