P - 78557REQUEST FOR ELECTRICAL INSPECTION
�,1- 3 5 4- 3 4 8 °A° Minnesota Board of Electricity
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� �'� (651) 642-0800 TTY/MRS 1-800-627-3529
www. electricity. state. mn. us
Identity the work covered by this request �
I�I NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Amoere � �25
401 to 800 Ampere � $50
Above 800 Ampere � $75
�UITS / FEEDERS
0 to 200 Ampere � $5
Above 200 Ampere � $10
RM, COMMUNICATION, RE
;UITS, CIACUITS OF LESS
Each System Device or App
ADDITIONS TO
3tot2
Lighting Retroffi � $25 per Fixture
CeMer Pivot Irrigation Boom � $4C
Manufactured Home Park Lots � �
50 VOLTS
� $.50
iENERAL FEES
FEES
Outdoor Li htin Standard � $1
Traffic Siqnal Standard � $5
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Trensformers over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li htin �$5
ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellina Unit ��8(
Fee �
osE
total fee is
thatlinspected Ne electricalinstallation described herein onfhe detes stated:
Se arate Bondin Ins 'on � $20
S ial Ins 'on �$30 r Hour ���^�+ n�h
S ecial In ection �$:31 r Mile �,s—r/3'
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
�R OFflCE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yes No Inspection Other Than Rough-In: eedy Now Q Will Call
— ��� You must call the inspector when ready! Date Ready:
I certity that i am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work ai