HomeMy WebLinkAboutLA197385 PERMIT
City Of LakeVille Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA197385
Lakeville,MN 55044
(952)985-4440
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wwwlakevillemn.gov Date Issued: 11/OS/2021
Site Address: 5196 161st St W
Lot: Block: Addition: Spirit of Brandtjen Fann 24th Addition
PID: 22-71348-02-010
Use: SBF 24th Bldg 11
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Description:
Sub Type: CommerciaUIndustrial
Work Type: New
Description: 9 Unit apartment building
Comments:
Fee Summary: Descri tion Amoun 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
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Applicant/Permitee: Signature Issued By: Signature
O � U nly
ELECTRICAL PERMIT APPLICATION � '
ermit Number�
CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT Received B
� r t 20195 HOLYOKE AVENUE 1 I ����
LAKEVILLE,MN 55044 �
952-985-4440 Date Received
www.lakevillemn.gov .�� �`�(�� ��
Submit to:permits@lakevillemn.qov F'ee Total
DATE 11/3/2021 YOUR E-MAIL ADDRESS tl@bUfI1SVIIiG212Ct1'IC.COfit
siTE anDltEss 5196 161 st Street
TEN�vT_Garrett Comqanies sui�No. Buildina 11
THE APPLIANT IS: ❑RESIDENT OWNER �✓CONTRACTOR
NAME Garrett Companies
RESIDENT OWNER �Dx�ss 1051 Greenwood Sprinas BLVD
ci'rY Greenwood STATE IN ziP 46143
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Burnsville Electric LICENSE#EA 000342
coNTRacTOR avDREss 14340 Countv Rd 5
Company name must be as CITI' Burnsville STA'rE MN z�P 55306
appears on state License pFFICE PHONE# 952 435 9062 FAX# 952 435 7556
CONTACT NAME TJ JBkUbIC PxorrE 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 ❑�STITUTIONAL
❑OTHER(see description)
Residenrial 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 t6at has meter bank instesd of single meters attac6ed to the anits.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
I�FTAII Ff� IlF$(`RIPTI(�N C�F I�K�RK'Q ����t artment R�i inn
RESIDENTIAL FEES:
New Constn►ction: $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)
COIVIMERCI.�.FEES: Minimum of$40.00+$1.00 State Surcharge(one trip}—Remodel Minimum$70.00+�1.00 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 wark 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 Jakubic
SIGNATURE OF APPLICANT: /
PLEASE NOTE: SEPARA ARE REQiJIRED FOR ANY BUILDING,MECHANICAL&PLUMBING WORK