P - 77330REQUEST FOR ELECTRICAL INSPECTION
1 3 4 7 5 2 1 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
Identify the work covered by this request:
❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
0 to 400 Ampere (� $
401 to 8Q0 Ampere �
Above 800 Ampere �
�UITS / FEEDERS
0 to 200 Amcere � �
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or A aratus �$.50
ADDITIONS TO THE GENERAL F
MULTIFAMILY DWELLINGS PER UNI
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
Ughting Retrofit � $25 per Fixture
Center Pivot irtiga6on Boom � $4(
Manufactured Home Park Lots � $
Recreational Vehicle Park Sites �
Separate Bonding Inspectlon � $21
Special Inspection � $30 per Hour
Special Inspection � $.31 per Mile
THIS INSTALLATION M�
�4� �' � i�'�G t �2l,s - y . �—_
Outdoor Liahtirw Standard � St
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 Dwellin Unit �$80
Addfional Ins ion Tri s�$20 +--
Investi ative Fee
Reins ion Fee �
� 1/� ���,f TOTAL FEE /
� (minimum total fee is $20)
wA iws�croR use aav
that i inspected the electrical installatlon described herein on the dates stated:
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FOR OFFICE USE ONLY /�
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Request Date: Rough-in Inspection Required? ❑ Yes ❑ No Inspection Other Than Rough-In: ❑ Ready Now ❑ Will Call
—` '� � You must call the inspector when readyl Date Ready:
I certify that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY WNER and hereby request inspection of the electrical work at: