P - 79828.
�1-266-714 -- �
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Identify the work covered by this request:
pNEW ❑REMODEL ❑ADDITION
GENERAL FEES
SERVICES ! POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am re (� $75
CIRCUITS / FEEDERS
0 to 200 Am re C� $5
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity !�
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electriciry.state.mn.us '� '
C�.nn 3��t - -
Above 2QQ Am ere � $tU
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
Center Pivot Irrigation Boom � $
Manufactured Home Park Lots (�
Recreational Vehide Park Sites �
Seaarate Bondina Ins�ection � 9
Traffic Si nal Standard � $5
Su demental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortner ! Power Su I for Si ns / Outline Li htin �$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and�or Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Addilional Ins ection Tri s(� $20
Investi ative Fee
Reinsoection Fee � $20
I lW, I —�°_�`_
I herebv certifv that I
total fee is
herein on tlre da�
Special Inspection �$.31 per MNe ��/— ' l l—O3 I
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFICE USE ONLY
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Request Date: Rough-in inspeclion Required? ❑ Yes o Inspection Ofher Than Rough-In: eady Now � wll Catl
+� 1 �,. You must call the inspector when ready! Date Ready:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at•