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Home My WebLink AboutLA 156338 16232 Elmhurst Lane Permit PackRESIDENTIAL BUILDING PERMIT APPLICATION CITY OF LAKEVILLE BUILDING INSPECTIONS DEPARTMENT 20195 HOLYOKE AVENUE LAKEVILLE, MN 55044 952-985-4440 www.ci.lakeville.mn.us Office Use Only __________________ Permit Number ___________________ Received By ___________________ Date Received ___________________ Fee Total SITE ADDRESS: MAILING ADDRESS: CITY: STATE: ZIP: JOB DESCRIPTION:__________________________________ MASTER PLAN: (Number or Address)____________________ LIST OTHER STRUCTURES ON PROPERTY:_______________________________________________________________ ESTIMATED VALUATION: PROPOSED START DATE: END DATE: (New Residential Only): LEGAL DESCRIPTION: LOT: _____ BLOCK: _____ SUBDIVISION: APPLICANT IS: RESIDENT OWNER CONTRACTOR EMAIL NEW MODEL HOME: YES NO (IF YES – ADMINISTRATIVE PERMIT REQUIRED)ISD # PLEASE FILL OUT THE FOLLOWING COMPLETELY (All Contractor information must be as listed on State License) RESIDENT OWNER NAME:_______________________________________________________________________________ HOME PHONE #:_____________________________ CELL PHONE:___________________________ GENERAL CONTRACTOR Homeowner Contractor CONTRACTOR:_______________________________________________________________________ LICENSE #:BC______________ LEAD CERTIFICATE#_______________ (PRE 1978 STRUCTURE) OFFICE PHONE #:_____________________________ CELL PHONE:___________________________ ADDRESS:____________________________ CITY:________________ ST:______ ZIP:____________ PLUMBING WORK Homeowner Contractor CONTRACTOR:__________________________________________LICENSE #: PM______________ OFFICE PHONE #:_____________________________ CELL PHONE:___________________________ ADDRESS:____________________________ CITY:________________ ST:______ ZIP:____________ MECHANICAL WORK Homeowner Contractor CONTRACTOR:________________________________________ _______________________________ OFFICE PHONE #:_____________________________ CELL PHONE:___________________________ ADDRESS:____________________________ CITY:________________ ST:______ ZIP:____________ BOND #:_______________________________________ EXPIRATION DATE____________________ SEWER/WATER CONTRACTOR New Construction Only NAME:________________________________________________ ______________________________ HOME PHONE _____________________________ CELL PHONE:______________________________ BOND #:_______________________________________ EXPIRATION DATE____________________ INTEREST EARNINGS ON THE ESCROW ACCOUNTS, IF ANY, ARE RETAINED BY THE CITY TO OFFSET THE ADMINISTRATIVE COSTS ASSOCIATED WITH PROCESSING THE ESCROW APPLICATION AND REFUND. I HEREBY APPLY FOR A BUILDING 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 AND WITH THE STATE BUILDING CODE, THAT I UNDERSTAND THIS IS NOT A PERMIT AND WORK IS NOT TO START WITHOUT A PERMIT AND THAT THE WORK WILL BE IN ACCORDANCE WITH THE APPROVED PLAN. NAME OF APPLICANT (Please Print)DATE APPLICANT’S SIGNATURE: RESIDENTIAL BUILDING PERMIT APPLICATION PAGE 2 OFFICE USE ONLY BUILDING PERMIT TYPE REQUIRED INSPECTIONS SINGLE FAMILY DWELLING BUILDING DUPLEX AS BUILT TOWNHOUSE UNITS BUILDING FINAL DETACHED TOWN HOUSE UNIT DECK FOOTING CONDO FIREPLACE ACESSORY BUILDING FOOTING REROOF FOUNDATION RESIDE FRAMING PORCH FRAMING GARAGES INSULATION RES ADDN/REPAIR/RMDL DECK PORCH GARAGES LATH LOWER LEVEL FINISH LOWER LEVEL FINAL ADDITION OTHER FOUNDATION ONLY PORCH FOOTING MISCELLANEOUS POURED WALL DEMO SEPTIC TANK REMOVAL MOVED SITE MECHANICAL CITY BUILDING VALUATION: $AIR TEST FINAL BUILDING PERMIT FEES ROUGH-IN $PERMIT FEE PLUMBING $PLAN CHECK FINAL $SURCHARGE ROUGH-IN $METRO SAC METER SIZE $CITY WATER HOOKUP UNIT PRESSURE REDUCING VALVE $CITY SEWER HOOKUP UNIT SEWER/WATER $LANDSCAPE ESCROW SEWER/WATER $TREE ESCROW FINAL $MISC ESCROW STREET DRAINTILE $PLUMBING BUILDING INFORMATION $MECHANICAL TYPE OF CONSTRUCTION $SEWER WATER ZONING $OTHER CODE EDITION $TOTAL FIRE SUPPRESSION SYSTEM OCCUPANCY GROUP APPROVED BY: BUILDING INSPECTOR: Date: PLUMBING/MECHANICAL INSPECTOR: Date: COMMENTS: Concept Approval ONLYSubject to Field InspectionInspectorDate2015MN BldgCode08/09/2017dmathews UFER Ground-Provide 20' Rebar in footing and stubup near electrical service panel.ShearwallShearwallShearwall -Min. 15" clearance to anyobstruction from center ofW.C., 24" in front(typ).Shearwall Shearwall Shearwall 55555555666655653.5PFHPFH4.5 R-4 on pipe in attic                                  ©                      16232 Elmhurst Lane Lakeville 55044                                                                            ©                                                                                   ©                                                                ©                                                        ©                                                      ©                                                                     ©                                                                  ©                                                                      ©                                                                                                  ©                                                                                                                 ©                                                                                                                                        ©                              ©                              ©                                                                                       ©                                              ©                        40,000 X X 40,000 2688 40,000 3000 3000 2688 3000 .9 .9 .1 40,000 40,000 13.33 13.33 .1 1.33 1.3 3608 541 280 415 415 541 Neg # 140 70 Date Certificate Posted x Passive (No Fan) Active (With fan and monometer or other system monitoring device) Location (or future location) of Fan: Other Please Describe Here X R-10 X R-21 X R-21 X R-21 X R-49 X R-30 X R-30 X R-30 X X Not applicable, all ducts located in conditioned space X Not required per mech. code Passive Powered Interlocked with exhaust device. Describe: Input in BTUS:80,000 Capacity in Gallons: Other, describe: AFUE or HSPF%92% Cfm's " round duct OR " metal duct Not required per mech. code 6"Passive Low: Other, describe: X Low: Location of fan(s), describe: Cfm's " round duct OR " metal duct Total ventilation (intermittent + continuous) rate in cfms: Balanced Ventilation capacity in cfms: High: High: MECHANICAL VENTILATION SYSTEM Capacity continuous ventilation rate in cfms: 43VP50E2 DX13SN0301A Location of duct or system: Heating or Cooling Ducts Outside Conditioned Spaces R-410A Make-up Air Select a Type Rheem Domestic Water Heater Gas MECHANICAL SYSTEMS Rating or Size Efficiency 13SEER /EER Model Heating System Gas Daikin DM92SS0803B Manufacturer Daikin 50 Output in Tons:2.5 Appliances Cooling SystemTotal R-Value of all Types of InsulationType: Check All That Apply Mineral FiberboardTHERMAL ENVELOPE Insulation Location Foam, Closed CellFoam Open Cell Wall Non or Not ApplicableFiberglass, BlownFiberglass, Batts Foundation Wall R-value Average U-Factor (excludes skylights and one door ) U: Duct system air tightness: Fuel Type Solar Heat Gain Coefficient (SHGC):0.30 Describe other insulated areas RADON CONTROL SYSTEM Rim Joist (2nd Floor+) 0.30 Building envelope air tightness: 6 MIL POLY - 4" AGG INTERIOR INTERIOR Below Entire Slab Rigid, Extruded PolystyreneRigid, Isocynurate Perimeter of Slab on Grade Ceiling, flat ATTIC EXTERIOR SEALANT Rim Joist (1st Floor) Windows & Doors Ceiling, vaulted Heat Recover Ventilator (HRV) Capacity in cfms: Energy Recover Ventilator (ERV) Capacity in cfms: Combustion Air Select a Type Location of duct or system: 24,22462,914 Heating Gain Cooling Load 70 140 Select Type Describe any additional or combined heating or cooling systems if installed: (e.g. two furnaces or air source heat pump with gas back-up furnace): 21,397 Residential Load Calculation Heating Loss Bay Windows or cantilevered areas Floors over unconditioned area Per R401.3 Certificate. A building certificate shall be posted on or in the electrical distribution panel.8/11/2017 New Construction Energy Code Compliance Certificate Name of Residential Contractor Robert Thomas Homes MN License Number BC644819 City Mailing Address of the Dwelling or Dwelling Unit Lakeville16232 Elmhurst Lane Builders Associaton of Minnesota version 101014