HomeMy WebLinkAboutLA197380 PERMIT
Clty Of Lal�evllle Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA197380
Lakeville,MN 55044
(952)985-a4ao * L R 1 9 7 3 8 t� *
www.lakevillemn.gov Date Issued: 11/OS/2021
Site Address: 5184 161st St W
Lot: Block: Addition: Spirit of Brandtjen Farm 24th Addition
PID: 22-71348-02-010
Use: SBF 24th Bldg 5 * 2 2 — 7 1 3 4 8 — 0 Z — 0 1 0 �K
Description:
Sub Type: CommerciaUIndustrial
Work Type: New
Description: 9 Unit apartrnent building
Comments:
Fee Summary' Descri t,n ion Amount Revenue Code
� EL-Commercial-New $725.00 1000-4167
Valuation: 67,500.00 Surcharge-Based on Valuation $33.75 1000-2127
Total: $758.75
Contractor: - Appl;�a,,t - Owner:
Burnsville Electric
14340 County Road 5 � � �
Burnsville MN 55306
(612)363-0407
I HEREBY AGREE THAT THIS WORK WILL BE PERFORMED ACCORDING TO: (1)THE APPROVED PLANS&
SPECIFICATIONS;(2)THE APPLICABLE CITY ORDINANCES&CODES;AND(3)THE MN STATE BUILDING CODE.
Please provide a minimum of a 24 hour notice to schedule inspections.BUILDING INSPECTIONS:(952)985-4440,8 am-4:30 pm,M-F
ELECTRICAL INSPECTIONS:Call Brian Grey at(507)381-1791,7-8:30 am,M-F to schedule appointments
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Applicant/Permitee: Signature Issued By: Signature
O ceUed
ELECTRICAL PERMIT APPLICATION
rmit Nu�er�
CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT Received B
J � � 20195 HOLYOKE AVENUE
LAKEVILLE,MN 55044 � i� �
952-985-4440 Date Received �
www.lakevillemn.gov �����$ �
Submit to:permits@lakevillemn.qov Fee Total
DATE 11/3/2021 YOUR E-MAIL ADDRESS tl@burnSvilleeleCtriC.Com
SiTE�n�ss 5184 161 st Street
TEN�T Garrett Comqanies SUITE NO. Buildina 5
THE APPLIANT IS: ❑RESIDENT OWNER �CONTRACTOR
NAME Garrett Comqanies
RESIDENT OWNER �D�ss 1051 Greenwood Sprinqs BLVD
ct� Greenwood STATE IN z� 46143
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Burnsville Electric LICENSE#EA 000342
CONTRACTOR .�DREss 14340 Countv Rd 5
Company name must be as CITY BUfC1SVl��2 STA'rE MN ZIP 55306
appears on State License oFF�CE PHo1vE# 952 435 9062 FAX# 952 435 7556
CONTACT NAME TJ JakUbIC PHONE 612 282 7392
❑SINGLE FAMILY 0✓MULTI-FAMILY ❑SWIMMING POOL
❑TWO FAMILY ❑COMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACTURED HOME �FIRE ALARM POWER
❑Meter Bank (Contractor Only) �SIGN
❑Single Meter ❑�STIT[JTIONAL
❑OTHER(see description)
Residential 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 attached to the unfts.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
1�FTA11 FI� IIF�C:RIPTI(�N nF WC1RK•g U1]Lt��]RC[Ole.LlfBU.11CIlIIg
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surcharge (up to three trips)
Repairs: $40.00+$1.00 State Surcharge (one trip)
Additions,Remodel,Lower I.evel: $70.00+$1.00 State Surcharge (two trips)
CO1VII�ERCIAI.FEES: Minimum of$40.00+$�.00 State Surcharge(ooe trip)—Remodel Minimum S70.00+S1.00 State Surc6arge(hvo trips)
JOB COST: $ 67,500.00 Example:$12,000 Job Cost
1-1/2%of conh-act 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 = $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 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 ofplans.
NAME OF APPLICANT(Please Print) TJ kUbIC
SIGNATURE OF APPLICANT: /
PLEASE NQTE: SEFe1RATE P REQUiRED FOR ANY BUILDINC,MECHANICAL&PLUMBING WORK