HomeMy WebLinkAboutLA189446 PERMIT
City Of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA189446
Lakeville,MN 55044 �
(952)985-4440 * L R 1 S 9 4 4 6 *
wwwlakevillemn.gov Date Issued: 04/OS/2021
Site Address: 4984 161st St W
Lot: Block: Addition:
PID: �
Use:
* �K
Description:
Sub Type: Lawn Sprinkler Controller
Work Type: New
Description: Irrigation system for townhome development
Comments:
Fee Summary: Description Amount Revenue Code
EL-Residential 1 Trip $40.00 1000-4167
Surcharge- $1.00 $1.00 1000.2127
Total: $41.00
Contractor: - Appllcant - Owner:
Horizon Electric
21025 Edmonton Ave
Farmington MN 55024
(952)985-8088
I HEREBY AGREE THAT THIS WORK WILL BE PERFORMED ACCORDING TO:(1)TI�APPROVED PLANS&
SPECIFICATIONS;(2)THE APPLICABLE CITY ORDINANCES&CODES;AND(3)THE MN STATE BUILDING CODE.
Please provide a minimum of a 24 hour notice to schedule inspections.BUILDING INSPECTIONS:(952)985-4440,8 am-4:30 pm,M-F
ELECTRICAL INSPECTIONS:Call Brian Grey at(507)381-1791,7-8:30 am,M-F to schedule appointments
Applicant/Permitee: Signature Issued By: Signature
Qffice Use Only
ELECTRiCAL PERMIT APPLICATION ��;C�1���,.�
���. —r--
`�:'�'=r'� Permit Number
CITY OF LAKEVILLE � , �,
BUILDING INSPECTIONS DEPARTMENT �-�
j � ' 20195 HOLYOKE AVENIJE ecerved B
LAKEVILLE,MN 55044 '� '
452-985-0440 ate Received
www.lakevillemn,�ov 0.00��
Submii ta:permitstc�lakevillsmn.qov Fee Toral �
DATE 4-5-2021 YOUR E-MATL ADDRESS leannek{cr�,horizonelectricco.com
SITE ADDRESS 4984 161 St St.W.
TENANT SUITE NO.
THE APPLIANT t5: []RESIDENT OWIVER mCONTRACTOR
NAME
RESIDENT OWNEI2 �DRESS
CITY STATE ZIP
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Horizon Electric Co. LICENSE#EA 723907
CONTRACTOR ADD��s 21025 Edmonton Ave.
Company name must be as CITY Farminqton STATE MN ZIP 55024
appears on State License OFFICE PI-IONE# 952-9$5-8088 FAX#
CONTACTNAME TonY Peterson PHONE 651-278-6663
❑SIIVGLE FAMILY ❑MULTI-FAMILY []SWIMMING POOL
❑TWO FAMILY ❑COMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACT[3REBHOME []FIREALARMPOWER
❑Meter Bank tContractor Only) []SIGN
❑Single Meter ❑INSTIT'UTIONAL �p�R(s�description)
ResidenrialAddition/Remodel PerniiuAvai/able on-line
TYPE OF WORK �N�W ❑�iDDITIflN QALTER/REMODEL
❑MAINTEiVANCE/REPAIR ❑TENANTFINISEI []DEMOLITION
Only Licensed Electricai Contrackors can do work in a Townhouse that has meter baok instead of single meters attsched to t6e units.
Only Licensed Electrical Contractors can do work in Mannfactured Home Parks.
�FTAII F11 t�FRf:RIP'f'IC7N(1F MI�RK• Irri tg2 inn �'j�ctam fnr ci�rm�in�iing tn�.inhnmac
RESIDENTIAL FEES:
New Constructian: $135.00+$1.00 State Sureharge (up to three irips)
Repairs: $40.00+$1.00 State Surchazge (one trip}
Additions,Remodei,Lower Level: $7U.00+$I.00 State Surcharge (two trips)
�Ol�'IMER�IA�.,FE�+.�l: �n,imum of$40.00+S1.Q0 Statc Sareharge(one trip}—Remodd Minimum S70.00+S1.00 Statc Surc6arge(hvo trips)
JOB COST: $ ��, �"" Example:512,000 Jab Cos#
1-1/2%of cantract cost up to�10,000 $10,000.04 x].5%= 5150.00
1%of cost above$10,000 plas surcharge + $ 2,004.U0 x 1% _ + 20.00
(Surcharge=Contract Cost x.0005) + $12,000 x.0005 = + (>,pp
TOTAL — — �176.00
I hereby apply for an electrical permit and I acknowtedge that the infocmation abave is complete and accurate;that the work wiil be in
conformance with the ordinances and codes of the City of Lakeville and with the Mirmesota Electripl Act;that I understand this is not a permit
but only an application for a permit and work is not to start without a permit;that the work will be in accordance with the approved plan in the
case of ail work which requires review and approval of plans
NAME OF APPLICANT(Please Print) Ton . .et rso
SIGNATURE OF APPLICANT:
PL;EA$E:NOTE: SEPARA"!'E PFJtMLTS A E QtJ ED AIYY BUYtiDYNG;MECHANICAL&PLUMBING WORK
, , , ,:
,.
FOR OFFIGE USE.UNLY; ': ;:<: -
TXPE OF WORK INSPECTIONS
�W r� F1NAL [-�
ADDITION �� FIRE ACCEPTANCE TEST r�
ALTER/REMODEL �1 IN FOOR HEAT �-�
ROUGH-IN �
SERVICE
- _ _
TRENCH [�
PERMIT FEE
PERMIT FEE: $
SURCHARGE: S
OTI�R: $
TOTAL: $ 0.00
PERMIT ISSUED BY: DATE:
�OMMENTS�