P - 82479REQUEST FOR ELECTRICAL INSPECTION
� � _�� S121 Unover � A eoue S terlS 28, Saint Paul, Minnesota 55104
.1 `�027 935 �
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electrici ty. state. mn. us
Identify the work covered by this request: ��
EW ❑ REMODEL ❑ADDITION ❑ REPAIR
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5
j 0 to 400 Am ere �$25 p Su lemental Fee �$20
401 to 800 Am ere �$50 Transformers u to 10 KVA �$10
Above 800 Am re �$75 Transformers over 10 KVA �$20
CIRCUITS / FEEDERS Transfortner / Power Su I for S' ns / Outline Li hd �$5
0 to 200 Am ere �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re �$10 Includes the Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwellin Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Addi�onal Ins ection Tri s�$20
Each S stem Device or ratus �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reinsoection Fee �$20
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unft
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Liahtlna Retrofit � $25 oer Fixture
I herebvi certiTV that
Inspection � $21
� $30 oer Hour
FOR OFFICE USE ONIY
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total fee is $20) I 3 0'� �
described herein on
,ETED_ WITHIN_ 18_
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I certity that I am the�CENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the elecirical work at
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OF ELECTRICITY COPV IN57AUCTIONS ON BACK OF YELLOW COPY