HomeMy WebLinkAboutLA108385 PERMIT
Llty Of LakCVllle Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA108385
Lakeville, MN 55044
(952) 985-4440 * L R 1 D 8 3 8 5
www.ci.lakeville.mn.us Date Issued: 10/06/2008
Site Address: 16276 Finch Way
Lot: 000 Block: 000 Addition: Donnay's Valley Park 8th
PID: 22-21177-011-00
Use: *Z2-2 1 177-(J 1 l-fdQ1
Description:
Sub Type: Furnace
Work Type: Replace
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:
Powerhouse Electric Inc Theodore R Tellman
1958 Raspberry Lane 16276 Finch Way
Shakopee MN 55379 Rosemount MN 55068
(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.
~~~~'l,
Applicant/Permitee: Signature Issued By: Signature
- - -
Office Use Only
ELECTRICAL PERMIT APPLICATION
~ H . Pemut Number
f% CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT. Received By
•
- . _ 20195 HOLYOKE AVENUE
, LAKEVILLE, MN 55044
~ w,~ 952-985-4440 Date Received
www. ci. l akevill e. mn. us
r Q'~ Fee Total
DATE / C? YOUR E-MAIL ADDRES
_ _ a
SITE ADD SS
TENANT f SUITE NO.
THE APPLIANT IS: RESIDENT OWNER ®CONTRACTOR ARCHITECT/ENGINEER
NAME t ~ 1 ~ ~
RESIDENT OWNER ADDRESS ~
CITY STATE ZIP
DAYTIME PHONE # WHERE YOU CAN BE REACHED
COMPANY NAME POWERIIOUSE ELECTRIC INC LICENSE # CA03631
ADDRESS 1958 RASPBERRY LANE
CONTRACTOR CHy SHAKOPEE STATE MN ZIP 55379
OFFICE PHONE # 952-233-5404 FAX #
CONTACT NAME PHONE 952-292-4981
S GL FAMILY MULTI-FAMILY SWIMMING POOL
TWO FAMILY COMMERCIAL /INDUSTRIAL UNDEFINED
PERMIT TYPE TOWNHOUSE MANUFACTURED HOME SPRINKLER/ALARM
Meter Bank (Contractor Only)
SIGN
Single Meter INSTITUTIONAL
ADDITION ALTER /REMODEL
TYPE OF WORK
ENANCE/REPAIR TENANT FII~IISH DEMOLITION
Only Licensed Electrical Contractors can do work in a Townhouse that has m~~ete~~r
bank instead of single meters attached to the units.
DETAILED DESCRIPTION OF WORK: ~V~, V V L~1JL./ ~-°~''f/ ~ ~LYYI.Q~i~l~~
RESIDENTIAL FEES:
New Construction $85.00 (84.50 + .50 surcharge) Repairs or Remode] $40.00 (39.50 + .50 surcharge)
COMMERCIAL FEES:
JOB COST: $
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 $1 Q,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 fora 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) ~1~~ ~Q
~ ~ Date
SIGNATURE OF APPLICANT: ,~~~Zf~V ~f'Uv
PLEASE NOTE: SEP?,RATE PERMITS ARE REQUIREA FOR A'titi" BUILDING, 1VIECFI:ANICAL & PLUMBIlVG WORK
r'
-
FOR OFFICE USE ONLY:
I
TYPE OF WORK INSPECTIONS
NEW _ FIRE ACCEPTANCE TEST
ADDITION ROUGH-Il~T
ALTER/REMODEL SERVICE
TRENCH
FINAL
PERMIT FEE
PERMIT FEE: $
SURCHARGE: $
OTHER: $
TOTAL: $
PERMIT ISSUED BY: DATE:
COMMENTS:
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