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Ideniity the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION �IE
GENERAL FE�S F
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere C� $50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Ampere � $10
ITS OF LESS THAN 50 VOLTS
Device or Apparatus � $.50
JDITIONS TO THE GENERAL F
Each Additional
Lighting Retrofit � $25 per Fixture
Center Pivot Irrigation Boom � $4(
Manufactured Home Park Lots � $
Recreational Vehicle Park Sftes �
Separate Bonding Inspection � $2i
Soecial Insoection � $30 oer Hour
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
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Tra�c Si nal Standard � $5
Su Iementai 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 andlor Power Supply up to 500 Amperes, All
CircuRs and Two Inspection Trips Each Dwelling Unit �$80
Add'Rional Inspectron Trips � $20
Investiaative Fee
total fee is
that I inspected the electrical inshaltation described herein on the dates stated:
WR OFFICE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yes No Inspection Other Than Rough-in: ❑ Ready Now ��II Call
Jp�--(Q � V tf You must call the inspector when readyl Date Reedy: — � O C�
I certiTy that I am the �%LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: