HomeMy WebLinkAboutLA179436 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA179436
Lakeville,MN 55044
(952)985-4440 * L R 1 7 9 4 3 6 �K
www.ci.lakeville.mn.us Date Issued• OS/07/2020
5ite Address: 17400 Glacier Way
Lot: Block: Addition:
PID: �
Use: Springs of Lakeville * *
Description:
Sub Type: CommerciaUIndustrial
Work Type: Alter/Remodel
Description: Garage#6
Comments:
Fee Summary: Descri,ption Amoun Revenue Code
Valuation: 5,000.00 EL-Commercial Addn/Rmdl $75.00 1000-4167
Surcharge-Based on Valuation $2.50 1000-2127
Total: $77.50
Contractor: - Appil��,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.
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Applicant/Permitee: Signature Issued By: Signature
Offi�e Use Onl��
ELECTRICAL PERMIT APPLICATION � G.�L..�'7 �
;� Permit Nwnber
�` CITY O�LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT i`� �` ��''
� � � 20195 HOLYOKE AVENUE ( Receivezi By
LAKEVILLF,,MN 55044 -) � � `�L
952-985-4440 Date Received
www.]akevillernn.Qov ��
0.00��-� �
r�To�i�-
DATE 5/7/2020 YOUR E-MAIL ADDRESS tj@burnsvilleelectric.com
STTE ADDREss 17400 Glacier Wav
TENANT Continental Properties SUIT'E NO.
THE APPLIAN'T IS: []RESIDBNT OVdNER mCONTRACTOR
NAMF, Cantinentai 484 Fund LLC
RESIDENTOWNER AD�Iu:Ss W134 N8675 Executive Parkwav
CITv Menomonee �alls S'rA'rE WI ztP 53051
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Bumsville Electric LICENSE#EA 000342
CON'PRACTOR ADDRESS 14340 County Rd 5
Company name must be as C1TY Burnsville STATE MN ZIp 55360
appears on State Lieense OFF[CE PHONE# FAX#
CONTACT NAME Tj Jakubic PHONE 952 435 9062
❑SINGLEFAMILY �MULTI-FAMILY ❑SWIMMINGPOOL
❑TWO FAMILY ❑COMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMI't TYPE
❑TOWNHOUSE ❑MANUFACTUREDHOME QrIREALARMPOWER
❑MeterBank (ContractorOnly) ��IGN
❑Single Meter ❑jNSTITUTIONAL mOTHER(see deseription)
Resddentiat Additionl Remodel Permits Available on-line
TYPE OF WORK mNEW ❑ADDITION �ALTER/REMODEL
❑MAINTBNANCEIREPAIR ❑TENANT FIN1SH ❑DEMOLITION
Only Licensed Electrical Contractors can do work in a Townhoese that has meter bank instead of single meters attached to the uaits.
Ouly Licensed Electrical Contractors can do work in blanul'actured Home Parks.
IlETAI� FI� I�FSCRIPTI(�N C�F V�/(�RK•Na�n,(;ara�a#R fnr��artmpp nmpla�{
RES[DENTIAL FEES:
New Construetion: $135.00+$1.00 StaYe 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)
C�MM�'RCI[�1,I'*EES: Minimum of$40.00+$1.00 State Sarcharge(one trip}--Remodel Minimum$70.00+�7,00 Stete Surcharge(two tripe)
JOB COST: $ 5,000.00 Example:$12,000 Job Cost
1-U2%of contract cose up Yo$10,000 $75.00 $10,000.00 x 1.5%= $150.00
1%of cost above$10,004 plus surcharge + $ 2,000.00 x 1% _ + 20.00
(Surcharge=Contract Cost x.0005) + $2,50 $}2,000 x.0005 = + 6.00
TOTAL = $77.50 = $}76.00
I hereby apply for an electrical permit and 1 acknowledge that the information above is compiete and accurate; that the work will be in
conformance with the ardinances and codes of the City of Lakeville and with the Minnesota Electrical Act;that I understand this is not a permit
but only an applieaYion for a permit atSd work is not to start wiYhout a pennit;that Yhe work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
NAME OP APPLICANT(Please Print) TJ Jakubic
SIGNATURE OF APPLICANT:
PLEASE NOTE: 9EPARATE PERMtTS ARE REQTJIRED FOB ANY BUIL111N(G,MECIiANICAL&PLUMBiPiG W ORK