HomeMy WebLinkAboutLA197387 PERMIT
City Of LakeVille Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA197387
Lakeville,MN 55044
(952)985-4440
* L R 1 9 7 3 8 7 *
www.lakevillemn.gov ' Date Issued: 11/05/2021
Site Address: 5111 161st St W
Lot: Block: Addition: Spirit of Brandtjen Farm 24th Addition
PID: 22-71348-02-010
Use: SBF 24th Bldg 17 �Ic Z 2 — 7 1 3 4 8 — 0 2 — PJ 1 P1 �K
Description:
Sub Type: CommerciaUIndustrial
Work Type: New
Description: 9 Unit aparhnent building
Comments:
Fee Summary' Descri tion 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: - Appli��,t - Owner:
Burnsville Electric
14340 County Road 5
Burnsviile 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-430 pm,M-F
ELECTRICAL INSPECTIONS:Call Brian Grey at(507)381-1791,7-8:30 am,M-F to schedule appointments
', \�,li
Applicant/Permitee: Signature Issued By: Signature
O�ice`se r�,ly
ELECTRICAL PERMIT APPLICATION
ermit Number
CITY OF LAKEVILLE �J�j �
BUILDING INSPECTIONS DEPARTMENT v
/ � � 20195 HOLYOKE AVENUE � Received By
LAKEVILLE,MN 55044 �
952-985-4440 Date Received
wwwlakevillemn.gov ���h� �j
Submit to:permits@lakevillemn.qov F'ee Total �
DATE 11/3/2021 YOUR E-MAIL ADDRESS tl@burnsvilleelectric.Com
siTE�.nD�ss 5111 161 st Street
TENAN'r Garrett Comqanies SUiTE No. Buildinq 17
THE APPLIANT IS: ❑RESIDENT OWNER ❑✓CONTRACTOR
NAME GarPett COmpanleS
RESIDENT OWNER �D�Ss 1051 Greenwood Sprinqs BLVD
c�'rY Greenwood STATE IN z�P 46143
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANYNAME Burnsville EleCtric LICENSE#EA 000342
CONT�cTOR ADD�ss 14340 Countv Rd 5
Company name must be as ct�t Burnsville s'rA'rE MN z�P 55306
appears on State License oFF�CE PHo1vE# 952 435 9062 FAX# 952 435 7556
CONTACT NAME TJ JakUbIC Pxo1vE 61 2 282 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 Addition/Remodel Permits Available on-line
✓❑NEW ❑ADDITION ❑ALTER/REMODEL
TYPE OF WORK
❑MAINTENANCE/REPAIR ❑TENANT FIIVISH �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.
�ETAII Fll 1�1FCCRIPTI[L�wS2sK• c�J Init�plent Ruiltlinn
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surchazge (up to three trips)
Repairs: $40.00+$1.00 State Surcharge (one trip)
Addirions,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+$1.00 State Surc6arge(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 = $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 I.akeville and with the Minnesota Electrical Act;that I understand this is not a permit
but only an applicarion 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 akubic
SIGNATURE OF APPLICANT: /
PLEASE NOTE: SEPARATE' AItE REQDIItED FOR ANY BUILDING,MECAAHICAL&PLUMBING WORK