P - 79719REQUEST FOR ELECTRICAL INSPECTION
1�^��-� 4� � m Minnesota Board of Electricity
� _� 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� 9 (651) 642-0800 TTY/MRS 1-800-627-3528
www. electriciry.state. mn. us
Identify the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION
GENERAL FEES
0 to 400 Ampere �
401 to 800 Ampere
Above 800 Ampere
�UITS I FEEDERS
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Li htin Retrofit �$.25 r Fixture
Center Pivot Irri ation Boom �$40
Manufactured Home Park Lots � $25
Recreadonal Vehicle Park Sites � $5
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Outdoor Llghting Standard � $1
Traffic Signal Standard � $5
Supplemental Fee � $2�
Transformers up to 10 KVA (� $10
Transformers over 10 KVA � $20
� Transformer / Power Supply for Signs / Outline Lighting �$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$S(
Additional Inspection Trips C� $20
Investiaative Fee
total fee is
1 ir�soec[ed the electrical inslallatian desaibed herein on
FOR OFFlCE USE ONLY
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Request D� _�� Rough-in Inspection Required? ❑ Yes No Inspe
You mus[ call the inspector when readyl Date
I certi(y that I am the � LICENSED COMRACTOR ❑ COMPANY ❑ OWNER
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Than Rough-In: Ready Now � Will Ca11
and hereby request inspection of ihe electricai work at