P - 79771REQUEST FOR ELECTRICAL INSPECTION -�.
Minnesota Board of Electricity
, 1-396-547 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 `
(651) 642-0800 TTY/MRS 1-500-627-3529
www. electricity. sta te. mn. us
Identify the work covered by this request:
���( XCEL ENEROY SAVER'S SWITCH
U NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traific Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am ere �$50 Transformers u to 10 KVA �$10
Above 800 Am ere �$75 Transfortners over 10 KVA �$20
CIRCU4TS / FEEDERS Transformers I Power S I for Si �s ! Outline Li tin �$5
0 to 200 Am ere �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$10 Includes the Service and/or Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelling Unft �$80
CIRCUITS CIRCUITS OF LESS THAN 50 VOLTS Additional Inspection Trips �$20
Each System Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNIT
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
� Retrofit � $.25 per Fixture
Pivot Irtigation Boom � $40
ctured Home Park Lots � $25 .� ,
�
FOF INSPECTOfl USE ONLV
1 hereby cerGfy that I inspected Me electrical
RWGH IN
b
OTAL FEE
fee is $20)
herein on Me dates stated:
DATE
S 18I IfIS 8Ct1011 �.�O f HOUi - FINAL INSPECT N DATE
S ecial Ins ection �$.31 er Mile �� 2'S G 3
THIS INSTALLATION MAY BE ORDERED DISCONNECTED, IF_ NQT COMPLETED VJ/—ITF�IN 1$_,�IQN_Ttl� �
� FOR OFFICE USE ONLY
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Reque Rough•in Inspection Required? ❑ Yes o Inspection Other Than Rough-in: Aeady Now ❑ Will Call
You must call the inspector when readyl Date Ready:
I certity that I am the � LICENSED CONTRACTOR ❑ COMPANY p OWNER and hereby request inspection of the electrical work at:
tts-oaa07n-7s 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY