P - 80018.
REQUEST FOR ELECTRICAL INSPECTION
...
Minnesota Board of Electricity
' 1-396-133 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 ,
(651) 642•0800 TTY/MRS 1-800-627-3529
www.electriciry.state.mn.us ' �
�dentify the work covered by this request:
O'NEW O REMODEL O ADDITION ❑ REPAIR
GENERAL FEES
401 to 800 Ampere �
Above 800 Ampere �
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS PER UNI'�
3 to 12 Units �$50 Per Unit
I 800111 � �V'�
Park Lots � I
Park Sites �
�peclion � $�
XCEL ENEROY SAVER'S SWITCH
Outdoor Lighting Standard � $1
�— Traffic Sinnal Standard � $5
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transfortners / Power Supply for Sipns / OuNine Lighting �$!
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and 7wo Inspection Trips Each Dwelling Unit �$SO
Additional Inspec6on Trips � $20
Investiaative Fee
FOF INSPECIOR USE IXJLV
I hereby certify ihat I inspac[ed the eleclrical
ROUGH IN
FINAL INSPECTION /
TOTAL FEE
total fee is $201
herein on the tlates slated:
DATE
DATE
�-7--d3
FOR OFFICE USE ONLY
IIIIIII�IIII�IIII IIIIIIIIIIIII�� �I�i y��
* 1 3961 339* ���
Fleque� 2 Rough-in Inspection Required? ❑ Yes l'�No Inspection Other Than Rough-in: �Ready Now ❑ Will Call
You must call the inspector when ready! Date Ready:
I certify that I am the C� LICENSED CONTRACTOR ❑ COMPANY O OWNER and hereby request inspection of the electrical work at:
EB-00001A-13 7/1/2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY