HomeMy WebLinkAboutLA197378 PERMIT
City Of LakeVille Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA197378
Lakeville,MN 55044 �
(952)985-4440 �k L Fl 1 9 7 3 7 8 �K
wwwlakevillemn.gov . Date Issued: 11/OS/2021
Site Address: 5220 161st St W
Lot: Block: Addition: Spirit of Brandtjen Farm 24th Addition
PID: 22-71348-02-010
Use: SBF 24th Bldg 3 * Z Z — � 1 3 4 8 — 0 Z — 0 1 0 *
Description:
Sub Type: CommerciaUIndustrial
Work Type: New
Description: 9 Unit apartment building
Comments:
Fee Summary' Description Amount Revenue Code
Valuation: 67,500.00 EL-Commercial-New $725.00 1000-4167
Surcharge-Based on Valuation $33.75 1000-2127
Total: $758.75
Contractor: - Appli�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 Issued By: Signature
ffice Use On
ELECTRICAL PERMIT APPLICATION
ermit u nber
CITY OF LAKEVILLE �
� t BUILDING INSPECTIONS DEPARTMENT Received By
/ 20195 HOLYOKE AVENUE �I����
LAKEVILLE,MN 55044
952-985-4440 Date Received
www.lakevillemn.gov � ��� � 7�
Submit to:permits@lakevillemn.qov Fee Total
DATE 11/3/2021 YOUR E-MAIL ADDRESS tlC�burnsvilleelectric.com
SITE ADDRESS 5220 161 St Street
TENANT_Garrett Companies SUITENO. Buildinp 3
THE APPLIANT IS: ❑RESIDENT OWNER ❑✓CONTRACTOR
NAME Garl'ett COmpanleS
RESIDENT OWNER �D1�Ss 1051 Greenwood Sprinqs BLVD
ct� Greenwood STATE IN ZIP 46143
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Burnsville Electric LICENSE#EA 000342
CONTRACTOR �D1�ss 14340 Countv Rd 5
Company name must be as Ci� Burnsville STATE �N zIP 55306
appears on state License OFFICE PHONE# 952 435 9062 FAX# 952 435 7556
CONTACT NAME TJ JakUbIC PHONE 612 282 7392
❑SINGLE FAMILY ❑✓MULTI-FAMILY ❑SWIMMING POOL
❑TWO FAMILY ❑COMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACTURED HOME �FIRE ALARM POWER
(Contractor Only)
❑Meter Bank ❑SIGN
❑Single Meter ❑�STITUTIONAL
DOTHER(see description)
Residenfial Addition/Remodel Permits Available on-line
TYPE OF WORK ��W ❑�DITION ❑ALTER/REMODEL
❑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]ETAII Ffl I�FSCRIPTIQN F W[1RK•A UfLf�(�AC�l�1Ent Rl ili rlinn
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surcharge (up to three trips)
Repairs: $40.00+$1.00 State Surcharge (one trip)
Addirions,Remodel,L,ower Level: $70.00+$1.00 State Surcharge (two trips)
COMMERCIAL FEES: Minimum ot$40.00+a1.00 State Surcharge(one trip)—Reroodel Minimum S70.00+S1.00 State Surcharge(hvo trips)
JOB COST: $ 67,500.00 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 + $575.00 $ 2,000.00 x 1% _ + 20.00
(Surcharge=Contract Cost x.0005) + $33.75 $12,000 x.0005 = + 6.00
TOTAL = $758.75 = $U6.00
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 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 all work which requires review and approval of plans.
NAME OF APPLICANT(Please Print) TJ Jakubic
SIGNATURE OF APPLICANT:
PLEASE NOTE: SEPARATE P ITS REQUIItED FOR.4NY BUILDING,MECHANICAL-.�c PLUMBING WORK