HomeMy WebLinkAboutLA107048 PERMIT
City of Lakeville Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA107048
Lakeville, MN 55044
(952) 985-4440 * L R 1 0 7 0 4 8
www.ci.lakeville.mn.us Date Issued: 07/21/2008
Site Address: 16335 Crystal Hills Cir
Lot: 049 Block: 001 Addition: Crystal Hills
PID: 22-18550-490-01
Use: *2Z- 18550-490-(~ 1
Description:
Sub Type: Furnace/Air Conditioning
Work Type: Replace
Description:
Comments:
Fee Summary: Description Amount Revenue Code
EL-Residential Addition/Remodel $39.50 1000-4]67
Surcharge (.50) $0.50 1000-2127
Total $40.00
Contractor: -Applicant - Owner:
Powerhouse Electric Inc Robert E Hoff
1958 Raspberry Lane 16335 Crystal Hills Cir
Shakopee MN 55379 Lakeville MN 55044
(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.
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Applicant/Permitee: Signature ~ Issued By: Signature
ELECTRICAL PERNIIT APPLICATION Office U e Only
~ ~e
~~t Umber
CITY OF LAKEVILLE
f BUILDING INSPECTIONS DEPARTMENT
~ ~ ~ 20195 HOLYOKE AVENUE Received By
LAKEVILLE, MN 55044
~ rf 952-985-4440 Date Received
www.ci.lakeville.mn.us
Fee Total
' DATE ~ O YOU E-MAIL ADD SS
SITE ADD SS V'
TENANT SUITE NO.
THE APPLIANT IS: RESIDENT OWNER ®CONTRACTOR ARCHITECT/ENGINEER
NAME
RESIDENT OWNER ADDRESS \
CITY STATE ZIP
DAYTIME PHONE # WHERE YOU CAN BE REACHED
COMPANY NAME POWERHOUSE ELECTRIC':INC LICENSE # CA03631
ADDRESS 1958 RASPBERRY LANE
CONTRACTOR CITY SHAKOPEE STATE MN ZIP 55379
OFFICE PHONE # 952-233-5404 FAX #
CONT GT NAME PHONE 952-292-4981
S GLE AMILY MULTI-FAMILY SWIMMING POOL
TWO FAMILY COMMERCIAL /INDUSTRIAL UNDEFINED
PERMIT TYPE TOWNHOUSE MANUFACTURED HOME SPRINKLER/ALARM
Meter Bank (Contractor Only)
SIGN
Single Meter INSTITUTIONAL
NE ADDITION ALTER /REMODEL
TYPE OF WORK
M IN NANCE/REPAIR TENANT FINISH DEMOLITION
Oaly Licepsed Electrical Contractors can do work in a~T`,ownhouse that has meter bank in)st~ead of single meters attached to the units.
DETAILED DESCRIPTION OF WORK: ~ V
~ d/ ~ ~MOI~
RESIDENTIAL FEES:
New Construction $85.00 (84.50 + .50 surcharge) Repairs or Remodel $40.00 (39',50 + .50 surchazge)
COMMERCIAL FEES:
JOB COST: $ l
Example: $12,000 Job Cost
1-I/2% of contract cost up to $10,000 and $10,000.00 x 1.5%= $150.00
1 % of cost above $i 0,000 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 + .SO 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 caseof/apll work
w/hich,rnequires review and approval of plans.
NAME OF APPLICANT {Please Print) ~~~V.
V £ V~ l~ )'~i~ Date ,
SIGNATURE. OF APPLICANT: ~'(~~~~`J
PLEASE NOTE: SEPARATE PERMITS ARE REQUHiED FOR ANY BUILDING; MECHANICAL,& PLUMBING WORK
FOR OFFICE USE ONLY:
TYPE OF WORK INSPECTIONS
NEW FIRE ACCEPTANCE TEST
ADDITION ROUGH-IN
ALTER/REMODEL SERVICE
TRENCH
FINAL
PERMIT FEE
PERMIT FEE: $
SURCHARGE: $
OTHER: $
TOTAL: $ ~ .
PE12MIT ISSUED BY: DATE:
COMMENTS:
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