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P - 79925- REQUEST FOR ELECTRICAL INSPECTION Minnesota Board of Electricity 1-396-185 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 � (651) 642-0800 TTY/MRS 1-800-627-3529 www. electricity. sta te. mn. us IdentiTy the work covered by this request: O"NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR GENERAL FEES SERVICES / POWER SUPPLIES 0 to 400 Am ere �$25 401 to 800 Am ere �$50 Above 8D0 Am ere � $75 CIRCUITS / FEEDERS 0 to 200 Am re �$5 Above 200 Am ere � $10 ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING CIRCUITS. GIRCUITS OF LESS THAN 50 VOLTS Each System Device or A paratus �$.50 ADDITIONS T� THF GENERAL FEES MULTIFAMILY DWELLINGS (PER UNf� 3 to 12 Units �$50 Per Unit Each Additional Unit � $25 OTHER ADDITIONAL FEES Li htin Retrofit �$25 er Fixture Center Pivot Irti tion Boom �$40 Manuiactured Home Park Lois � $25 Recreatlonal Vehicle Park Sftes �$5 � Se arate Bondi ins ion �$20 Special Insaection � $30 �er Hour XCEL ENER{3Y SAVER'S SWIT�H ONE & TWO FAMILY DWELLINGS, EACH UNIT Includes the Service andlor Power Supply up to 500 Amperes, All CircuRs and Two I�pection Trips Each Dwelling Unit �$80 Additional Insoection Trios � $20 is wA ms�croa use oniv 1 herebvi ceAik that 1 insoected the eleclrical inslaVlalbn described herein on the dates sfateE: EWy1NSPECTION 6r/�_"O� FOR OFFlCE USE ONLY I IIIIII 11� (II� IIIII �I�I �� IIII� �� �I� (�I * 1 3 9 6 1 8 5 9* �� a?O SD Reque��� Rough-in Inspection Required? ❑ Yes C]�No Inspection Qther Than Rough-in: I�Ready Now ❑ WiN Call You must call tFie inspector when ready! Date Feady: I certity that I am the L� LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: