HomeMy WebLinkAboutLA197397 PERMIT
City Of LakeVille Permit Type: Electrical
20195 Holyoke Ave ` Permit Number: LA197397
Lakeville,MN 55044 -
(952)985-4440 �K L Fl 1 9 7 3 9 7 �K
www.lakevillemn.gov Date Issued: 11/OS/2021
Site Address: 5200 161st St W
Lot: Block: Addition: Spirit of Brandtjen Fann 24th Addition
PID: 22-71348-02-010
Use: SBF 24th
* Z Z — 7 1 3 4 8 — 0 Z — Q1 1 0 *
Description:
Sub Type: CommerciaUIndustrial
Work Type: New
Description: Maintenance Building
Comments:
Fee Summary: Description Amount Revenue Code
Valuation: 10,000.00 EL-Commercial-New $150.00 1000-4167
Surcharge-Based on Valuation $5.00 1000-2127
Total: $155.00
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-430 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 : Signature
ELECTRICAL PERMIT APPLICATION o£fice U�jse O 1
f 9''7,>�"�
Permit Numbet
CITY OF LAKEVILLE
,`r�4 � BUILDING INSPECTIONS DEPARTMENT �Rec ived By
/ 20195 HOLYOKE AVENUE ���
LAKEVILLE,MN 55044 �
952-985-4440 Date Received
www.lakevillemn.gov 0 � `'
Submit to:permits@lakevillemn.gov ee Total �
DATE 10/3/2021 YOUR E-MAIL AnD1tESS tIC«�burnsvilleelectric.com
siTE aDn�ss 5200 161 Street
�rtarrT Garrett Companies sviTE No. Maintenance buildina
THE APPLIANT IS: ❑RESIDENT OWNER ❑CONTRACTOR
NAME GaPf2tt C01'Ylpatll@S
RESIDENT OWNER �D�ss 1051 Greenwood Sprinqs BLVD
CITY Greenwood STATE IN zIP 46143
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME BUrnsville Electric LICENSE#EA 000342
CONTRACTOR ADD1tEss 14340 Countv Rd 5
Company name must be as CITY Burnsville STA� MN zrn 55306
appears on state License OFFICE PHONE# 952 435 9062 FAX# 952 435 7556
CONTACT NAME TJ JakUbIC Pxo1�tE 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 (ConCractor Only) �SIGN
❑Single Meter ❑�STI1'tJTIONAL
�OTHER(see description)
Residential Addition/Remodel Permits Available on-line
TYPE OF WORK ��W ❑�DITION ❑ALTER/REMODEL
❑MAINTENANCE/REPAIR ❑TENANT FII�IISH ❑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.
11ETAll FIl I�FSC: IPTI N Q� RK• �,g�te,p��,�g��ilclin�
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surcharge (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)
COMn'IERCIAL FEES: Minimum ot$40.00+$1.00 State Surcharge(one Mp)—Remodel Minimum S70.00+S1.00 State Surc6arge(two trips)
JOB COST: $ 10,000.00 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 + $ 2,00o.00 x 1% _ + 20.00
(Surcharge=Contract Cost x.0005) + $5.00 $12,000 x.0005 = + 6.00
TOTAL = $155.00 = $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: SEFARATE ARE REQUIRED FOR ANY BUILDING,MECHANICAL'&PLUMBING WORK