P - 81966REQUEST FOR ELECTRICAL INSPECTION
' Minnesota Board of Electricity
�-3�]%-1 �� � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 -
(651) 642-0800 TTY/MRS 1-500-627-3529
www. electricity. state. mn, us
Ideniify the work covered by this request:
❑�IEW ❑ REMODEL ❑ ADDITION ❑
GENERAI FEES
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Amoere � �50
0 to 200 Am ere �$5
Above 200 Am ere (� $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus � 5.50
to 12
dditional Unit � $25
OTHER ADDITIONAL FEES
I Retrofit � $25 per Fixture
Pivot Irrigation Boom � $40
�tured Home Park Lots � $25
ional Vehicle Park Sites � $5 ,
e Bondinq Inspection � $20
X(�L ENERGY SAVER'S SINITGH
i
Transformers u to 10 KVA �$10
Transfortners over 10 KVA � $20
Transfortners / Power Supply for Signs I Outline Lighting �$5
ONE & TWO FAMIIY DWELLiNGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unft �$80
Additional Inspection Trips � $20
Investigative Fee
Reinspection Fee (� $20
TOTAL FEE
(minimum total fee is $201
I hereby ceNty that I inspec[ed the electricel installation described �arein on the detes statetl:
ROUGHIN DATE
FIW1L INSVEGTION DATE
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FOR OFFICE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ Inspection Other Than Rough-in: eady Now ❑ Will Call
d��� You must call the inspector when ready! Date Ready:
I certiiy that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: