HomeMy WebLinkAboutLA176620 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA176620
Lakeville,MN 55044
(952)985-4440 * L R 1 7 6 6 2 0 *
www.ci.lakeville.mn.us Date Issued• Ol/10/2020
Site Address: 17408 Glacier Way
Lot: Block: Addition:
PID:
Use: Bldg 2
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Description:
Sub Type: Temporary Service
Work Type: New
Description:
Comments:
Fee Summary: Descri tn ion Amount Revenue Code
Electrical Addition/Remodel Fees $40.00 1000-4167
Surcharge- $1.00 $1.00 1000.2127
Total: $41.00
Contractor: - Appli�ant - 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 Issued By: Signature
ELECTRICAL PERMIT APPLICATION �ce use only
I��.a� ►�0
Permit Number
� CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT Rec ived By
� "' 20195 HOLYOKE AVENLJE
LAKEVILLE,MN 55044 ,���"r�
952-985-4440 Date Received �
wwryv.lakevillemn.gov 0.00�
Fee Total ,
DATE 1/9/2020 YOUR E-MAIL ADDRESS tj@bumsvilleelectric.com
SITE ADDRESS 17408 Glacier WaV
TENANT Continental Properties SLJITE NO. BUIId111Q 2 ✓
THE APPLIANT IS: ORESIDENT OWNER �CONTRACTOR
NAME Continental Properties
RESIDENT OWNER �DRESS
CITY STATE ZIP
DAYTTME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Bumsville Electric LICENSE#EA 000342
CONTRACTOR ADDRESS 14340 County Rd 5
Company name must be as CITY Bumsville STAT'E ti1� ZIP 55360
appears on State License OFFICE PHONE# FAX#
CONTACT NAME Tj Jakubic pgp�952 435 9062
❑SINGLE FAMILY ❑MULTI-FAMILY ❑S WIMMING POOL
❑TWO FAMILY ❑COMMERCIAL/INDUSTRIAL ❑i1NDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑IVIANUFACTURED HOME �FIRE ALARM POWER
❑Meter Bank (Contractor Only) �SIGN
❑Single Meter ❑�STTTUTTONAL mOTHER(see description)
Residential Addition/Remodet Permits Available on-line
TYPE OF WORK mNEW QADDITTON ❑ALTER/REMODEL
❑MAINTENANCE/REPAIR ❑TENANT FINISH ❑DEMOLITTON
Only Liceased Electrical Contractors can do work in a Townhouse that has meter bank instead of single meters attached to the units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
IIFTAIi Fll I'�FS(:RIPTInN (lF ln/(�RK• Riiilriinn 7 Tam�pr�Sar•ijra
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surchazge (up to three trips)
Repairs: $40.00+$1.00 State Surcharge (one trip)
Additions,Remodel,Lower Level: $70.00+$1.00 State Surcharge (two trips)
CON�'TERCIE�1.F'EE$: Minimum of$40.00+$1.00 State Surcharge(one trip}—Remodel Minimum$70.00+$1.00 State Surcharge(lwo trips)
JOB COST: $40 Exampie:$12,000 Job Cost
1-1/2%of contract cost up to$10,000 $40.00 $10,000.00 x 1.5%= $150.00
1%of cost above$10,000 plus surcharge + $ 2,000.00 x 1% _ + 20.00
(Surcharge=Contract Cost x.0005) + $1.00 $12,000 x.0005 = + 6.00
TOTAL = $41.00 = $176.00
I hereby apply for an electricat permit and I acknowledge that the information above is compiete 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 undeistand 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 OF APPLICANT:
PLEASE NOTE: 3EPARATPs PTItMITS ARE A�QUItiED FOR ANY BL7ILBING,M�CFfANiC�cL&PL,UMBING WO12K