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Identity the work covered by this request: �
❑NEW ❑REMODEL ❑ADDITION ❑REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
Above 800 Ampere �
�UtTS I FEEDERS
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity �"�
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 `�/��
www. electrici ty. state. mn. us
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Outdoor Li htin Standard � $1
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transtortners u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transtormer I Power Su tor Si ns ! Out6ne Li Min �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, AII
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circufts and Two Inspection Trips Each Dweili Unit �$8(
CIRCU{TS, CIRCUITS OF LESS THAN 50 VOLTS Additional Inscection Trips �$20
Each S stem Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Unfts �$50 Per Unit
Retrofit � $25 cer Fixture
Inspection � $2(
� $30 oer Hour
(minimum total fee is $20) 5,
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I here6v certitv that 1 insoeeted the electrical instaNation desttibed herein an tlie dates siated:
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FOR OFFICE USE ONLY
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Reques/t Date: Rough-in Inspecfion Required4 ❑ Yes No Inspecdon Olher Than Rough-In: ❑ R�dy Now W�I CaU
�! � 3 O/ Yau must call the inspector when readyi Date Ready:
I cerMy that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical wo�C at: