HomeMy WebLinkAboutLA184525 PERMIT
City Of LakeVille Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA184525
Lakeville,MN 55044
(952)985-4440 * L R 1 8 4 5 Z 5 *
www.ci.lakeville.mn.us Date Issued• 09/30/2020
Site Address: 20612 Dodd Rd
Lot: Block: Addition:
PID:
Use: MN Energy
* *
Description:
Sub Type: CommerciaUIndustrial Addn/Rmdl
Wark Type: Alter/Remodel
Description: 1 circuit pole mounted electrical service for utility
equip
Comments:
Fee Summary: Description Amount Revenue Code
Valuation: 1,725.00 Electrical Commercial(Minimum) $40.00 1000-4167
Surcharge- $1.00 $1.00 1000.2127
Total: $41.00
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Contractor: - applicant - Owner:
Midbrod Electric
5627 Memorial Ave N
Stillwater MN 55082
(651)351-5074 X7
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
�� ELECTRICAI.PERMIT APPLICATION .�ce use only
. ���.��
Permit Number *
CITY OF LAKEVILLE � ��� � r , ���J
BIJILDING INSPECTIONS DEPARTMENT Received B T
� ; 20195 HOLYOKE AVENtTE �_ y
LAKBVILLE,MN 55044 �„� " '1�� ��
952-985-4440 Date Received
www.lakevillemn.�ov 0.00`�Lfi���
Fee Total
DA� 9/28/2020 YOUR E-MAIL ADDRESS dmidbrod(a�comcaSt.net
S�TE ADDRESS 20612 Dodd Rd., Lakeville, MN
TEN�vT Minnesota Enerqv Resource Sul'rE 1vo.
THE APPLIANT IS: ORESIDENT OWNER OCONTRACTOR
NAME
RESIDENT OWNER �DRESS
CITY STATE ZIP
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY N�E Midbrod Electric, inc. LICENSE#EA 001234
CONTRACTOR �n�ss 5627 Memoriai Ave. N
Company name must be as CITI' St111WateP sTA�MN zIP 55082
appears on State License oFFiCE PHOrtE# 651-351-5074 FAX# 651-351-5075
CONTACTNAME Debbie Junker PHONE651-351-5074
❑SINGLE FAMILY ❑MULTI-FAMILY ❑SWIMMING POOL
❑TWO FAMILY ❑✓COMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACTURED HOME �FIRE ALARM POWER
❑Meter Bank t�ontractor Only) �SIGN
❑Single Meter ❑INSTITU'TIONAL �OTHER(see description)
Residential Addition/Re»wdel Permits Available on-line
TYPE OF WORK �N�W ❑�DITION �ALTER/REMODEL
❑MAINTENANCE/REPAIR ❑TENANT FINISH �DEMOLITION
Onty Licensed Electrical Contractors can do work in a Townhouse that has meter bank instead of single meters attached W the units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
DETAILED DESCRIPTION OF WORK: 1 circuit pole mounted electrical service for utility equipment-
Minnesota Energy esource
RESIDENTIAL FEES:
New Consiruction: $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 Surcharge (two trips)
COMMERCIAL FEES: M�otmam or sao.00+s1.00 State Surcharge(one trlp}—Remodel Minimum 570.00+$1.00 Skate Surcharge(two Mps)
JOB COST: $1,725.00 Example:512,000 Job Cost
1-1/2%of contract cost up to$10,000 $40.00 $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) + $1.00 $12,000 x.0005 – + 6.00
TOTAL -�41.00 J = $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 applicarion for a permit and work is not to start without a pernut;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) K�iSt ' brod
SIGNAT'URE OF APPLICANT: tr
l�il9�1V�TL;x5�'PA�A'�1'��MiTS'Att�`�2�`.Q[�IREb`�R A2V7.'� CHAhfIC�S.'�c llLUl�!$11VCi W()RK