P - 78858REQUEST FOR ELECTRICAL INSPECTION
1� 3'�F 7- 315 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,Ks
Itlentify the work covered by this request:
❑ NEW I� REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES
SERVICES / POWER SUPPLIE
0 to 400 Am ere �,;�20' /-c7
401 to 800 Am ere �$50
Above 800 Am re � $75
CIRCUITS / FEEDERS
.� 0 to 200 Ampere �,$B'
Above 200 Amcere �� �10
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNIn
� 3 to 12 Units �$50 Per Unit `—
� Retrot'd 0
Pivot Irriaat
SIS@S �
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7reffic Si nal Standard � $5
Su demental Fee � $20
Transfortners u to 10 KVA �$10
Trensformers over 10 KVA � $20
Transformer / Power S I for S' ns / Oulline ' hti �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Additional Insoection Trios � $20
Fee �
(minimum total fee is $20;
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reby certlfv that I insoected the electrical insfallatian described herein on Me i
S ecial In ion �$.31 V r Mile � �.�.. 1�—� �
►_ THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 ONTHS
FOR OFFICE USE ONLY
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�°• yn-m mspecoon rlequ1f80"! �Yes ❑ No fnspection Other Than Rou h-In: dy
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You must call the inspector when readyl Date Ready
I certi(y that i am the ❑ LICENSED CONTRACTOR ❑ COMPANY �] OWNER and hereby request inspectlon of the electrical work at
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