HomeMy WebLinkAboutLA176616 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA176616
Lakeville,MN 55044
(952)985-4440 �K L R 1 7 6 6 1 6 *
www.ci.lakeville.mn.us Date Issued: O1/10l2020
Site Address: 17452 Glacier Way
Lot: Block: Addition:
PID:
Use: Bldg 4 * *
Description:
Sub Type: Temporary Service
Work Type: New
Description:
Comments:
Fee Summary' Descrintion Amount Revenue Code
Electrical AdditionlRemodel Fees $40.00 1000-4167
Surcharge- $1.00 $1.00 1000.2127
Total: $41.00
Contractor: - appticant - 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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ApplicantlPermitee: Signature -'-Issued By: Signature
, Office Use Only
ELECTRICAL PERMIT APPLICATION � "
Pe nm�
CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT eived B
/ � � 20195 HOLYOKE AVENUE (_ �O f-�
LAKEVILLE,MN 55044 AV
952-985-4440 Aate Received
www.lakeviilemn.gav 0.00��"� ���
Fee Total
DATE 1/9I2020 YOUR E-MAIL ADDRESS tj@bumsvilleelectric.com
SITE ADDItEss 17452 Glacier Wav
T'ENANT Continental Properties SITIT'E NO. BUildinq 4`✓
THE APPLIANT IS: ORESIDENT OWNER �CONTRACTOR
NAME Continental Properties
RESIDENT OWNER �DRESS
CITY STATE ZIP
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Bumsville Electric LICENSE#EA 000342
CONT'RACTOR ADDRESS 14340 County Rd 5
Company name must be as CITY gumsvil{e STATE�� ZIP 55360
appears on State License OFFICE PHONE# FAX#
CONTACT NAME Tj Jakubic PHONE 952 435 9062
❑SINGLE FAMILY ❑MULTI-FAMILY ❑SWIMMING POOL
❑TWO FAMILY ❑COMMERCIAL/INDUSTRIAL ❑tJNDEFINED
PERMIT TYPE
❑TOWNHOUSB ❑MANUFACTURED HOME �FIRE ALARM POWER
❑Meter Bank (Contractor Only) �SIGN
Sin le Meter ❑�STTT[JTTONAL
❑ g mOTHER(see description)
Residential Additionl Remodel Permits Available on-line
TYPE OF WORK m�W ❑�DITION �ALTER/REMODEL
❑MAINTENANCE/REPAIR ❑TENANT FII�tISH QDEMOLITION
Only Licensed Electrical Contractors can do work in a Townhouse that has meter bauk instead of single meters attached to the units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
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RESIDENTIAI,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 triQs)
C�MM�'RCIAI,FE�'S: Minimum of$40.00+$1.00 Stete Surcharge(one trip)--Remodel Minimum$70.00+$1.00 State Surcharge(two trips)
JOB COST: $40 Egample:$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%ofcost 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 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 OF APPLICANT:
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED EOR ANY�UILD)NG;MECIIANICAL&c PLIJMBING WORK