P - 77714REQUEST FOR ELECTRICAL INSP CTI N V
� � 8 � 9 � � � �, °���' Minnesota Board of Electricity p���,� �-.��
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 ���
S�.�Urrn L.�e �T�n 5��651)642-0800TTY/MRS1-800-627-3529www.electricity.state.mn.us
Describe -using the back of the white copy if necessary - the work covered by this request:
401 ta 800 Am ere $50
Above 800 Am ere a$75
CIRCUITS / FEEDERS
0 to 200 Am ere $5
Above 200 Am ere $10
ALARM, COMMUNICATION, REMOTE CANTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Ap aratus $.50
ADDITIONS TO THE GENERAL F
MULTIFAMILY DWELLINGS PER UNIT
3 to 12 Units @$50 Per Unit
Each Additional Unit (� $25
Manufactured Home Park Lots a$25
Recreational Vehicle Park Sites $5
Se arate Bondin Ins ection a$20
Special Inspection $30 r Hour
Special Ins 'on $.31 er Mile
THIS INSTALLATION MAY BE ORDERE[
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18591743
Outdoor Li htin Standard a$1
Traffic Si� nal Standard $5
Supplementai Fee a $20
Transformers u to 10 KVA $10
Transformers over 10 KVA $ 20
Transformer I Power Su I for Si ns I Outline L' htin $5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Additional Insoection Trios C� $20
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TOTALFEE
total fee is $201
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that I inspected the electrical installation described herein on Ne dates stated: �
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Rough-in Inspection Required? ❑ Yes �Na Inspec�on Other Than Rough-In: � Ready Now ❑ Will Call
�"���5 You must call the inspector when ready! Date Ready:
I certify that I am the 8'C�ENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at
Job Site Strcet Address C�
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EB-00007A-15