P - 79764REQUEST FOR ELECTRICAL INSPECTION E..,
Minnesota Board of Electricity _
1-396-539 � 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 covered by this request:
O NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
C[�:�]
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or A aratus �$.50
ADDITIONS TO THE GENERAL FEES
3 to 12 Units �
Each Additlonal
9t � $25 per Fi�ure
rigation Boom � $40
Home Park Lots � $25
'ehicle Park Sites � $5
ling Inspection � $20
:tion � $30 per Hour
;tion � $.31 per Mile
XCEL ENEROY SAVER'S SWITCN
Su lemental Fee � $20
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
Transformers / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$80
Additional Inspection Tnps � $20
Investi ative Fee
Reinspection Fee � $20
TOTAL FEE
lminimum total fee is $20)
I hereby c
ROUGHIN
FIW1L IN51
I inspected ihe electrical installation describeC herein on the detes statetl:
DATE
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FOR OFFICE USE ONLY
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* 1 3965397'` �
Requesj Q�/�2 Rough-in Inspection Required? ❑ Yes �NO Inspection Other Than Rough-in: � Ready Now ❑ Will Call
You must call the inspector when ready! Date Ready:
I certify that I am the �I LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: