P - 77120REQUEST FOR ELECTRICAL INSPE�TION � ���
% Minnesota Board of Electricit ��
1-.91 �� O 1 O� 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 ���`
(651) 642-0800 TTY/MRS 1-800-627-3529 www.electricity.state.mn.us �"`��
Descri -using the back of the white copy ifinecessa - he work covered by this request:
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GENERAL FEES Outdoor Lighting Standard $1
SERVICES / POWER SUPPLIES Traffic Si nal Standard @$5
0 to 400 Ampere $25 r Sup lemental Fee $20
401 to 800 Am re $50 Transformers u to 10 KVA $10
Above 800 Am ere $75 Transformers over 10 KVA $ 20
CIRCUITS / FEEDERS Transformer I Power Su I for S' ns / Outline Li htin $5
0 to 200 Am re $5 ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere $10 Includes the Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelling Unit @$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ction Tri s $20
Each S stem Device or aratus $.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reins ection Fee $20
MULTIFAMILY DWELLINGS PER UNIT TOTAL PEE �O` ��
3 to t2 units an $5o Per Unit Iminimum total fee is $201
Each Additional Unit
I insoected the electrical installation described herein on the dates stated: I
Center Pivot Irriqation Boom
R2C28tio0al Vehicle Pahc SROS $5 "'""'""""`"" """ r
Se arate Bondin Ins ction $20 p'�-��`� ��`�' 'S
S ial Ins tion $30 per Hour EXPiREOUanNOOnEn onh
S cial Ins ection $.31 r Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 12 MONTHS
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I certify that I am the �L
Job Site Street Addr
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Rough-in Inspec[ion Required? ❑ Yes �Jo Inspection Other Than Rough-Irr. j,�'�teady Now �Will Cali
You must call the inspector when ready! Date Ready: /� `/ Q s�
JSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby re ction of the electrical work at
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Section Range Fire No. oun �
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Please ProvKle Two (2 Phone Numbers Including Area Code
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Master Elechician or Power Limited Technician I
License Number
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