P - 81597REQUEST FOR ELECTRICAL INSPECTION
� Q%% Minnesota Board of Electricity
1� 0 4 5� V 1 1 182� University Avenue Suite S-128, Saint Paul, Minnesota 55104
i (651) 642-OS00 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us " '
Identify the work covered by this request: ,.� �
❑ NEW ❑ REMODEL ❑ADDITION �REPAIR
GENERAL F S
SERVICES / POWER SUPPLIES
0 to 400 Am ere �$25
401 to 800 Am ere �$50
Above 800 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIG
CIRCUITS, CIRCUITS OF LESS 7HAN 50 VOLTS
Each S stem Device or aratus �$.50
ADDITIONS TO THE GENERAL FEES
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
Manufactured Home Park Lots �
Recreational Vehicle Park Sites �
Seoarate Bondina Insoection � $;
Ouldoor Li htin Standard � $1
Traftic Si nal Standard (� $5
Su �emental 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 and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$8(
Additional Inspection Trips � $20
I insoected Me electrical installauon described herein on ihe dates stated:
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I certify that I am the',�
Job Address (Street, Box, or
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Section Township
Occupant � ry ,
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CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
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INSTRUCTIONS ON BACK OF
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