P - 79731RECZUEST FOR ELECTRICAL INSPEC i�...
1 'O �� ��� P Minnesota Board of Electricity �
� � e" ' 1821 University Avenue Suite S-128, Sainf Paul, Minnesota 55104
��` ,�: (651) 642-0800 TTY/MRS 1-800-627-3529
www. e lectrici ty. state. mn. us
IdentiTy the work covered by this request:
❑ NEW � REMODEL ❑ ADDITION ❑ REPAIR �Z�S�� �(/«^ ��""' �-
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Ampere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am re � $10
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each em Device or A aretus +� $.5Q
ADDITIONS TO THE GENERAL F
MULTIFAMILY DWELLINGS PER UNt
3 to 12 Units �$50 Per Unit
RetroM � $25 per Fia
'Not Irriaation Boom �
Recreational
�
Outdoor Li htin Stantlard � g1
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 I Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Inciudes the Service andlor Power Supply up to 500.Amperes, AII
Circuits and Two Inspection Trips Each Dwellin Unit �$S(
Additional Inspection Trips � $20 _
Fee
total fee is
thetlinsnected the electricafinstallation described herein on the
FOR OF}7CE U9E ONLY
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Reque� ate: � Rough-in Inspection Required? ❑ Yes No Inapection Other Than Rough-In: ❑ Ready Now ill Call
� � You must call the inspector when ready! Date Ready:
I certify that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspecdon of the electrical work at
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