P - 75902REQUEST FOR ELECTRICAL INSPECTION
1� 9 7��� 3 0 �, Minnesota Board of Electricity
, 1821 University Avenue Su(te 5-128, Saint Paul, Minnesota 55104 � �
� � (651) 642-0800 TTY/MRS 1-800-627-3529 www.edectrdcity.state.mn.us
Desaibe -using the back of the wh' copy'rf necasseiy - the work covered by this requ�t:
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GENE FEES Outdoor Lighti Standard @$1
SERVICES / POWER SUPPLIES TraTflc Signal Standard @$5
0 to 400 Am re @$25 Sup lememal F� @$20
401 W 800 Am re$50 Transformers to 10 KVA $10
Above 8Q0 Am re $75 Transformers over 10 KVA $ 20
CIRCUITS / FEEDERS Transformer / Power Su I for S' ns / Outline Li ' $5
0 to 200 Am re $5 ONE & 1W0 FAMILY DWELLINGS, EACH UNIT
Nmve Z00 Am re $10 Includes the Service and/or Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Cirarits arid Two Inspedion Trips Each Dwellir�g Unit @$BO
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus $.50
ADDITIONS TO THE GENFRAL I
MULTIFAMILY DWELLINGS IPER UNITI
i
Manufactured
S al 1� on $.31 r MIIe
THIS INSTALLATION MAY BE ORDERED
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total fee is
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IF N(?T COMPLETED WITH
FOft OFFICE USE ONLY
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You must c�ll the inspector when readyf Date Ready.
I certify that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request insp�tion of the etectrical work at
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Contractor / Compeny Name
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