HomeMy WebLinkAboutLA176617 PERMIT
City of Lakeville re�nit Type: Electrical
20195 Holyoke Ave Permit Number: LA176617
Lakeville,MN 55044
(952)985-4440 * L A 1 7 6 6 1 7 *
www.ci.lakeville.mn.us Date Issued• Ol/10/2020
Site Address: 17444 Glacier Way
Lot: Block: Addition:
PID:
Use: Bldg 6
* *
Description:
Sub Type: Temporary Service
Wark Type: New
Description:
Comments:
Fee Summary: Description Amount Revenue Code
Electrical Addition/Remodel Fees $40.00 1000-4167
Surcharge- $1.00 $1.00 1000.2127
Total: $41.00
Contractor: - Appli�a,,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.
,
Applicant/Permitee: Signature ssued y: Signature
ELECTRICAL PERMIT APPLICATION �. oi�ice Use Only
-�umbi ei_�
CITY OF LAKEVILLE
BUILDING INSPBCTIONS DEPARTN�NT
• � 20195 HOLYOKE AVENUE R eived By
LAKEVILLE,MN 55044 � U Ot/
952-985-4440 �Date Received
www.lakevillemn.�ov O.OU�''�"� �-�
Fee Total
DATB 1/9/2020 YOUR E-MAIL ADDRESS tjQbumsvilleelectric.com
SITE ADD1tEss 17444 Glacier Wav
T'ENANT Continental Properties SUITE NO. BUIIdltlq 6�
THE APPLIANT IS: �RESIDENT OWNER �CONTRACTOR
NAME Continental Properties
RESIDENT OWNER �DRESS
CITY STA'I'E ZIP
DAYTIME PHONE#WFiERE YOU CAN BE REACHED
COMPANY NAME Bumsville Eiectric LICENSE#EA 000342
CONTRACTOR ADDRESS 14340 County Rd 5
Company name must be as CITY 8umsvitle STATE MN Zjp 55360
appears on State License OFFICE PHQNE# FAX#
CONTACT NAME Tj Jakubic PHONE 952 435 9062
❑SINGLE FAMILY ❑MLIf�TI-FAMILY ❑SWIMMING POOL
❑TWO FAMILY ❑COMMERCIAL 1 INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACTtJRED HOME �FIRE ALARM POWER
❑Meter Bank (Contractor Only) �SIGN
❑Single Meter ❑INSTITCJTIONAL mOTHER(see description)
Residential Addition/Remodel Permits Availabde on-line
TYPE OF WORK mNEW ❑ADDITION QALTER!REMODEL
❑MAINTENANCE/REPAIR ❑TENANT FINISH �DEMOLITION
Only Licensed Electrical Contractors can do work ia a Townhoase that has meter bank instead of single meters attached to t6e units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
t'IFTAII FI� I�FSC:RIPTI(1N C1F WC1RK• R��il�n��am�ypr3��rvi�
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surcharge (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)
COl�'11�2�'RCIL�II.F�'�+S: Minimum of$40.00+$1.00 State Surcharge(one tripy--Remodel Minimum$70.00+$1.00 State Surcharge(two trips)
JOB COST: $40 Example:$12,000 Job Cost
1-1i2%of contract cost up to$10,000 $40.00 $10,000.00 x 1.5°/a= $150.00
1%of cost above$10,000 plus surcharge + $ 2,000.00 x 1% = + 20.00
(Surcharge=Contract Cost x.OQOS) + $1.00 $12,000 x.0005 = + 6.00
TOTAL = $41.00 = $176.00
I hereby apply for an electrical permit and I acknowledge that the information above is complete and accurate; that the work will be in
confarmance with tfie ordinances and codes of the City of Lakeville and with the Minnesota Electrical Act;that I understand this is not a permit
but only an application for a permit and wark is not to start without a permit;that the work wili be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
NAME OF APPLICANT(Piease Print) T,!Jakubic
SIGNATURE OF APPLICANT:
PLEASE NOTE: S�Pt1RATE 1'ERMITS ARE REQUIRED FOR ANY$UILDING;ME�HAIYICAL&PLUMBING VYORK'