P - 79924� REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity
� 1-396-186 � 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 _
(651) 642-0800 TTY/MRS 1-800-627-3529
www,electricity.state.mn.us '
Iderrtity the work covered by ihis request
�ICEW ❑ REMODEL ❑ ADDITION
401 to 800
Above 800
CIRCUITS i FEf
ALARM, CQMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCUITS. CIRCUITS OF LESS THAN 50 VOLTS
Each S stem Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
MULTIFAMILY DWELLINGS (PER UNIT)
3 to 12 Units �$50 Per Unit
Retrofit �
Recreational Vehicle Park Sites �
Separate Bondinq Ins�7ection � $;
XGEL EhIEROY 5AVER'S SWIT�H
Outdoor Liahtina Standard � $t
Transformers u to 10 KVA �$10
Transformers over 10 KVA � $20
� Transfortners ! Power Supply for Sipns / Outline Li9hting �$5
ONE & TNlO FAMILY DWELLINGS, EACH UNIT
Includes the Service ancUor Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$80
Additional Inspection Trips � $20
investi ative Fee
Reinspection Fee � $20
TOTAL FEE
(minimum total fee is $20)
PoP INSPECTOR USE ONLY
I hereby certity Ihat I inspec[atl the electrical instalWtion desCribed �arein on the dates stated:
ROUGHIN OnTE
FINAL INSPECTION � � E ` �
6
�NF.�IED 1F NQT �ONIPLETED 16t17�i1l�L,1R.�A�IxHS__ __ _
FOR OFFICE USE ONLY
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Reque�8�A2 Rough-in inspection Required? ❑ Yes C�No Inspection Qther Than Rough-in: �Ready Now ❑ Wi0 Call
You must call the inspecror when ready! Data Fieady:
I certify that I am the � LICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at:
E&00001A•13 7!1l2000 BOARD OF ELECTRICITY COPY INSTRUCTIONS ON BACK OF YELI.QW COPY