HomeMy WebLinkAboutLA197383 PERMIT
City Of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA197383
Lakeville,MN 55044
(952)985-4440 * L R 1 9 7 3 8 3 �K
www.lakevillemn.gov Date Issued: 11/OS/2021
Site Address: 5136 161st St W
Lot: Block: Addition: Spirit of Brandtjen Farm 24th Addition
PID: 22-71348-02-010
Use: SBF 24th Bldg 8 �K 2 2 — 7 1 3 4 8 — f�J Z — 0 1 0 *
Description:
Sub Type: CommerciaUIndustrial
Work Type: New
Description: 9 Unit aparlment building
Comments:
Fee Summary: Descri tn 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: - appiicant - 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
fi e Use
��I� ELECTRICAL PERMIT APPLICATION `�
, .;f PermitNumber,.: n
CITY OF LAKEVILLE a i/
BUILDING INSPECTIONS DEPARTMENT �'���,�
/ � � 20195 HOLYOKE AVENUE Received By
� LAKEVILLE,MN 55044 1� ''��l/ �
952-985-4440 Date Receiv�d
www.lakevillemu.�ov � � �� � � �
Submit to:permits@lakevillemn.qov �e Total �
DATE 11/3/2021 YOUR E-1VIAIL ADD1tESS tl@burnsvilleelectric.com
siTE�nitEss 5136 161 st Street
TENANT Garrett Comqanies SUITE NO. Buildina 8
THE APPLIANT IS: �RESIDENT OWNER �✓CONTRACTOR
NAME G81'I'@tt C0111qa111eS
RESIDENT OWNER �D1�ss 1051 Greenwood Sprinas BLVD
ci� Greenwood sTATE IN ziP 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 ci�r�t Burnsville STA� MN zIP 55306
appears on state License OFFICE PHONE# 952 435 9062 FAX# 952 435 7556
coNTacT rtaNtE TJ Jakubic Pxo1vE 612 282 7392
❑SINGLE FAMILY ❑✓MULTI-FAMILY ❑SWIMMING POOL
❑TWO FAMILY ❑COMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWNHOUSE ❑MANUFACTURED HOME �FIRE ALARM POWER
❑Meter Bank (Contractor Only) �SIGN
❑Single Meter ❑�STITUTIONAL �OTHER(see description)
Residential Additronl Remodel Permits Available on-line
TYPE OF WORK ONEW ❑ADDITION �ALTER/REMODEL
❑MAINTENANCE/REPAIR ❑TENANTFINISH ❑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.
I�FTAII Fll f)FSCRIPTInI` (�F WC�RK• Q URi��{�3CL]1P.IItBL11lL'11t1�
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surchazge (up to three trips)
Repairs: $40.00+$1.00 State Surcharge (one trip)
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 Minimum$70.00+S1.00 State Surc6arge(two 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 = $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 of plans.
NAME OF APPLICANT(Please Print) TJ Jakubic
SIGNATURE OF APPLICANT:
PLEASE NOTE: SEPARATE ARE RF,QUIItED FOR ANY BUILDING,MECHANICAL&PLUMBING WORiC