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; SUPPLIES
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 wxnv.electricity.state.mn.us
r- the work wve e� by this request:
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� Out oor Liqhtinp Standard (a) $1
401 to 800 Am ere $50
Above 800 Am re $75
ClRCUITS I FEEDERS
0 to 200 Am ere $5
Above 200 Am ere $10
ALARM, COMMUNICATION, REMOTE CANTROL, SIGNALING
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
MILY DWELLINGS (PER UNi�
12 Units @ $50 Per Unit
i Additional Unit @ $25
OTHER ADDITIONAL FEES
Center Pivot Ircigation Boom , $40
Manufactured Home Park Lots �$25
Recreational Vehicle Park Sfles a$5
Se arate Bondi Ins ection $20
Special Inspection $30 per Hour
S ial Inspection $.31 r Mile
IS INSTALLATION MAY BE ORDERED
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Transformers u to 10 KVA $10
Transformers over 10 KVA @$ 20
Transformer / Power Supply for Signs I Outline Lightlng @$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit @$80
Additional Inspection Trips @ $20
Investiqative Fee
TOTALFEE
total fee is $201
I herebv certi(v that I insceded the elecVical installation descnbed herein on fhe dates stated:
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JECTED IF NOT COMPLETED WITHIN 12 MONTHS __ �
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Date: Rough-in Inspection Required? ❑Yes /m No Inspection Other Than Rough-In: ❑ Ready Now�Will Call
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You must call the inspector wl�en ready! Date Ready:
I certify that I am the LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at
Job Site.S t A ss C�Y '
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Address
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Electrical Utility Address
or Owner
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rador License Numbb��r Master Electncian or P�
2 %1� 'i / _/ � License Number
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Please Provide Two (2) P one um
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