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LA108198
PERMIT City of Lakeville Permit Type: .Electrical 20195 Holyoke Ave Permit Number: LA108198 Lakeville, MN 55044 (952) 985-4440 * L R 1 8 1 9 8 www.ci.lakeville.mn.us Date Issued: 09/24/2008 Site Address: 17263 Finch Path Lot: 002 Block: 003 Addition: Dodd Ridge PID: 22-20875-020-03 Use: *z2-20875-(~z0->J3* Description: Sub Type: Saver Switch Work Type: New Description: Comments: Fee Summary: Description Amount Revenue Code EL-Residential Addition/Remodel $39.50 1000-4167 Surcharge (.50) $0.50 1000-2127 Total: $40.00 Contractor: -Applicant - OWner: Dale Franke Electric Inc Jayme J Benson 12803 Florida Lane 17263 Finch Path Apple Valley MN 55124 Lakeville (vIN 55024 (612) 245-4707 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 9ffic Use Onl ELECTRICAL PERMIT APPLICATION l ~ Permit um er CITY OF LAKEVILLE " BUILDING INSPECTIONS DEPARTMENT Received By 20195 HOLYOKE AVENUE LAKEVILLE, MN 55044 952-985-4440 Date Received ~ www. c i.l akeville. m n. us Fee Total 9-~ Y-6~ DATE YOUR E-MAIL ADDRESS SITE ADDRESS_~ ~ ~~ll TENANT ? I~ ~ ~ ri 1 S G r~ SUITE NO. THE APPLIANT IS: ? RESIDENT O~NER ®CONTRACTOR ? ARCHITECT/ENGINEER NAME RESIDENT OWNER ADDRESS CITY STATE ZIP DAYTIME PHONE # WHERE YOU CAN BE REACHED COMPANY NAME DALE FRANKS ELECTRIC INC LICENSE # CA00682 ADDRESS 12803 FLORIDA LANE CONTRACTOR CITY APPLE VALLEY STATE MN ZIP 55124 OFFICE PHONE ~ FAX # CONTACT NAND DALE FRANKS PHONE 612-245-4707 ? SINGLE FAMI~,Y ?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 ? MAINTENANC~/REPAIR ? TENANT FINISH ? DEMOLITION Only Licensed Electrical Contractors can do work in a Townhouse that has meter bank instead of single meters attached to the units. DETAILED DESCRIPTION OF WORK: ~~fJ Ir°if JGU~ RESIDENTIAL FEES: ' New Construction $85.00 (84.50 + .50 surcharge) Repairs or Remodel $40.00 (39.50 + .50 surcharge) COMMERCIAL FEES: / / °r~"~ JOB COST: $ ~c ~ 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 Minimum of $40.00 (39.50 + .50 surcharge) 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 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 work will be in accordance with the approved plan in the case bf all worLLk which requi/res review and approval of plans. c~, NAME OF APPLICANT (Please Print) © `P /~~iL ~1~~ Date / G SIGNATURE OF APPLICANT: