P - 81582REQUEST FOR ELECTRICAL INSPECTION
� � � � � � � � � �� Minnesota B�ard of Electricity
1821 Universi Avenue Suite S-128, Saint Paul, Minnesota 55104
a� �z (651) 642-0800 TTY/MRS 1-800 627-3529
www.electricity.state.mn.us ,`��, j � '; � � � �j ��• ��� 1
IdentiTy the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION
GENERAL F
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Amoere � $75
0 to 200 Ampere � $5
Above 200 Ampere � $10
RM, COMMUNICATION, REMOTE CONTROL,
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL f
.TIFAMILY DWELLINGS (PER UNI�
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Outdoor Lightinq Standard � $1
Traffic Si nal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two ins ction Trips Each Dwelling Unit �$8C
Additional Insoection TriDS � $20
Fee �
Cerrter Pivot trm a6on Boom �$40
Manufactured Home Park Lots �$25 �� r I hereby certify that I inspected the electrical inslalla6on
Recreational Vehicle Park SRes �$5 � � pW�IN �
FpR OFFlCE USE ONLY
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total fee is
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I certiiy that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspectlon of the electrical work at