P - 79745REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
1-396-564 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
,, (651) 642-0800 TTY/MRS 1-800-627-3529
www,electricity.state,mn.us '
Identify the work covered by this request
0 NEW ❑ REMODEL ❑ ADDITION
0 to 400 Ampere �
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNI�
Park Sites �
�,pection � $;
XCEL ENERQY SAVER'S SWITGH
�
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
CircuRs and Two Inspection Trips Each Dwelling Unft �$80
Additional Inspection Trips � $20
Investiaative Fee
TOTAL FEE
total fee is $20)
FOR INSPECTOF USE ONLY
I hereby certily Mat I inspected ihe eleclricel installation described-herein on the dates stetetl:
ROUGMIN DATE
FINAL IN3PECTIIXJ DATE
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FOR OFFlCE USE ONLY
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Requesj �f� Rough-in Inspection Required? ❑ Yes �No Inspection Other Than Rough-in: Ready Now ❑ Will Cell
You must call the inspector whea ready! Date Ready:
I certiTy that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: