HomeMy WebLinkAboutLA179434 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA179434
Lakeville,MN 55044
(952)985-4440 * L R 1 7 9 4 3 4 *
www.ci.lakeville.mn.us Date Issued• OS/07/2020
Site Address: 17400 Glacier Way
Lot: Block: Addition:
PID:
Use: Springs of Lakeville * *
Description:
Sub Type: CommerciaUIndustrial
Work Type: Alter/Remodel
Description: Garage#4
Comments:
Fee Summary: Description Amount Revenue Code
EL-Commercial Addn/Rmdl $75.00 1000-4167
Valuation: 5,000.00 Surcharge-Based on Valuation $2.50 1000-2127
Total: $77.50
Contractor: - Appl;�a,,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.
���Y.
�, ���� V
Applicant/Permitee: Signature Issued By: Signature
, Of'fice Use Only
ELECTRICAL PERMIT APPLICATION ( �-��l-} '-•, _�-
� Permit Number
CITY OF LAKEVILLE .--.
BUILDING INSPECTIONS DEPARTMENT �```� ~ � '� r
/ � "� 20145 HOLYOKE AVENUE Receive3 By
Lr,KEVILLE,MN 55044 �� �" � L�i
952-985-4440 Date Received
ww�lakevil(emn,eov �?
o.00��-�
Fee ToYal
DATE 5/7/2020 YOUR E-MAIL ADDRESS tj@burnsvilleelectric.com
SITE aDDRESs 17400 Glacier Wav
TENANT Continental Properties SUITE NO.
THF,APPLIANT IS: []REStDF.NT OWNER �CONTRACTOR
NAME Continental 484 Fund LLC
xESIDENT Ow1vER ADDRESS W134 N8675 Executive Parkwav
CtTY Menomonee Falls s'rA'rF Wi ziP 53051
DAYTIME PHONE#WHERE YOU CAN BE REACHED
CaMPANY NAME Bumsville Electric LICENSE#EA 000342
CONTRACTOR ADDRESS 1434Q County Rd 5
Company name must be as CITY Burnsville STATE �N ZIP 55360
appears on State License OFFICE PHONE# FAX#
CONTACT NAMF,Tj Jakubic PHONE 952 435 9062
❑SINCLEFAMILY mMULTI-FAMILY ❑SWIMMINGPOOL
�T'WOFAMILY ❑COMMfiRCIAL/INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACTURED HOME ❑FIRE ALARM POWER
(Contractar Only)
❑Meter Bank �SIGN
❑Si�gle Meter ❑INSTITCTTIONAL �OTHER(see descxiption)
Residential Additiora/Remodel Permits Available on-tine
TYPE OF WORK �NE W ❑ADllTTTON �ALTER/REMODEL
❑MAINTENANCE/REPAIK ❑TENANT FINISH ❑DEMOLI'ITON
Only Licensed Electrical Contractors cun do work in a Townhouse t6at has meter bank inste�d of single meters attached to the units.
Only Licensed Etectrical Contractors can do work in MannSactured Home Parks.
I�FTAIt FI� I�FS(�R�p11C�N [)F�N(7RK•NP�u C,argg,g#tl fnr a�rtmenfi r.nmp,(pY
RESIDENTTAL FEES:
New Constructio�: $135.00+$1.00 Shate Surcharge (up Co three trips)
Repairs: $40.00+$1.00 State Suroharge (one trip)
Additions,RemQdel,Lower Level: $70.00+$1.00 State Surcharge (two trips)
COMM�'RCT[��.F��+S: Mioimum of$40.00+$1.00 State Sorcharge(one trip�--Remodel Minimum$70.00+$1.00 State Surcharge(two trips)
JOB COST: $ 5,000.00 Example:$12,000 Job Cost
1-1/2%ofcontract cost up to$10,000 $75.00 $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) + $2.50 $12,000 x.0005 = + 6.00
TOTAL = $77.50 = $176.00
I hereby apply for an electrical permit and [ acknowledge that the inf'ormation above is camplete and accurate; that the work will be in
conformance with the ordinances and codes of the Ciry of Lakeville and with the MinnesoCa Electricat 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 wiil 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:
PLEAS�NOTE: SEPA-RATE kERMIfiS ARE REQUIRED FdR ANY BU[LDING,MECHAYICAL&PLtjMBING VS'ORK