HomeMy WebLinkAboutLA185295 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA185295
Lakeville,MN 55044
(952)985-4440 * L Fl 1 8 5 Z 9 5 �K
www.ci.lakeville.mn.us Date Issued• 10/26/2020
Site Address: 16099 Cedar Ave
Lot: Block: Addition:
PID: �
Use:
* �K
Description:
Sub Type: CommerciaUIndustrial Addn/Rmdl
Work Type: Alter/Remodel
Description: Electrical Pole for Cell Service
Comments:
Fee Summary' Description Amount Revenue Code
EL-Commercial Addn/Rmdl $82.50 1000-4167
Valuation: 5,500.00 Surcharge-Based on Valuation $2.75 1000-2127
Total: $85.25
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Contractor: - Applicant - Owner:
Premise Inc
4024 N Washington AVe
Minneapolis MN 55412
(612)850-0089
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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ELECTRICAL PERMIT APPLICATION �
Permit Numb�'r
CITY OF LAKEVILLE �(,(,{ ,�
� R � BUILDING INSPECTIONS DEPARTMENT -1��gy
/ 20195 HOLYOKE AVENUE
LAKEVILLE,MN 55044 �� '����
952-985-4440 Date Received
www.lakevillemn.�;ov 0 � ���
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Fee Total �
DATE 10/22/2020 YOUR E-MAIL ADDRESS w�ato(a�premiseco.com
SiTE.�DDREss 16099 Cedar Ave S Lakeville,MN 55124
TENANT SUITE NO.
THE APPLIANT IS: �RESIDENT OWNER mCONTRACTOR
NAME
RESIDENT OWNER �DRESS
CITY STATE ZIP
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Premise, Inc LICENSE#EA709349
Co1vTRACTolt �D�SS 4024 N Washington Ave
Company name mustbe as CITY Minneapolis STATE MN ZIP 55412
appears on State License OFFICE PHONE# 612-216-1850 FAX#
CONTACT NAME Will Lato PHONE 612-274-6651
❑SINGLE FAMILY ❑MULTI-FAMILY ❑SWIMMING POOL
❑TWO FAMILY m COMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACTURED HOME �FIRE ALARM POWER
�M��B� (Contractor Only) �SIGN
❑Single Meter ❑�STITUTIONAL QOTHER(see description)
Residential Addition/Remodel Permits Available on-llne
TYPE OF WORK mNEW ❑ADDITION �ALTER/REMODEL
❑MAINTENANCE/REPAIR ❑TENANT FINISH �DEMOLITION
Only Licensed Electrical Contractors can do work in a Town6ouse that has meter bank instead of single meters attached to the units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
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RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surcharge (up to three trips)
Repairs: $40.00+$1.00 State Surcharge (one trip)
Additions,Retnodel,I,ower Level: $70.00+$1.00 State Swcharge (two trips)
C�MT'IERCIAI.FEES: Minimum of$40.00+$1.00 State Surcharge(one trip)—Remodel Minimum$70.00+$1.00 State Sarcharge(two trips)
JOB COST: $5,500.00 Example:$12,000 Job Cost
1-1/2%of contract cost up to$10,000 $82.50 $10,000.00 x 1.5%= $150.00
1%of cost above$10,000 plus surchazge + $ 2,000.00 x 1% _ + 20.00
(Swcharge=Contract Cost x.0005) + 2.75 $12,000 x.0005 = + 6.00
TOT.�. _ $85.25 = $176.00
I hereby apply for an electrical peimit and I acknowledge that the information above is complete and accurate; that the wark will be in
conformance with the ordinances and codes of the City of Lakeville and with the Minnesota Electrical Act;that I understand tlus is not a permit
but only an applicarion for a permit and work is not to start without a peimit;that the work will be in accordance with the approved plan in the
case of all work wluch requires review and approval of plans.
NAME OF APPLICANT(Please Print) WIII LatO
SIGNATURE OF APPLICANT: !N(,O�
PLEASE NOTE: SEPARATE PERMITS rYRE REQUIRED FOR ANY BUILDING,MECHANICAL&PLiJ&IBING WOItK