P - 78126[ REQUEST FOR ELECTRICAL INSPECTION
1� J� O- 7 4 5� Minnesota Board of Electriaty
1821 University Avenue Suite S-128, SaiM Paul, Minnesota 55104
- (651)642-080011Y/MRS 1-800-627-3529 www.electricity.state.mn.us
NEW REMODEL O ADDITION ❑ REPAIR Describe -using the bxk of the white copy if necessary - the work covered by this tequest
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ALARM,
CIRCUITS OF LESS THAN 50 VOLTS
�vstem Device or Aooaratus � 5.50
Trafic Sianal Standard
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, PJI
Circuits and Two Inspection Trips Each Dwellirg Unit @ 380
I IhAMILT UWtLLINtiS YtK UNI I TOTAL FEE
3 to 12 Units @$50 Pe� Unit (minimum total fee is $20) 3 �.�Q
E2ch Addi6Wlal Unit �$25 TMS u�, Fa+irs�cTOa us� orar
I hmeby ceNfy tlwt I inspected tlre ebctrical i�tallation desaibed hdein on 1he data sfa0ed:
OTHER ADDITIONAL FEES �� ���r .� u �, GG� 6aS�j—
Liahtina Retrofit � 5.25 oer Fixture
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