P - 798461-��74-185 �a:e
Identiiy the work covered by this request:
❑ NEW ❑ REMODEL DITION ❑ REPAIR
GENERAL FEES
0 to 400 Ampere �
CIRCUITS / FEEDERS
0 to 200 Amoere �
IALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
TIFAMILY DWELLINGS (PER UNI�
3 to 12 UniGS �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
LigMing Retroffi � $25 per Fxture
Center Pivot Irrioadon Boom � $40
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�EQUF�T FC1R ELECTRICAL INSPECTION
Minnesota Board of Electricity °"'�
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-500-627-3529
www.electricity.state.mn.us
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Outdoor Li htin Standard � $1
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service ancllor Power Supply up to 500 Amperes, All
GNALING Circuits and Two Inspection Trips Each Dwellin Unit �$80
Additional I an Tri s�$20
Inves' tive Fee
:S Reinsoection Fee � $20 .
total fee is
I herebv cerMv Mat I insaected the electrical instaNaOOn described lrerein on the detes s�ted:
FOR OFFICE USE ONLY
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IRequest Date: I Rough-in Inspectian Required4 �ee ❑ No I Inspection O[her Than pough-In: ❑ Ready No�Y1fi�Ca11 I
�� 3 U Z You must calf the inspector when ready! Date Ready:
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1 ceR'rfy riiat I am 1h��t1EENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspec6on of the elechical work at
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