P - 82477REQUEST FOR ELECTRICAL INSPECTION
,1 0 2 7 9 31 � � Minnesota Board of Electriciry
� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� wmAe;�,� (651) 642-0800 TTY/MRS 1-800-627-3529 �
;......� '
www electricity state mn.us
[ity the wark covered by this requesT. V�� '��p`� �� �� ��,��
EW ❑REMODEL ❑ADDITION ❑REPAIR
GENERAL FEES Outdoor Li htin Standard �$1
VICES I POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am ere �$25 `° ,� Su lemental Fee �$20
401 to 800 Am ere �$50 Transformers u to 10 KVA �$10
Above 800 Am ere �$75 Transformers over 10 KVA �$20
�UITS / FEEDERS Transiormer / Power Su I(or Si ns / Outline Li htin �$5
0 to 200 Am ere �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$10 Includes the Service andlor Power Suppty up to 500 Amperes, All
RM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwellin Unit �$80
�UITS, CIRCUITS OF LESS THAN 50 VOLTS 1 Add'Rional Ins eclion Tri s�$20
Each S stem Device or aratus �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reinspection Fee �$20 _
Lighting Retrofit � $25 per Fixture
Center Pivot Irrigation Boom � $4C
Manufactured Home Park Lots � $
Recreational Vehicle Park Sites � '
FOR OFFlCE USE ONLY
I ���i�� ���l� ����� ����� �I�I� I�I����i� �II� �I�)
3� 1 O 2 7 9 3 I 3 3E
(�,.(�(�,�• tsV IVIAI
(minimum total fee is
that I insoected the electricel
�
6fZ3�
� .Sa
Than Rough-In: ❑ Ready Now �
s�ated:
��V �
� �(� — �"'� —� � You must call the inspector when readyl � Date Ready: �
—��
i certify that I am the �PICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the etectrical work at: