HomeMy WebLinkAboutLA197375 PERMIT
City Of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA197375
Lakeville,MN 55044
(952)985-4440 * L R 1 9 7 3 7 5 *
www.lakevillemn.gov Date Issued: 11/OS/2021
Site Address: 5244 161st St W
Lot: Block: Addition: Spirit of Brandtjen Farm 24th Addition
PID: 22-71348-02-010
Use: SBF 24th Bldg 1 * Z 2 — 7 1 3 4 8 — 0 Z — 0 1 0 *
Description:
Sub Type: CommerciaUIndustrial
Work Type: New
Description: 12 Unit aparhnent building
Comments:
Fee Summary' Descri tp ion Amount Revenue Code
Valuation: 90,000.00 EL-Commercial-New $950.00 1000-4167
Surcharge-Based on Valuation $45.00 1000-2127
Total: $995.00
Contractor: - Appl;�a„t - Owner:
Burnsville Electric �
14340 County Road 5
Burnsville MN 55306
(612)363-0407
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 appointments
'�
Applicant/Permitee: Signature ssued By: Signature
Offi� �J e �ly
ELECTRICAL PERMIT APPLICATION
�-"��' P rmit tmbyr
CITY OF LAKEVILLE � �Cj;�y��Q
BUILDING INSPECTIONS DEPARTMENT ��"
/ � � 20195 HOLYOKE AVENUE Received By
LAKEVILLE,MN 55044 ,f"�'��
952-985-4440 Date Received
wwwlakevillemn.gov �
Submit to:permits@lakevillemn.gov ee Total
DATE 11/3/2021 YOUR E-MAIL ADDRESS tl@bUfI1SVIIle212Ct1'IC.COfit
s1TE anvl�ss 5244 161 st Street
TENANT Garrett Comqanies svITE 1vo. Buildina 1
THE APPLIANT IS: ❑RESIDENT OWNER ❑CONTRACTOR
NAME Gal'P@tt COI'Y1pc11112S
RESIDENT OWNER �D1�ss 1051 Greenwood Sprinqs BLVD
ci�t Greenwood STATE IN z� 46143
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Burnsville Electric LICENSE#EA 000342
CONTRACTOR �D�ss 14340 Countv Rd 5
Company name must be as c��t Burnsville STA'cE MN ZIP 55306
appears on State License pFFICE PHo1vE# 952 435 9062 FAX# 952 435 7556
coNTACT N�E TJ Jakubic Pxor�612 282 7392
❑SINGLE FAMILY ❑✓MULTI-FAMILY ❑SWIMMING POOL
❑TWO FAMILY ❑COMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACTURED HOME �FIRE ALARM POWER
❑Meter Bank ��ntractor Only) �SIGN
❑Single Meter ❑�STI'TUTIONAL �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 attac6ed to the units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
1]FTAII Fll IIFSrRIPTInN C�F W(�RK• 19 �Jnit ATartmPJ]LHUIId���
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surchazge (up to three trips)
Repairs: $40.00+$1.00 State Surcharge (one trip)
Addirions,Remodel,I,ower Level: $70.00+$�.00 State Surcharge (two trips)
C�MIKERCIAI.FEES: Minimum of$40.00+$1.00 State Surc6arge(one trip�Remodel Miuimum S70.00+S1.00 State Surc6arge(two trips)
JOB COST: $ 90,000.00 Example:$12,000 Job Cost
1-1/2%of contract cost up to$10,000 $150.00 $10,000.00 x 1.5%= $150.00
1%of cost above$10,000 plus surcharge + $$00.00 $ 2,000.00 x 1% _ + 20.00
(Surcharge=Contract Cost x.0005) + $45.00 $12,000 x.0005 = + 6.00
TOTAL = $995.00 = $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 permit;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) T.1 ak IC
SIGNATURE OF APPLICANT: /
PLEASE NOTE: SEPARATEPERM QUIRED FOR ANY BUILDINC,,MECHANICAL&PLUMBING WORK