HomeMy WebLinkAboutLA177790 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA177790
Lakeville,MN 55044
(952)985-4440 �K L A 1 7 7 7 9 0 �K
www.ci.lakeville.mn.us Date Issued• 03/04/2020
Site Address: 17444 Glacier Way
Lot: Block: Addition:
PID: �
Use: Springs of Lakeville * *
Description:
Sub Type: CommerciaUIndustrial
Work Type: New
Description: Building#6
Comments:
Fee Summary: Description Amount Revenue Code
Valuation: 158,000.00 EL-CommercialAddn/Rmdl $1,630.00 1000-4167
Surcharge-Based on Valuation $79.00 1000-2127
TotaL• $1,709.00
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.
�� .L. �
Applicant/Pertnitee: Signature Issued By: Signature
_ "+�
ELECTRICAL PERMIT APPLICATION y�c�seOnly �
L � - 1
Permit Number
� CITY OF LAKEVILLE
� BUILDING INSPECTIONS DEPARTMENT �`�'�
� � Received By
/" 20195 HOLYOKE AVENiJE ,• a
LAKEVILLE,MN 55044 � � � �V
952-985-4440 Date Received
wtivw.lakevillemn,�ov OAO`'�� � �
'3�� � Fee Total
DATE � YOUR E-MAIL ADDRESS tj�bumsvilleelectric.com
SITE ADDRESS 17444 Glacier Way
'T'ENANT Continental Properties SUITE NO. BUIIdlllq 6
THE APPLIANT IS: ORESIDENT OWNER mCONTRACTOR
N�v1E Continentat 484 Fund LLC
RESIDENT OWNER ADDRESS W134 N8675 Executive Parkway
CITY Menomonee Falls STATE WI zIP 53051
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAN1E Bumsville Electric LICENSE#EA 000342
CONTI2ACTOR ADDRESS 14340 County Rd 5
Company name must be as CITY Bumsville STATE MK ZIP 55360
appears on State License OFFICE PHONE# FAX#
CONTACT NAME Tj Jakubic PHONE 932 435 9062
❑SINGLE FAMILY m MULTI-FAMILY ❑SWIMMING POOL
❑TWO FAMILY ❑COMMERCIAL/INDUSTRIAL ❑LJNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANtJFACTURED HOME �FIRE ALARM POWER
❑Meter Bank (Contractor Only) �SIGN
❑Single Meter ❑INSTTTUTTONAL mOTHER(see description)
Residentral Addition/Remodel Permits Available on-line
TYPE OF WORK mNEW ❑ADDITION �ALTER/REMODEL
❑MAINTENANCE/REPAIR ❑TENANTFINISH �DEMOLITION
Only Licensed Etectrical Contractors can do work in a Townhouse that has meter bank instead of single meters attac6ed to the units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
RETAIf Fil n�S�RIPTInAI nF 1NQRK• R�iilriing#F fnr a an rtmPn{�nm�Y
RESIDENTIAI.FEES:
New Construction: $135.00+$1.00 State Surcharge (up to three trips)
Repairs: $40.00+$1.00 State Surchazge (one trip)
Additions,Remodel,Lower Level: $70.00+$1.00 State Surchazge (two trips)
COMM�'RCT��.F�'�'S: Minimum of$40.00+$1.00 Sfate Surcharge(one trip}--Remodel Miuimum$70.00+$1.00 State Surcharge(two trips)
JOB COST: $ 158,000.00 Example:$12,000 Job Cost
1-1/2%of contract cost up to$10,000 $150.00 $10,000.00 x 1.5%= $150.00
1%of cost above�10,000 plus surcharge + $1,480.00 $ 2,000.00 x 1% _ + 20.00
(Surcharge=Contract Cost x.0005) + $79.00 $12,000 x.0005 = + 6.00
TOTAL = $1,709.00 = $176.00
I hereby apply for an elech-ical 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 Lakevitle 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 wili be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
NAME OF APPLTCANT(Please Print) TJ Jakubic
SIGNATURE pF APPLICANT:
FLEt1SE NOTE: SEPARATE PERMITS ARE REQUIRED FOIi ANY BUILDING;MECI3ANICAL&PLUMBING WORI�