HomeMy WebLinkAboutLA197384 PERMIT
City of Lakeville Pe�it Type: Electrical
20195 Holyoke Ave Permit Number: LA197384
Lakeville,MN 55044
(952)985-4440 * L R 1 9 7 3 8 4 �K
wwwlakevillemn.gov Date Issued: 11/OS/2021
Site Address: 5112 161st St W
Lot: Block: Addition: Spirit of Brandtjen Farm 24th Addition
PID: 22-71348-02-010
Use: SBF 24th Bldg 9 * 2 Z — � 1 3 4 8 — 0 Z — 0 1 0 *
Description:
Sub Type: CommerciaUIndustrial
Wark Type: New
Description: 9 Unit apartment building
Comments:
Fee Summary' Descri tn ion 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: - Applicant - 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)381-1791,7-830 am,M-F to schedule appointments
�°��
Applicant/Permitee: Signature Issued By: Signature
#�i e s O ly
m�
ELECTRICAL PERMIT APPLICATION r
'' Pe(`�// b�
CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT Received B
/ � � 20195 HOLYOKE AVENUE
LAKEVILLE,MN 55044 ��� �
952-985-4440 Date Received
www.lakevIllemn.�ov � � ��
Submit to:permits@lakevillemn.qov Fee Total
DATE 11/3/2021 YOUR E-MAIL ADDRESS tIC@bUfI1SV1112e12CtfiC.00111
siTE Avn�ss 5112 161 st Street
TENANT Garrett Companies SUITE NO. Buildinq 9
THE APPLIANT IS: ❑RESIDENT OWNER ❑✓CONTRACTOR
N.�E Garrett ComqanieS
RESIDENT OWNER �D�ss 1051 Greenwood Sprinas BLVD
ci'rY Greenwood STATE IN z�P 46143
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Burnsville Electric LICENSE#EA 000342
CONTRACTOR .�DDREss 14340 Countv Rd 5
Company name must be as CIT'Y BUrt1SV1118 STATE MN zIP 55306
appears on state License oFFICE PxoNE# 952 435 9062 FAX# 952 435 7556
coNTacT rtaME 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 (Contractor Only) �SIGN
❑Single Meter ❑�STIT'UTIONAL �OTHER(see description)
Residential Addition/Remodel Permits Available on-line
�NEW ❑ADDITION ❑ALTER/REMODEL
TYPE OF WORK
❑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 IIFSC:RIPTI[LN(ZF W(�RK•91jplt�]gC�p1P.11�BUlICIIIIn
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surchazge (up to three trips)
Repairs: $40.00+$1.00 State Surcharge (onetrip)
Additions,Remodel,Lower I.evel: $70.00+$1.00 State Surcharge (two trips)
COMMERCIAL FEES: Minimum of$40.00+$1,00 SWte Surcharge(one trip}—Remodel Minimum S70.00+S1.00 State Surcharge(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 $ 2,0(1�•Q�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 REQUIRED FOR ANY BUILDING,MECHANICAL&PLUMBING WORK '