P - 79907' � REQUEST FOR ELECTRiCAL INSPECTION
Q Minnesota Board of Electricity
1� 19 7� V�� ,��`n 182� Universiry Avenue Suite S-128, Saint Paul, Minnesota 55104
� , (651) 642-0800 TTY/MRS 1-800-627-3529
www. electriciry.state, mn. us
Identify the work �overed by this request:
❑ NEW ❑ REMODEL ❑ ADDITION
GENERAL F
0 to 400 Am re �$
401 to 800 Am ere �
Above S00 Am re �
CIRCUITS / FEEDERS
Above 200 Ampere � $10
RM, COMMUNICATION, REMOTE CQNTROL, SIGI
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
.TIFAMILY DWELLINGS (PER UNI�
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
Lighting Retrofit � $25 per Fixture
Cemer Pivot irrigation Boom � $4t
Manufactured Home Park Lots � S
Recreatlonal Vehicle Park Sites �
5eaarate Bondina Insoection � $2i
I
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Outdoor Lighting Standard � $t
Traific Signal Standard � $5
Supplemental Fee � $20
Transformers up to 10 KVA �$10
Transformers over 10 KVA � $20
Ir�cludes the Service and/or Power Supply up to 500 Amperes, All
Gircufts and Two Inscection Trios Each Dwellina Unft �$6(
Fee �
(minimum total fee is
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I inspected the electrical inshallation desaibad herei� on
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FOR OFFlCE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yas �No fnspeclion Otlier Than Rough-In: ❑ Ready Now [] Will Call
�'[ / � � Z You must call the inspector when ready! Date Ready:
i certify that 1 am the .�LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electricai work at: