HomeMy WebLinkAboutLA197391 PERMIT
City Of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA197391
Lakeville,MN 55044
(952)985-4440 �K L R 1 9 7 3 9 1 �K
www.lakevillemn.gov Date Issued: 11/OS/2021
Site Address: 5087 161st St W
Lot: Block: Addition: Spirit of Brandtjen Farm 24th Addition
PID: 22-71348-02-010
Use: SBF 24th Bldg 20 * 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: Description 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)381-1791,7-8:30 am,M-F to schedule appointments
.
� ��
Applicant/Permitee: Signature Issued By: Signature
f� e se Only
� ELECTRICAL PERMIT APPLICATION
Permi Num r
� � � CITY OF LAKEVILLE �� �
! � BUILDING INSPECTIONS DEPARTMENT Received By
/ 20195 HOLYOKE AVENUE � I ��
LAKEVILLE,MN 55044
952-985-4440 Date Received
www.lakevillemn.gov ������
Submit to:permits@lakevillemn.� Fee Total
DATE 11/3/2021 YOUR E-MAIL ADDRESS tl@burnsvilleeleCtriC.COm
SiTE�.nnitEss 5087161 st Street
TENA1vT_Garrett Comoanies SUI'TE NO. Buildinq 20
THE APPLIANT IS: ❑RESIDENT OWNER ❑✓CONTRACTOR
NAME Garrett Companies
RESIDENT OWNER �D�ss 1051 Greenwood Sprinqs BLVD
c�'rY Greenwood STATE IN zip 46143
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Burnsville Electric LICENSE#EA 000342
CONTRACTOR �.nDltEss 14340 Countv Rd 5
Companynamemustbeas CIT'Y Burnsville STATE MN zIP 55306
appears on State License OFFICE PHONE# 952 435 9062 FAX# 952 435 7556
CONTACT NAME TJ JBkUbIC Pxox�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 ❑TENANT FINISH �DEMOLITION
Only Licensed Electrical Contractors can do work in a Town6ouse that has meter bank instead of single meters attached to the units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
1]FTAII Fll f�FSj;RIPTI[1N(�F Wf)RK• qJ Init ArarF01ent �LJ�jpn
RESIDENTIAL FEES:
New Constn►ction: $135.00+$1.00 State Surchazge (up to three trips)
Repairs: $40.00+$1.00 State Surchazge (one trip)
Additions,Remodel,L,ower Level: $70.00+$1.00 State Surcharge (two trips)
C�MMERCIAI.FEES: Minimum of$40.00+$1.00 State 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 $ 2,000.00 x 1% _ + 20.00
(Surcharge=Contract Cost x.0005) + 33.75 $12,000 x.0005 = + 6.00
TOTAL = $758.75 = $1�6.00
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) T akubic
SIGNATURE OF APPLICANT: / GCi
PLEASE N01'E: SEPARATE ARE REQUIt;ED FOR ANY BUILDING,R'IECHANICAL&PLUMBIAIG WORK