HomeMy WebLinkAboutPermit b PERMIT
Clty Of LakeVllje Permit Type: Electrical
201,95 Holyoke Ave Permit Number: LA105704
Lakeville, MN 55044
(952) 985-4440 %K L A 1 5 7 Q1 4
www.ci.lakeville.mn.us - Date Issued: 05/07/2008
Site Address: 16478 Elm Creek La
Lot: 002 Block: 001 Addition: Fieldstone Creek 2nd Addition
PID: 22-26701-003-11
Use: *Z2-267PJ 1-QJf~3-1 1*
Description:
Sub Type: Off Peak
Work Type: Addition
Description:
Comments:
Fee Summary: Descri to ion Amount Revenue Code
EL-Residential Addition/Remodel $39.50 1000-4167
Surcharge (.50) $0.50 1000-2127
Total: $40.00
Contractor: -Applicant - OWner:
Powerhouse Electric lnc Misba Rehman
1958 Raspberry Lane 4868 189th St
Shakopee MN 55379 Farmington MN 55024
(952) 233-5404
I HEREBY AGREE THAT THIS WORK WILL BE PERFORMED ACCORDING TO: (1) THE APPROVED PLANS &
SPECIFICATIONS; (2) THE APPLICABLE CITY ORDINANCES & CODES; AND (3) THE MN STATE BUILDING CODE.
Applicant/Permitee: Signature Issued By: Signature
i - Office Use Only ,
ELECTRICAL PERMIT APPLICATION Cd
" Permit Numb r
i ~ CITY OF LAKEVILLE
~1 BUILDING INSPECTIONS DEPARTMENT
~ ~ I 20195 HOLYOKE AVENUE ~a$~t'~ ~t ~i : 'r? 4~ I~
~ ~ LAKEVILLE, MN 55044
~ 952-985-4440 Date Received
www.ci.lakeville.mn.us
Fee Total
DATE ~ l/ YOUR E-M/~AIL ADDRESS
SITEADDRESSC II4~~~ ~ Im C I~LQF-~
TENANT J 4?'k. ~t ~ ik~•G.~ SUITE NO.
THE APPLIANT IS: RESIDENT OWNER ®CONTRACTOR ARCHITECT/ENGINEER
NAME rG. D t GQ.
RESIDENT OWNER ADDRESS/I l /Y'l ~
CITY. NI.~.I~ Vy i ~ STATE Vl~j~ ZIP r~ t ~ /
DAYTIME PHONE # WHERE YOU CAN BE REACHED (1 ~ a - C D3- D t c3y
COMPANY NAME POWERHOUSE ELECTRIC INC LICENSE # CA03631
ADDRESS 1958 RASPBERRY LANE
CONTRACTOR CITY SHAKOPEE STATE MN ZIP 55379
OFFICE PHONE # 952/I-Z33-5404 FAX #
CONTACT NAME S"fc (l( ~ •'4C. ~L- PHONE 952-292-4981
SII LILY MULTI-FAMILY SWIMMING POOL
TWO FAMILY COMMERCIAL /INDUSTRIAL UNDEFINED.
PERMIT TYPE TOWNHOUSE MANUFACTURED HOME SPRINKLER/ALARM
Meter Bank (Contractor Only)
SIGN
Single Meter INSTITUTIONAL..
NEW ADDITION ALTER /REMODEL
TYPE OF WORK
MAINTENANCE/REPAIR TENANT FINISH DEMOLITION
Only Licensed Electrical Contractors can do work in a Tonnwn/phouse tha~t-h~*as meter~ybank instead of single meters attached to the units.
DETAILED DESCRIPTION OF WORK: ~ rll~ ~ ~~F 1 >_..U~
RESIDENTIAL FEES:
New Construction $85.00 (84.50 + .50 surcharge) Repairs or Remodel $40.00 (39.50 + .50 surcharge)
COMMERCIAL FEES:
JOB COST: $ Icx~.a~
r
Example: $12,000 Job Cost
1-1/2% of contract cost up to $10,000 and $10,000.00 x 1.5% _ $150:00
1% of cost above $10,000 plus surcharge. + $ 2,000.00 x 1% _ 20.00.
(Surcharge =Contract Cost x .0005) + $12,000 x .0005 = 6.00 '
TOTAL = TOTAL $176.00
i Minimum of 540.00 (39.50 + .50 surcharge)
I hereb a 1 for an electrical ermit and I acknowled a that the information above is com lete and accurate• that the work will
P
Y P Y P g P >
be in conformance with the ordinances and codes of the City of Lakeville and with the Minnesota Building Codes; 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 workwill be
in accordance with the approved plan in the case of al] work which requires review and approval of plans:
NAME OF APPLICANT (Please Print) ~~~~~,1f l.~ ~ Date ~~_7,~~f~
SIGNATURE OF APPLICANT:
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR ~1.iV1' BUILDING, MECAANTCAL & 1'LUR'IBING ~iTOI2K
FOR OFFICE USE ONLY:
TYPE OF WORK INSPECTIONS
NEW FIRE ACCEPTANCE TEST
ADDITION v ROUGH-IN
ALTER/REMODEL SERVICE
TRENCH
FINAL
PERMIT FEE
PERMIT FEE: $
SURCHARGE: $
OTHER: $
TOTAL: $
PERMIT ISSUED BY: fi'~,~[. DATE: ' 7-~J~
COMMENTS:
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