P - 81905REQUEST FOR ELECTRICAL INSPECTION
1-10 3- 2 3 7 � Sf21 U over ity A en�ue Su ttelSt128, Saint Paul, Minnesota 55104
�651) 642-OS00 TiY/MRS 1-800-627-3529
www.electricity.state.mn.us 'l' �
Identity the work covered by this request:
❑NEW ❑REMODEL ❑ADDITION ❑REPAIR C �
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES ! POWER SUPPLIES 7raffic Si nai Standard (� $5
0 to 400 Am ere �$25 Sup lemental Fee �$2�
401 to 800 Am ere �$50 Transformers u to 10 KVA �$10
Above 800 Am ere �$75 Transformers over 10 KVA �$ZO
CIRCUITS / FEEDERS 7rar�sfamer I Power Su I ior S' ns I Ouiline Li htin �$5
0 to 200 Am ere �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re (� $10 Includes the Service andlor Power Suppy up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and 7wo Inspection Trips Each Dwellin Unit (� $80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional In ion Tri s�$20
Each S tem Device or A aratus �$.50 Investi tive Fee
ADDITIONS TO THE GENERAL FEES Reins ection Fee �$20
MULTIFAMILY DWELLINGS PER UNI TOTAL FEE
3 to 12 Units �$50 Pef Unit �R11(tIR1URl 1O131 f2@ IS $2O� Q�
Each Addftional Unit �$25 F0�'"�� "� a"�Y
OTHER ADDITIONAL FEES
Li hfin Retrofd �$25 r Fixture
CeMer Pivot Imaa6on Boom � S40
Se arate Bondin Ins ion �$20 FI v v v�
S ecial Ins ection �$30 r Hour '*OLR�f01 �^��
S ecial Ins ection �$.31 er Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTH$ ___
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Req est D e: Rough-in Inspection Required? ❑ Yes o Inspeclion Other Than Rough-In: eady Now [] �11 Call
61 �� You must call the i�spactw when readyf Date Ready:
f certiiy that f am the CENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
Job Address (�treet, Bp�, or Route No.) C'�(y ZP C�e
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