P - 80078REQUEST FOR ELECTRICAL INSPECTION
, J � � � � � � � : Minnesota Board of Electricity =
1 r � �a 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us
Identity the work cnvered 6y this request:
❑ NEW ❑ REMODEL ADDITION ❑ REPAIR
G NERAL FEES
SERVICES / POWER SUPPLIES
0 to 400 Ampere � $25
401 to 800 Ampere � $50
Above 800 Ampere � $75
;UITS / FEEDERS
0 to 200 Ampere � $5
Above 200 Ampere � $10
RM, COMMUNICATION, REMOTE CONTROL,
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus �$.50
OTHER ADDITIONAL FEES
Lighting Retrofit � $25 per Fi�ure
Center Pivot Irrigation Boom � $40
Manufactured Home Park Lots � $25
Recreational Vehicle Park Sites � $5
Separate Bonding Inspection � $20
Special Inspection � $30 per Hour
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Outdoor Lighting Standard (� $1
7raffic Signal Standard � $5
Supp{ememal Fee � $20
Transformers up to 10 KVA �$10
Transformers over 10 KVA � $20
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and�or Power Supply up to 500 Amperes, Ail
Circuits and Two Inspection Trips Each Dwellin Unit �$8(
Additional Insoection Trips � $20
total fee is
I in ed tl�e elecfrical insfallati�on describ� herein on the dates s�ted:
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r7equest ate: Rough-in Inspeclion Required? �Yes ❑ No Inspection Other Than Rough-In: � Ready Now ❑ wll Call
� O�'T/� 2 You must call tFie inspector when ready! Date Ready:
I ce�ify that I am the �LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: