HomeMy WebLinkAboutLA177071 PERMIT
City Of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA177071
Lakeville,MN 55044
(952)985-4440 �K L R 1 7 7 f� 7 1 �K
www.ci.lakeville.mn.us Date Issued• Ol/30/2020
Site Address: 9574 217th St W
Lot: Block: Addition:
PID: �
Use: QA 1
* *
Description:
Sub Type: CommerciaUIndustrial Addi�/Rmdl
Work Type: Alter/Remodel
Description: Control wiring for gardener monotube machine
Comments:
Fee Summary: Descri tion Amount Revenue Code
EL-2 Trips $70.00 1000-4167
Surcharge- $1.00 $1.00 1000.2127
Total: $71.00
Contractor: - Applic�,t - Owner:
Prairie Electric Company Inc
6595 Edenvale Blvd# 120
Eden Prairie MN 55346
(952)949-0074
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
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„ n ELECTRICAL PERMIT APPLICATION I�"��,-,;
�„k, Perm t u�
CITY OF LAKEVILLE `
BiJILDING INSPECTIONS DEPARTMENT eceived By
20195 HOLYOKE AVENUE ��� ��
LAKEVILLE,MN 55044
952-985-4440 � Date Received
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Fee Total
DATE 1/13/2020 YOUR E-MAIL ADDRESS frontdesk(a�prairieelectric.com
SITE ADDRESS 9574 217TH STREET WEST
TENANT QA1 PRECISION PRODUCTS SUITE NO.
Tf-IE APPLIANT IS: �RESIDENT OWNER �CONTRACTOR
NAME QA1 PRECISION PRODUCTS
RESIDENT OWNER ADDRESS 9574 217TH STREET WEST
C�TY L/\KEVILLE STATE iUN ZIP 55044
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Prairie Electric Co Inc LICENSE#EA 001452
CONTRACTOR ADDRESS 6595 Edenvale Blvd#120
Company name must be as CIT'Y Eden Prairie STATE MN ZIP 55346
appears on State License oFFICE PHONE# 952-949-0074 FAX#
CONTACT NAME PHONE
❑SINGLE FAMILY ❑MtJI,TI-FAMILY ❑S WIMMING POOL
❑TWOFAMILY mCOMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACTURED HOME �FIRE ALARM POWER
❑Meter Bank (Contractor Only) �SIGN
❑Single Meter ❑�STITUTIONAL []OTHER(see description)
Residentral Addition/Remodel Permits Available on-line
TYPE OF WORK mNEW ❑ADDITION []ALTER/REMODEL
❑MAII�TTENANCE/REPAIR ❑TENANT FINISH �DEMOLITION
Only Licensed 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.
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RESIDENTIAL FEES: 1 c
New Construction: $135.00+$1.00 State Surcharge (up to three trips) �1 '� a �J �
Repairs: $40.00+$1.00StateSurcharge (onetrip) �p�'�'� �A� � g ��
Additions,Remodel,I.ower Level: $70.00+$1.00 State Surchazge (two trips) ��,11,�I1./ �'�
C��'l1�ERCIt�I.FEEs: Minimum of$40.00+$1.00 State Surcharge(one trip)---Remodel Minimum$70.00+S1.00 State Surcharge(two trips)
JOB COST: $ Example:$12,000 Job Cost
1-1/2%ofcontract cost up to$10,000 $10,000.00 x 1.5%= $150.00
1%ofcost above$10,000 plus surcharge + $ Z,000.00 x 1% _ + 20.00
(Surcharge=Contract Cost x.0005) + $12,000 x.0005 = + 6.00
TO'i'AL = � 7(�/ _ $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) Brian Summerville �U�
SIGNATURE OF APPLICANT:
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