P - 77230REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity '�
�� 3 4 7- 4 8 5 �82� University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529 - _
www. electrici ry. state. mn. us
Identify the work covered by this request:
❑ NEW C�REMODEL ADDITION ❑ REPAIR G C �� �
GENERAL FEES Outdoor Li htln Standard �$t
SERVICES / POWER SUPPLIES Traific Si nal Standab �$5
0 to 400 Am ere �$25 Su lemental Fee �$20
401 to 800 Am re�$50 Transformers u to 10 KVA �$10
Above 800 Am re �$75 Transformers over 10 KVA �$20
CIRCUITS / FEEDERS Transfortner / Power Su for Si ns / OuUine Li htin �$5
0 to 200 Am re�$5 G#�{� ��C..� ONE & TWO FAMILY DWELLINGS, EACH UNIT
Above 200 Am re �$10 7✓ Includes the Service and/or Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelli Unit �$80
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Ins ion Tri s�$20
Each em Device or aratus �$.50 Investi ative Fee . DD
ADDITIONS TO THE GENERAL FEES Reins ion Fee �$20 G, .
MULTIFAMILY DWELLINGS PER UNI TOTAL FEE
3 to 12 Units � S5o Per unit _(minimum total fee is $20) %,s
Li htin Retrofit �$.25 er Fixture
Center PNot Irri ation Boom �$40
Manufactured Home Park lots �$25 I here ceroty tliat I inspected me e�ectrical instauauon described herein on the dates stated:
Recreational Vehicle Park SRes �$5 10�' "' °��
Se rate Bondin Ins ion �$20
S ial In 'on �$30 r Hour """""S"E`�n°" °p*�
S ial In ' n�$.31 r Mile � '��
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFICE USE ONLY
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Request ate: Rough-in Inspeclion Required? ❑ Yes ❑ No Inspection Other Than Rough-In: ❑ Ready Now � Will Call
,�" /U� You must call the inspector when ready! Date Ready:
I ceRi(y that I am the ❑ LICENSED CONTRACTOR ❑ COMPANY �OWNER and hereby request inspection of the electrical work at:
EB-00001A-13 7/1/2000 BOMD OF ELEC7AICIlY COPY INSTFIUC710N5 OPI BACK OF VELLOW COPY