P - 805081-1D8-489 ���
Identify the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION
GENERAL F
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1821 Universify Avenue Suite S-i2$, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. e lectricity. state. mn. us
, . �, s�,� �� . � -R1�n�1'D� �
0 to 400 Ampere � $25
401 to 800 Ampere � $50
Above 800 Ampere � $75
�UITS / FEEDERS
0 to 200 Ampere � $6
Above 200 Ampere (� $10
RM, COMMUNICATION, REMOTE CONTROL, SIGI
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
.TIFAMILY DWELLINGS (PER UNI"�
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
LigMing Retrofit � $.25 per Fixture
Center Pivot Irrigation Boom � $40
Manufactured Home Park Lots � �
Supplemental Fee � $20 ,
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transtormer ! Power S for ' ns / Outline li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin UnR �$8(
Additional Insoection Trios � $20
Fee �
S ial In ion �$30 er Hour �" "�"°"
Special Inspection � $.31 per Mile
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETEI
FOR OFFICE USE ONLY
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Request D /� Rough-in Inspection Required? ❑ Yes o Inspection Other Than Rough-ln:
~� ��,/ I You must call the inspector when readyl Date Ready:
total fee is
herein
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I certify that I am the� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work aC