P - 797651-396-534 $�
IdXtify the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION ❑
GENEflALFEES
SERVICES 1 POWER SUPPLIES
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board ot Electric+ty
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www. eiectricity. sta te. mn, us
XCEL ENERC3Y SAVEft'S SWITGH
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Ap aratus �$.50
ADDITIONS TO THE GENERAL FEES
3 to 12 Units �$50 Per Ur
Each Additional Unit � $25
OTHER A
Lighting Retrofit (� $25 per
Cenier Pivot Irriqation Boon
M�ia
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Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers overl0 KVA � $20
Transformers / Power Su I tor Si s I Outline ' hti �$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuds and Two Inspection Trips Each Dwelling Unit �$80
Additional Inspection Trips � $20
Investi tive Fee
Reinspection Fee � $20
TOTAL FEE
Iminimum total fee is $20)
FOP 1NSPECTOfl USE ONLY
I hereby certNy that I inspecled the efectricel installation dasc�betl herein on tlre dates ststed:
ROUGHIN OATE
% OATE
--------- 3 _z,_ � 3
� FOR OFFlCE USE ONLY
�' ti�� �
I{IIIII�NINIII���NIN�IIIIIIIINiHilllll � �
* 1 3 9 6 5 3 4 8* �
Reque Rough-in Inspection Required? ❑ Yes No Inspection Other Than Rough-in: Ready Now ❑ Will Call
You must call the inspector when ready! Date Ready:
I certify that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
ttS-UUOOlA-13 711l2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELLOW COPY