HomeMy WebLinkAboutLA107056 PERMIT
City Of LakeVlllC Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA107056
Lakeville, MN 55044
(952) 985-4440 * L R 1 0 7 0 5 6
www.ci.lakeville.mn.us Date Issued: 07/21/2008
Site Address: 16325 Crystal Hills Cir
Lot: 050 Block: 001 Addition: Crystal Hills
PID: 22-18550-500-01
Use:
* Z Z- 1 8 5 5 0- 5 0 0- f~ 1
Description:
Sub Type: Furnace/Air Conditioning
Work Type: Replace
Description:
Comments:
Fee Summary Description Amount Revenue Code
EL-Residential Addition/Remodel $39.50 1000-4167
Surcharge (.50) $0.50 1000-2127
Total: $40.00
Contractor: -Applicant - Owner:
Powerhouse Electric Inc Terrance R Obrien Tste
1958 Raspberry Lane 16325 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.
Applicant/Permitee: Signature Issued By: Signature
i
O ce Use Only
ELECTRICAL PERMIT APPLICATION Q
_ ~ Permit Number
CITY OF LAKEVILLE
- i
~ ~ BUILDING INSPECTIONS DEPARTMENT .
i ~ 20195 HOLYOICE AVENUE Received By
! LAKEVILLE, MN $5044
~ ~ 952-985-4440 " Date Received „
www.ci.lakeville.mn:us
Fee Total
DATE ~,J L Y/OUR E-MAiL ADD SS
SITE ADD S ~ G. 1~~ ~ ~ ~ S
TENANT ~ l SUITE NO.
THE APPLIANT IS: RESIDENT OWNER ®CONTRACTOR ARCHITECT/ENGINEER
NAME I ~ 1
RESIDENT OWNER ADDRESS ~ ~
CITY STATE ZIP
DAYTIME PHONE # WHERE YOU CAN BE REACHED ~ Z"
COMPANY NAME POWERHOUSE ELECTRIC INC LICENSE # CA03631
ADDRESS 1958 RASPBERRY LANE
CONTRACTOR CITY SHAKOPEE STATE MN ZIP 55379
OFFICE PHONE # 952-233-5404 FAX #
CONTACT NAME PHONE 952-292-4981
S G 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
NEW ADDITION ALTER /REMODEL
TYPE OF WORK
M NANCE/REPAIR TENANT FINISH DEMOLITION
Only Licensed Electrical Contractors can do work in a Townhouspe that has meter bank(i~nstead of single meters attached to the units.
DETAILED DESCRIPTION OF WORK: ~ C;'V (~V~,~ Vl_~' ~ ~ ~
RESIDENTIAL FEES:
New Construction $85.00 (84.50 + .50 surcharge) Repairs or Remodel $40.00 (39.50 + .50 surcharge)
COMMERCIAL FEES ] a
JOB COST: $ l'(~-
Ezample: $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 of all work
,w/hichj,r~equires review and approval of plans.
NAME OF APPLICANT (Please Print) C (1~ ~ Date l4?
SIGNATURE OF APPLICANT: i 'Vv
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR ANY BUILDING, NIECHAN7CAL & PLUMBING WORK
_ _ _
FOR OFFICE USE ONLY:
TYPE OF WORK INSPECTI
ONS
:NEW FIRE ACCEPTANCE TEST .
ADDITION ROUGH-IN
ALTER/REMODEL SERVICE
TRENCH
FINAL
PERMIT FEE
PERMIT FEE: $
SURCHARGE:. $
OTHER: $
TOTAL: $ ~ .
PERMIT ISSUED BY: DATE:
COMMENTS:
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