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P - 78328REQUEST FOR ELECTRICAL INSPECTION Minnesota Board of Electricity ��`"�. 1� 3 4 7- 3 8 3 182� University Avenue Suite S-128, Saint Paul, Minnesota 55104 (651) 642-0800 TTY/MRS 1-800-627-3529 - � - www.electricity.state.mn.us IdeMity the work covered by this request: � T (J ❑NEW �REMODEL ❑ADDITION ❑REPAIR _;�A/YJ " �-r 0 to 400 Am re �$25 B U �G� ' Su lemental Fee �$20 401 to 800 Am re �$50 Transformers u to 10 KVA �$10 Above 800 Am re �$75 Transfortners over 10 KVA (� $20 CIRCUITS / FEEDERS Transformer / Power Su I for Si ns / Outline Li htin �$5 0 to 200 Am re (� $5 ONE 8 TWO FAMILY DWELLINGS, EACH UNIT Above 200 Am re�$10 Includes the Service andlor Power Supply up to 500 Amperes, All ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspectbn Trips Each Dwellin Unit �$80 CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ion Tri �$20 Each S tem Device or ratus �$.50 Investi ative Fee ADDITIONS TO THE GENERAL FEES Reins ion Fce �$20 MULTIFAMILY DWELLINGS PER UNI TOTAL FEE ( 3 to t2 Un�s �$5o Per Unit (minimum total fee is $20) •.Y� Each Additional Unit �$25 FOH INSPECTOfl USE ONLY OTHER ADDITIONAL FEES U htin Retroftl �$.25 r Fixture CeMer Pivot I' ation Boom �$40 Manufactured Home Park Lots �$25 I hereby certily ihal I inspected the electrical installati�on described herein on the dates stated: Recreatlonal Vehide Park Sites �$5 '�" �" oa,� te Bondin Ins ion � $20 S �al In 'on �$30 r Hour FTM^� "��"�" wre S'al Ins ion �$.31 r Mile '�—'°�°`°-�p �� _ THIS INSTALLATION MAY BE ORDERED DISCONNECT NOT COMPLETED WITHIN 18 MONTHS FOR OFFICE USE ONIY Illllll11111Ifllllllll11111IIIII111Nillllllllllll ,� a�� 3E 1 3 4 7 3 8 3 O�E 3�, �v Request D e: Rough-in Inspection Required? ❑ Yes No Inspec[ion Other Than Rough-In: ❑ Ready No Will Call '� ��O You must call the inspector when readyl Date Ready: I certiiy that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY�OWNER and hereby request inspection of the electrical work at: