HomeMy WebLinkAboutLA186351 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA186351
Lakeville,MN 55044
(952)985-4440 �K L R 1 8 6 3 5 1 �K
www.ci.lakeville.mn.us Date Issued• 11/19/2020
Site Address: 17261 North Creek Dr
Lot: 000 Block: 003 Addition: Section 11 Twn 114 Range 20
PID: 22-01100-03-012
Use: �KZZ - 0 1 1f�Jf0 - 03 — fd 1z *
Description:
Sub Type: Res Addition/Remodel
Work Type: Alter/Remodel
Description: Bathroom remodel
Comments:
Fee Summary' Description Amount Revenue Code
EL-Residential Addition/Remodel $70.00 1000-4167
Surcharge- $1.00 $1.00 1000.2127
Total: $71.00
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Contractor: - Appli�ant - Owner:
Shortstop Electric North Creek Co
16481 Flintwood ST NW %W R Block
Andover MN 55304 369 Kellogg Blvd E
(763)434-7742 Saint Paul MN 55101--141
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
Office U5e Only
ELECTRICAL PERMIT APPLICATION ��,� ?�G��
(�,�i'�� Pcrmrt Numbcr
CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT �"�"`" �'���"�
20195 HOLYOKE AVENUE Received By
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LAKEVILLE,MN 55044 '1 ' ���" L-v
952-985-4440 Date Received
www.lakevillemn.ao�� 0.00�'��
Fee Total
DATE 11/16/2020 YOUR E-MAIL ADDRESS shortstopelectric an,comcast.net
SITE�DREss 17261 N Creek Drive
TENANT SUITE NO.
THE APPLIANT IS: �RESIDENT OWNER OCONTRACTOR
1van�1E Next Day Access (John)
RESIDENT OWnrEtt �D1�,ss Same as above
CITY STATE Z1P
DAYTIIviE PHONE#WHERE YOU CAN BE REACHED 651-755-3809
COMPANY NAME ShOrtstOp EleCtriC LICENSE#EA001670
CONTRACTOR ADDRESS 16481 Flintwood St. NW
Company name must be as Ci� Andover STA�MN z�P 55304
appears on State License OFFICE PHO1vE# 763-434-7792 FAX#
CONTACT NAME Bob BoVum PHONE
QSINGLEFAMILY ❑MULTI-FAMILY ❑SWIMMINGPOOL
❑TWO FAMILY ❑COMMERCIALI[NDUSTR[AL ❑UNDEFINED
PERMIT TYPE
❑TOWNi�OUSE ❑MANL7FAC'TURED HOME �FIRE ALARM POWER
❑Mecer Bank (�ontractor Only) �SiGN
❑Single Meter ❑�STITUTIONAL �OTHER(see aescription)
ResideniiaZAddition/Remodel Permiis Avuitable on-line
❑NEW ❑ADDiTiON DALTER/REMODEL
TYPE OF WORK
❑MAINTENANCE/REPALR ❑TENANT FINISH ODEMOLITION
Only Licensed Electrical Contractors can do work in a Townhouse that has meter bank instead oi'single meters attached to the units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
DETAILED DESCRIPTION OF WORK: Bathraom remodel
RESIDENTIAL FEES:
New ConstrucHon: $135.00+$1.00 State Surcharge (up to three trips)
Repairs: $40.00+$l.00 State Surcharae (one trip)
Additions,Remodel,Lower Le�•el: $70.04+$1.00 State Surcharge (two trips)
COIVIMERCIAI.FEES: Minimum of$40.00+$L00 State Surcharge(one trip)--Remodel Minimuro$7D.00+51.00 State Surcharge(two trips)
JOB COST: $ Example:$12,000 Job Cost
1-1/2%of contract cost up to$10,000 $l0,Ofl0.00 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) + $12,000 x.0005 — + 6.00
TOTAL = $O.OQ = $176.00
I hereby apply for an electrical permit and I acknowledge tCiat the intormation above is complete and accurate; that the work will Ue in
conformance with the ordinances and codes of che Ciry of Lakeville 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 Gvill 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) BO
� SIGNATURE OF APPLICANT:
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TYPE OF WORK 1NSPECTIONS
NEW � F1NAL �
ADDITION [� FIRE ACCEPTANCE TEST ��
ALTER/REMODEL [-� IN FOOR HEAT �
ROUGH-iN r�
SERVICE 0
TRENCH �,
PERMIT FEE
PERMIT FEE: $
SURCHARGE: $
OTHER: $
TOTAL: $ 0.00
PERMIT ISSUED BY: DATE:
COMMENTS: