HomeMy WebLinkAboutLA193625 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA193625
Lakeville,MN 55044
(952)985-4440 * L A 1 9 3 6 2 5 *
wwwlakevillemn.gov Date Issued: 08/09/2021
Site Address: 715 Romeo Dr
Lot: 001 Block: O51 Addition: Section 27 Twn 114 Range 20
PID: 22-02700-51-010
Use:
* 2z — Q12700 - 5 1 - 0 10 *
Description:
Sub Type: Manufactured Home
Work Type: New
Description:
Comments:
Fee Summary: Descri tn ion Amount Revenue Code
EL-Manufactured Home $40.00 1000-4167
Surcharge- $1.00 $1.00 1000.2127
Total: $41.00
Contractor: - Appli�a„t - Owner:
Mercury Electric Corporation . Ardmor Mhc Llc
10 N Oaks Rd 8800 Broiix Ave N Fi 2
Vadnais Hts MN 55127 Skokie IL 60077
(651)464-1660
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.
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 appointrnents
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Applicant/Permitee: Signature Issued By: Signature
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Ofl`ice Use Only
ELECTRICAL PERMIT APPLICATION I v�,�j(�Zt'i>
�s��� Permit Number `
CITY OF LAKEVILLE � , ,��� �
BUILDING INSPECTIONS DEPARTMENT Received By
/ � l 20195 HOLYOKE AVENUE
LAKEVILLE,MN 55044 �; � �'� ���
952-985-4440 Date Received
www.lakevillemn.gov 0.00�� + C� '
Submit to:permitsCa�lakevillemn.qov Fee Total
DATE AUgUSt 9, 2021 YOUR E-MAIL ADDRESS pbourland@mercury-electric.com
SITE ADDREss 715 Romeo Drive
�N�vT Ardmor Village MHP SUITE NO.
THE APPLIANT IS: ❑RESIDENT OWNER �CONTRACTOR
Na�EArdmorVillage MHP
RESIDENT OWNER
.a.DD�ss 20990 Cedar Ave. S.
CITy Lakeville STA�MN ziP 55044
DAYTIME PHONE#WHERE YOU CAN BE REACHED 952-469-5319
COMPANY NAME M2fCUly EIeCtPiC COPpO�atl011 LICENSE#EA�`004259
CONTRACTOR AnDltEss 10 North Oaks Road
Company name must be as CITY $t. P2UI STATE MN ZIP 55127
appears on State License OFF�CE PHONE# 651-464-1660 FAX#
CON'rAc'r N.�E Steve Tomnitz-Electrician pHp�651-755-4284
❑SINGLE FAMILY ❑MULTI-FAMILY ❑SWIMMING POOL
❑TWO FAMILY ❑COMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMTT TYPE FIRE ALARM POWER
❑TOWNHOUSE �GIANUFACTURED HOME ❑
�Meter Bank v(Contractor Only) �SIGN
❑Single Meter ❑�STITUTIONAL �OTHER(see description)
Residential Addition/Remodel Permits Available on-line
❑NEW ❑ADDITION ❑ALTER/REMODEL
TYPE OF WORK
�MAINTENANCE/REPAIR ❑TENANT FINISH ❑DEMOLITION
Only Licensed Electrical Contractors can do work in a Townhouse that has meter bank instead of single meters attached to the units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
DETAILED DESCRIPTION OF WORK• Install new pedestal, wire home and A/C
RESIDENTIAL FEES:
New Conshuction: $135.00+$1.00 State Surcharge (up to three h-ips)
Repairs: $40.00+$1.00 State Surchazge (one hip)
Additions,Remodel,Lower Level: $70.00+$1.00 State Surcharge (two trips)
COMMERCIAL FEEs: Minimum of$40.00+$1.00 State Surcharge(one trip)--Remodel Miuimum$70.00+$1.00 State Surcharge(two trips)
, JOB COST: $ Example:$12,000 Job Cost
� 1-1/2%of contract cost up to$10,000 $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) + $12,000 x.0005 = + 6.00
TOTAL = $0.00 = $176.00
I hereby apply for an electdcal permit and I acknowledge that the information above is complete and accurate; that ihe work will be in
conformance with the ordinances and codes of the City of Lakeville and with the Minnesota Electrical Act;that I understand flus is not a permit
but only an application for a permit and work is not to star[without a penuit;that the work will be in accordance with ihe approved plan in the
case of all work wluch requires review and approval of plans.
NAME OF APPLICANT(Please Prinnt) Peter Bourland
SIGNATURE OF APPLICANT: /"�.- d
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' TYPE OF WORK INSPECTIONS
NEW _� FINAL r�
ADDITION �� FIltE ACCEPTANCE TEST _�
ALTER/REMODEL _ �� IN FOOR HEAT r�
ROUGH-IN ��
SERVICE ��
TRENCH ��
PERMIT FEE
PERMIT FEE: $
SURCHARGE: $
OTI�R: $
TOTAL: $ 0.00
PERMIT ISSUED BY: DATE:
COMMENTS: