P - 81849, REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
, 1-375-409 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 -
(651) 642•08�Q TTY(MRS 1-800-627-3529
www.electricity.state.mn.us '
Identi(y the work covered by this request:
OMIEW ❑ REMODEL ❑ ADDITION ❑ REPAIR iGCEL ENERGY SAYEFr� SWITCH
401 to B00 Am ere �$50 Transfortners u to 10 KVA �$10
Above 800 Am ere �$75 Transiormers over t� KVA �$20
CIRCUITS / FEEDERS Transformers / Power Su I for Si ns / OuUine Li htin �$5
0 to 200 Am ere C� $5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$t0 Includes the Service and/w Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelling Unit �$80
CIRCUITS. CIRCUITS OF LESS THAN 50 VO�TS Additional Inspection Trips �$20
Each S stem Device or A paratus �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reinspection Fee �$20
MULTIFAMILY DWELLINGS (PER UNIT TOTAL FEE
3 to 12 Units �$50 Per Unit (minimum total fee is $20
Each Additional Unit C� $25 Foa iNSPECTOR us=_ au�v
� $.31 per Mile
I hereby ceKdy ihai I inspectetl the eleqrical installafion describeO herein on ihe dates steted:
RWGH IN DATE
FINF� INSPECTION DATE
� � r� c�'�
______ � ______,__ _, � ___ _ __ _ ` _ iNECTED IF NOT COMPLETED WITHI 1� MONTHS `
FOR OFFlCE USE ONLY
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* 1 3754098* aD,,sO
Request Date: Rough-in I�spection Required? ❑ Yes ❑ Inspeetion Other Than Rough-in: eady Now ❑ Will Call
You must call the inspector when ready! Date Ready:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: