HomeMy WebLinkAboutLA197392 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA197392
Lakeville,MN 55044
(952)9g5-4440 ' * L R 1 9 7 3 9 2 *
www.lakevillemn.gov Date Issued: 11/OS/2021
Site Address: 5172 161st St W
Lot: Block: Addition: Spirit of Brandtjen Farm 24th Addition
PID: 22-71348-02-010
Use: SBF 24th Bldg 12
* Z Z — 7 1 3 4 8 — 0 Z — 0 1 0 *
Description:
Sub Type: CommerciaUIndustrial
Work Type: New
Description: 12 Unit aparhnent building
Comments:
Fee Summary: Description Amount Revenue Code
EL-Commercial-New $950.00 1000-4167
Valuation: 90,000.00 Surcharge-Based on Valuation $45.00 1000-2127
Total: $995.00
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 ' Iss d By: Signature
ELECTRICAL PERMIT APPLICATION � S �
Permit Num�r
CITY OF LAKEVILLE - �j )
BUILDING INSPECTIONS DEPARTMENT �
/ � � 20195 HOLYOKE AVENUE Received By
LAKEVILLE,MN 55044 �' "�
952-985-4440 Date Received��
www.lakevillemn.gov 0.00 ��
Submit to:permits@lakevillemn.gov Fee Total
DATE 11/3/2021 YOUR E-�L aDD�SS tiC�burnsvilfeelectric.com
siTE�nxEss 5172 161 st Street
TENANT Garrett Companies SUITE NO. Buildinq 12
THE APPLIANT IS: ❑RESIDENT OWNER OCONTRACTOR
NAME GarCett COmpanleS
RESIDENT OWNER �D�ss 1051 Greenwood Sprinas BLVD
ct� Greenwood STATE IN ztP 46143
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Burnsville Electric LICENSE#EA 000342
CONTRACTOR a�DREss 14340 Countv Rd 5
Company name must be as crrY Burnsville STA1� MN z�P 55306
appears on state License oFF�CE PHONE# 952 435 9062 FAX# 952 435 7556
coNTacT NaNtE TJ Jakubic Pxo1vE 61 2 282 7392
❑SINGLE FAMILY OMULTI-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 Townhouse that has meter baek instead of single meters attached to the units.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
�FTAII FI� I�FS�RIPTInN C�F V�(ZRK• 19 Unit A�artp�ent ��ildinn
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surcharge (up to three trips)
Repairs: $40.00+$1.00StateSurcharge (onetrip)
Additions,Remodel,I.ower Level: $70.00+$I.00 State Surchazge (two trips)
C�MIVIERCIAL FEES: Minimum of$40.00+$�,p0 State Surcharge(one trip)—Remodel Minimum S70.00+S1.00 3tate Surcharge(two trips)
JOB COST: $ 90,000.00 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 + $$00.00 $ 2,000.00 x 1% _ + 20.00
(Surcharge=Contract Cost x.0005) + $45.00 $12,000 x.0005 = + 6.00
TOTAL = $995.00 = $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) TJ Jakubic
SIGNATURE OF APPLICANT:
PLEASE NO'FE: SEiARATE ARE REQUIttED FOR ANY BUILDIlVG,MECHANICAL&PLUMBIIVG 1VORK