Loading...
P - 77291REQUEST FOR ELECTRICAL INSPECTION 1� 6 7 9- 3 3 8� Minnesota Board of Electricity - 1821 University Avenue Suite S-128, SaiM Paul, Minnesota 55704 (651) 642-0800 TTY/MRS 1-800�27-3529 www.electricity.state.mn.us ❑ NEW EMODEL ❑ ADDITION ❑ REPAIR Describe -using Me baok of ttie white copy 'rf necessary - the work covered by ihis request: GENERAL FEES Outdoor ' htin Standard E7 SERVICES / POWER SUPPLIES Trafic S' nal Sfandard E5 0 to 400 Am re;25 Su mental Fee $20 401 to 800 Amcere � E50 T.ao�r�,�o� ��„ �� t n�cve ua e�n ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Each Svstem Device or Anoaratus 0 5.50 3 to 12 Units @$50 Per Unit Exh Additional Unit � $25 �Transfortners over 10 KVA �0 S 20 Tra�sfortner / Power SuDdY fa Signs I Outline �qhtinq ES ONE 8 TWO FAMILY DWELLINGS, EACH UNIT Includes the Service and/or Power Supply up to 500 Amperes, All Circuits and Two Inspection Trips Each Dwellirg Unit � E80 ( TOTAL FE; �^ D �� minimum total fee is $20 �[ � TItlS AREA FOR IIISPECTOR USE 0ldv I hereby ceAfy that I inspecBed Ihe electrical instaY�on described herein on Ihe da�es sfaBed: �' Hour (I� IIIII IIIII IIIII IIIII II III IIII) �II�I �� I� i �'j 16793382 �v ����� R��� �e� Rough�n Inspection Required? ❑ Yes �.Ib Inspedion Other Than Rough-In: �dy Now � y1�ll Call ��� �%s You must call the inspector when ready! Date Ready: I certify that I am ihe �IICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:: �•.o...,...�.....a....o....�.T.�.w..w.. eou�oF�cTwcmcavr E&00001M1I 8.1.2002