HomeMy WebLinkAboutLA102233-EL PERMIT
City Of LakCVllle Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA102233
Lakeville, MN 55044 Date Issued: 08/10/2007
(952) 985-4440
www. ci.lakeville. mn, us
Site Address: 16465 Elm Creek La
Lot: Block: Addition:
PID:
Use:
Description:
Sub Type: Lawn Sprinkler Controller 1 Inspections (Each)
Work Type: New
Description: pedestal
Comments' Trench will be inspected at time of fmal.
Fee Summary: Description Amount Revenue Code
Electrical Commercial (Minimum) $39.50 1000-4167
Surcharge (.50) $0.50 1000-2127
Total: $40.00
Contractor: -Applicant - ~Wner:
PHASE ELECTRIC INC.
9917 LYNDALE AVE S
BLOOMINGTON MN 55420
(952) 881-4100
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. A
SEPARATE ELECTRICAL PERMIT IS REQUIRED
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A licant/Permitee: Si ature Issued B : Si nature
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Office Use Only
< ELECTRICAL PERMIT APPLICATION
Permit Number
~ ~ CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT ~~L
/ ~ ~ ~ 20195 HOLYOKE AVENUE Received By
LAKEVILLE, MN 55044
952-985-4440 Date Received
- www.ci.iakevilie.mn.us
Fee Total
DATE ~d~U YOUR E-MAIL ADDRESS ~~L1
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SITE ADDRESS 6~~ ~ ~ ~ ~ ~.~'~L~t~c. L /~/tr
TENANT /~JC ~i/'~~: ~ 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 /f/~j'~ ,C`~'~= ~ ~ ~ tic: LICENSE # ~i~D/~~
ADDRESS ~ yi?p.~~~ ~v~~ -
CONTRACTOR CITY ~i>C~1~/irUG ..c/ STATE ~/y ZIP .~~-Ci yZl~
OFFICE PHONE # !°-Jr"
~ ~ ~ y~~G? FAX # ~ J ~ " ~ty~
CONTACT NAME ~.C~~ ru<:.SS` PHONE ~J~ ~~f Y/'Gd1
? SINGLE FAMILY ?MULTl-FAMILY ? SWIMMING POOL
? TWO FAMILY ? COMMERCIAL /INDUSTRIAL ? UNDEFINED
PERMIT TYPE ? TOWNHOUSE D MANUFACTURED HOME J~SPRINKLER/ALARM
? Meter Bank (Contractor Only)
? SIGN
? Single Meter ? INSTITUTIONAL
? NEW ? ADDITION ? ALTER /REMODEL
TYPE OF WORK
? MAINTENANCE/REPAIR ? TENANT FINISH ? DEMOLITION
Onty Licensed Electrical Contractors can do work in a Townhouse that has meter bank instead of single meters attached to the units.
Oniy Licensed Electrical Contractors can do work in Manufactured~ome Parks.
DETAILED DESCRIPTION OF WORK:
RESIDENTIAL FEES:
New Construction $85.00 (84.50 + .50 surcharge) Repairs or Remodel $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 $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 which requires review and approval of plans.
NAME OF APPLICANT(Please Print) ~ol~i~~~//~~ Date ~ G~
SIGNATURE OF APPLICANT: C~Q~i~
PLEASE NOTE: `SEPARATE PERMCI'S ARE REQUIRED: OR ANI' BUILDING, NIECHA?VICAL & PLUMBING WORK