P - 81967RE(1UEST FOR ELECTRICAL INSPECTION
' Minnesota Board ot Electricity
1-377-1 �1 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
w (651) 642-0800 TTY/MRS i-800-627-3529
www. electriciry. sta te. mn. us
IdentiTy the work covered by this request:
Q�GEW ❑ REMODEL ❑ ADDITION ❑ REPAIR XCEL ENERGY SAVER�S SWITCH
GENERAL FEES Outdoor Liahtlna Standard �$1
to
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
3 to 12 Units �$50 Per Unit
Each Additionat Unit � $25
le Park Sites � ;
Inspection � $2I
� $30 per Hour
� $.31 qer Mile
�,
, )�.
Transiortners overl0 KVA � $20
Transfortners / Power Supply for Signs / Outline Lighting �$'
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuds and Two Inspection Trips Each Dwelling Unit �$80
Addifional Inspection Trips � $20
� Reinspection Fee � $20
FOR WSPEGTOR USE �NIY
I hereby certfijthatlinspec�ed Ue electrical
RWGH IN
FINAL INSPECTION
TOTAL FEE
d fee is $201
DATE
DATE
�2?
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FOR OFFICE USE ONLY
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ Inspection Other Tha� Rough-in: eady Now ❑ Will Call
��1 You must call the inspector when ready! Date Ready:
I certi(y that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: