HomeMy WebLinkAboutLA177740 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA177740
Lakeville,MN 55044
(952)985-4440 * L Fl 1 7 7 7 4 PJ �K
www.ci.lakeville.mn.us Date Issued: 03/02/2020
Site Address: 17400 Glacier Way
Lot: Block: Addition:
PID:
Use: Spring at Lakeville * *
Description:
Sub Type: CommerciaUIndustrial Addn/Rmdl
Work Type: Alter/Remodel
Description: Install fire alarm system
Comments:
Fee Summary: Description Amount Revenue Code
Valuation: 6,000.00 EL-Commercial Addn/Rmdl $90.00 1000-416'7
Surcharge-Based on Valuation $3.00 1000-2127
Total: $93.00
Contractor: - appiicant - Owner:
Chamberland Fire
15510 Cornell Tr
Rosemount MN 55068
(651)322-5024
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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Office Use Only
ELECTRICAL PE T APPLICATION �_� 'J�.�}1,
Permrt Number
CITY OF LAKEVILLE � ��`
BUILDING INSPECTIONS DEPARTMENT � '"`� � � ��`�C���
20195 HOLYOKE AVENUE Received By
LAKEVILLE,MN 55044 �� L ` f��'
952-985-4440 Date Received
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Fee Total �
DaTE 2/27/20 YouR E-lviaiL ADD�ss MChamberland(c�ChamberlandFire.com
S�'rE AnD1�ss 17400 Glacier Way
TENANT Sprinqs at Lak@ville SUITE NO.
THE APPLIANT IS: ❑RESIDENT OWNER ✓❑CONTRACTOR
NAME
RESIDENT OWNER ADDRESS
CITY STATE ZIP
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAMEChaI11b2f1811d Fife& SBCUI'Ity, Inc. LICENSE#EATS657041
CONTRACTOR ADDRESS 15510 Cornell Trail
Company name must be as ci'rY Rosemount STATE�VIN zlP 55068
appears on State License OFFICE PxONE# (651)322-5024 FAX# (651) 322-5024
CONrAC'r NaME Mark Chamberland Pxo1vE(651) 322-5024
❑SINGLE FAMILY �MULTI-FAMILY ❑S WIMMING POOL
❑TWO FAMILY ✓❑COMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACTURED HOME �FIRE ALARM POWER
❑Meter Bank (Contractor Only) �SIGN
❑Single Meter ❑INSTITUTIONAL �OTHER(see description)
ResidentialAddition/Remodel Permits Available on-line
�NEW ❑ADDITION ❑ALTER/REMODEL
TYPE OF WORK
❑MAINTENANCE/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.
Install fire alarm system.:
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surcharge (up to three trips)
Repairs: $40.00+$1.00 State Surcharge (one trip)
Addirions,Remodel,Lower Level: $70.00+$1.00 State Surcharge (two trips)
COIVJM�'RC�II.FE�'S: Minimum of$40.00+$1.00 State Surcharge(one trip)---Remodel Minimum$70.00+$1.00 State Surcharge(two trips)
JOB COST: $6,000.00 Example:$12,000 Job Cost
1-1/2%of contract cost up to$10,000 $90.00 $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) + $3.00 $12,000 x.0005 = + 6.00
TOTAI, _ $93.00 = $176.00
I hereby apply for an e(ectrical 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) Mark Chamberland ,, �-�� �f '� ��!�-�"�'
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