P - 82532REQUEST FOR ELECTRICAL INSPECTION
� Minnesota Board of' Electricity '�
1-0�6-990 tl�m
4 1821 University Avenue Suite S-128, Saint Paut, Minnesota 55104
- � v � (651) 642-0800 TTY/MRS 1-800-627-3529
� � www.electricity.state.mn.us ''°�'
Identity the work covered by this reques . � ��! �
❑ NEW REMODEL ❑ ADDITION AIR ���"� � L 7 7� /� O�
GENERAL FEES Outdoor Li htin Standard �$1
SERVICES / POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am ere �$50 Transformers u to 10 KVA �$10
Above 800 Am ere �$75 Transtormers over 10 KVA �$20
CIRCUITS / FEEDERS Transformer / Power Su pl tor Si ns / Outline Li htin (� $5
0 to 200 Am ere �$5 ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am ere �$10 Includes the Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circufts and Two Inspection Trips Each Dwelling Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ection Tri s�$20
Each S stem Device or aratus �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reinsoection Fee �$20
Each Additional Unft � $25
OTHER ADDITIONAL FEES
Liahtino Retrofii � �.25 oer Fixture
Recreational Vehicle Park Sites �
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total fee is
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Than Rouah-In: ❑ Ready Nav
�� You must call the inspector when ready! Date Ready:
I cerlify that I am the ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at