P - 79792REQUEST FOR ELECTRICAL INSPECTION - -
1 3 3 6 8 6 4 �° e; 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
Identity the work covered by this request:
❑ NEW REMODEL ❑ ADDITION ❑ REPAIR �I[�� �jOV (CE U�� �TC � iC C� t/11 EL
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee (� $20
401 to 800 Am re �$50 Transformers u to 10 KVA �$10
Above 800 Am ere (� $75 Transtormers over 10 KVA �$20
CIRCUITS / FEEDERS Transfortner / Power Su I for Si ns I Outline Li hHn �$5
0 to 200 Am re C� $5 ONE & TWO FAMIIY DWELLINGS, EACH UNIT
Above 200 Am re �$10 Includes the Service andlor Power Suppry up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwellin Unft �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Addftional Ins ion Tri s�$20
Each S tem Device or A aratus �$.50 Investi tive Fee
ADDITIONS TO THE GENERAL FEES Reins ection Fee �$20
MULTIFAMILY pWELLiNGS PER UNI TOTAL FEE
3 to 12 Units �$50 Per Unit (minimum total fee is $20) �
EaCh Additi0nat Uflit �$25 F°" i"S�cra' usE °"�v
OTHER ADDITIONAL FEES
Li Min Retrofit �$25 r Fixture
Center Pivot Irri ation Boom �$40
Manufactured Home Park Lots �$25 � here certify that I inspected the e�echical insfalla6on described herein on 1�e dstes si�ed:
Recreational Vehicle Park Sftes �$5 n A il • "�"'" °A� -
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I certify that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electricai work at:
Job Address (Streei, Box, or Route No.) City Zip Code
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EB-00001A•13 7/1/2000
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Phone
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Atldress
iany Name Contractor License Number Master License Number
�Company o ner Pe orming Installation)
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