P - 79314REQUEST FOR ELECTRICAL INSPECTION
�=� 7 7 � � � � � � Minnesota Board of Electricity -
1 B21 University Aven�e Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TfY/MRS 1-800-627-3529 www.electriciry.state.mn.us
�! NEW ❑ REMODEL O ADDITION ❑ REPAIR Describe -using the back of the white copy if necessary - the work covered by this request:
?�CEL ENERGY SAVER'S SWCTCH
I POWER SUPPLIES
ALARM, COMMUNICATION, REMOTE CONTROI
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus @$.50
ADDITIONS TO THE GENERAL
MULTIFAMILY DWELLINGS PER UNIT
3 to 12 Units @$50 Per Unit
Each Additional Unil p $25
Hour
II II �
I I{I411 � 111811 � II I{I � III II �I II NI I I�I
� L77357`70
Transformers u to 10 KVA $10
Transformers over 10 KVA @$ 20
] Transformer / Power Supply for Signs I Outline Lighting @$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service and/or Power Supply up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dwelling Unit �$80
(minimum total fee is $20) � $20.50
TMIS AREA Fqi INSPELTOR USE IXJIV
I hereby ceAity that I inspected tlie electricai instalfation described herein on the dates stated:
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Requesl Date: � Rough-in Inspection Required? LJ Yes LJ'Rb Inspedion Other Than Rough-In: URbady Now lJ Will Call
Q�Q(� You must call the i�spector wh� ready! Date Ready:
I certi(y that I am the C�iCENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the elecUical work at:
INSTRUCTONS ON BACK OF YELLOW COPY BOARD OF ELECTRICITV COPV EB-00001M14 8.1. 2002