HomeMy WebLinkAboutLA176623 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA176623
Lakeville,MN 55044 �
(952)985-4440 * L R 1 7 6 6 Z 3 *
www.ci.lakeville.mn.us Date Issued: O1/10/2020
Site Address: 17404 Glacier Way
Lot: Block: Addition:
PID:
Use: Bldg 1 * *
Description:
Sub Type: CommerciaUIndustrial
Work Type: New
Description: Building#1 for aparhnent complex
Comments:
Fee Summary' Descri tion Amoun Revenue Code
Valuation: 168,000.00 EL-Commercial-New $1,730.00 1000-4167
Surcharge-Based on Valuation $84.00 1000-2127
Total: $1,814.00
Contractor: - Appi;��,t - Owner:
Burnsville Electric
14340 County Road 5
Burnsville MN 55306
(612)363-0407
I HEREBY AGREE THAT THIS WORK WILL BE PERFORMED ACCORDING TO: (1)THE APPROVED PLANS&
SPECIFICATIONS;(2)THE APPLICABLE CITY ORDINANCES&CODES;AND(3)THE MN STATE BUILDING CODE.
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Applicant/Permitee: Signature I sued By: Signature
`�..i`,.��'�'�,�..��J � '��ti iL�i�� ���� _ .j�"�"�
ice Use Only
ELECTRICAL PERMIT APPLICATION �� ' � 'J rj_,4;
' �y Pe it Number
CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT
/ ! � 20195 HOLYOKE AVENiJE qeceived By
LAKEVILLE,MN 55044 ' / ') ✓�
952-985-4440 Date Received
www.lakevillemn.gov 0.00��� _��'� ��
Fee Total
DATE 1/9/2020 YOUR E-MAIL ADDRESS tj@bumsvilleelectric.com
SI'rE ADDRESS 17404 Glacier Way
TENANT �ontinental Properties SUITE NO. BUlldlnq 1
THE APPLIANT IS: ❑RESIDENT OWNER �CONTRACTOR
NAME Continental 484 Fund LLC
RESIDENT OWNER �D�ss W134 N8675 Executive Parkway
CI'I'Y Menomonee Falls s'rATE WI zIP 53051
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME eurnsville Electric LICENSE#EA 000342
CONTRACTOR ADDRESS 14340 County Rd 5
Company name must be as CITY Bumsville STATE MN ZIp 55360
appears on State License OFFICE PHONE# FAX#
CONTACT NAME T�akubic PHONE 952 435 9062
❑SINGLEFAMILY �MUI.,TI-FAMILY ❑SWIMMINGPOOL
❑TWO FANIILY ❑COMMERCIAL/INDUSTRIAL ❑iJNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACTURED HOME []FIRE ALARM POWER
❑Meter Bank (Contractor Only) []SIGN
❑Single Meter ❑�STTTUTIONAL �OTHER(see description)
Residential Additionl Remodel Permits Available on-line
TYPE OF WORK m�W ❑��ITION ❑ALTER/REMODEL
❑MAINTENANCE/REPAIR ❑TENANT FINISH ['DEMOLITION
Only Licensed Electrical Contractors can do work in a Town6ouse that has meter bank instead of siogle meters attached to the units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
I�FTAII Fn I�FSC;RIPTI[�N (�F l/VnRK• Riiilrlin�1 fnr�artmant r,pmnlaY
RESIDENTIAL FEES:
New Construction; $135.00+$1.00 State Surcharge (up to three trips)
Repairs: $40.00+$1.00 5tate Surcharge (one trip)
Additions,Remodel,Lower Level: $70.00+$1.00 State Surcharge (two trips)
C�n��'RC�I.FEEs: Minimum of$40.00+$1.00 State Surcharge(one trip}—Remodel Minimum$70.00+$1.00 State Surcharge(two trips)
70B COST: $ 168,000.00 Example:$12,000 Job Cost
1-U2%ofcontract costup to$10,000 $150.00 $10,000.00 x 1.5%= $150.00
1%ofcostabove$10,000plussurcharge + $1,580.00 $ 2,00O.00x1% _ + 20.00
(Surcharge=Contract Cost x.0005) + $$4.00 $12,000 x.0005 = + 6.00
TOTAL = $1,814.00 = 5176.00
I hereby apply for an electrical permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Lakeville and with the Minnesota Electrical Act;that I understand this is not a permit
but only an application for a permit and work is not to start without a permit;that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
NAME OF APPLICANT(Please Print) TJ Jakubic
SIGNATURE OP APPLICANT:
'PLEASE NOTE: SEPARATE PERMITS e1RE ItEQIJIRED FOR ANY BUILDING,IVIECHi1NICAL&PLiI1NiEIlYG WORK