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LA157736 16236 Equestrian Trail Permit Pack
RESIDENTIAL 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: PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... OF SHEETCopyright of these documents is owned by Robert Thomas Homes, Inc. and reserves ALL rights.These plans may not be re-used, copied or assigned to another party nor shall they be modified orused in part in other designs without the prior written consent of Robert Thomas Homes, Inc.1 12 APPROXIMATE SQUARE FOOTAGE ABOVE GRADE FINISHED BELOW GRADE FINISHED BELOW GRADE UNFINISHED GARAGE SQ. FT. SQ. FT. SQ. FT. SQ. FT. 2,258 673 197 572 Concept Approval ONLY Subject to Field Inspection Inspector Date 2015 MN Bldg Code 10/20/2017dmathews PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... OF SHEETCopyright of these documents is owned by Robert Thomas Homes, Inc. and reserves ALL rights.These plans may not be re-used, copied or assigned to another party nor shall they be modified orused in part in other designs without the prior written consent of Robert Thomas Homes, Inc.2 12 PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... OF SHEETCopyright of these documents is owned by Robert Thomas Homes, Inc. and reserves ALL rights.These plans may not be re-used, copied or assigned to another party nor shall they be modified orused in part in other designs without the prior written consent of Robert Thomas Homes, Inc.3 12 UFER Ground -Provide 20' Rebar in footing and stub up near electrical service panel. PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... OF SHEETCopyright of these documents is owned by Robert Thomas Homes, Inc. and reserves ALL rights.These plans may not be re-used, copied or assigned to another party nor shall they be modified orused in part in other designs without the prior written consent of Robert Thomas Homes, Inc.4 12 4 3.52.4 4 4 4 PFG PFG 4 6 5 54 4 4 Connections 6.5 TEMPER Stagger floor sheathing above wall, fasten porch LVLs to top plate w/(4) 3-5/8" Ledgerlocks Connections PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... OF SHEETCopyright of these documents is owned by Robert Thomas Homes, Inc. and reserves ALL rights.These plans may not be re-used, copied or assigned to another party nor shall they be modified orused in part in other designs without the prior written consent of Robert Thomas Homes, Inc.5 12 -Min. 15" clearance to any obstruction from center ofW.C., 24" in front(typ). 6 4 4 4 4 4 4 4 4 4 4 4 4 3.5 2.75 2.75 2.75 4 Connections PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... OF SHEETCopyright of these documents is owned by Robert Thomas Homes, Inc. and reserves ALL rights.These plans may not be re-used, copied or assigned to another party nor shall they be modified orused in part in other designs without the prior written consent of Robert Thomas Homes, Inc.6 12 PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... OF SHEETCopyright of these documents is owned by Robert Thomas Homes, Inc. and reserves ALL rights.These plans may not be re-used, copied or assigned to another party nor shall they be modified orused in part in other designs without the prior written consent of Robert Thomas Homes, Inc.7 12 R-4 on pipe in attic PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... OF SHEETCopyright of these documents is owned by Robert Thomas Homes, Inc. and reserves ALL rights.These plans may not be re-used, copied or assigned to another party nor shall they be modified orused in part in other designs without the prior written consent of Robert Thomas Homes, Inc.8 121/4"1-1/2" PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... OF SHEETCopyright of these documents is owned by Robert Thomas Homes, Inc. and reserves ALL rights.These plans may not be re-used, copied or assigned to another party nor shall they be modified orused in part in other designs without the prior written consent of Robert Thomas Homes, Inc.9 12 PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... OF SHEETCopyright of these documents is owned by Robert Thomas Homes, Inc. and reserves ALL rights.These plans may not be re-used, copied or assigned to another party nor shall they be modified orused in part in other designs without the prior written consent of Robert Thomas Homes, Inc.10 12 LED LED LOW VOLTAGE LED LED CFL HALOGEN LED PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... OF SHEETCopyright of these documents is owned by Robert Thomas Homes, Inc. and reserves ALL rights.These plans may not be re-used, copied or assigned to another party nor shall they be modified orused in part in other designs without the prior written consent of Robert Thomas Homes, Inc.11 12 LED LED LOW VOLTAGE LED LED CFL HALOGEN LED PJW C.O. C.O. REVISIONS: PERMIT CUSTOMER .. 10/4/17 .. 10/11/17 .. .. DRAWN BY: .... .... 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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 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.10/11/2017 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 Lakeville16236 Equestrian Trail Heat Recover Ventilator (HRV) Capacity in cfms: Energy Recover Ventilator (ERV) Capacity in cfms: Combustion Air Select a Type Location of duct or system: 24,10254,376 Heating Gain Cooling Load 65 130 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): 21,331 Residential Load Calculation Heating Loss 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 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): 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: Total ventilation (intermittent + continuous) rate in cfms: Balanced Ventilation capacity in cfms: High: High: MECHANICAL VENTILATION SYSTEM Capacity continuous ventilation rate in cfms: Builders Associaton of Minnesota version 101014 NEW RESIDENTIAL CONSTRUCTION SWPPP VERIFICATION This form must be completed and submitted with all new residential permit applications. New residential building permits WILL NOT be issued without this completed form. Company Name: _________________________________________________________________________ Project Site Address: _____________________________________________________________________ Description of Land Disturbing Activity: _____________________________________________________ NPDES Construction Stormwater Permit # C000 ___ ___ ___ ___ ___ or # SUB00 ___ ___ ___ ___ ___ If you are not covered under a NPDES Construction Stormwater Permit administered by the MPCA, an erosion and sediment control plan MUST be submitted with the residential building permit application. “The permittee(s) shall ensure that the individuals are trained by local, state, federal agencies, professional organizations or other entities in erosion prevention, sediment control, permanent Stormwater management and the Minnesota NPDES/SDS Construction Stormwater Permit.” (NPDES Construction Stormwater Permit, MPCA) “The permittee(s) must ensure that a trained person (as identified in Part III.A.3.a) will routinely inspect the entire construction site at least once every seven (7) days during active construction and within 24 hours after a rainfall event greater than 0.5 inches in 24 hours.” (NPDES Construction Stormwater Permit, MPCA) Contact information of person CERTIFIED to provide weekly onsite erosion and sediment control inspections and corrective actions: Name of Person: ________________________________Company: _______________________________ Phone # (24 hr Contact): ______________________ Email: ______________________________________ Entity that Provided Training: ________________________ Certification Expiration Date: ____________ NOTE: Prior to any land-disturbing activity, all erosion and sediment controls must be installed on the project site and on individual lots. No land disturbing activity may begin until a residential building permit has been issued. I understand, the above information to be true and I will have read, understood, and accepted all terms and conditions of the National Pollutant Discharge Elimination System (NPDES) Permit (MN R 100001). The City of Lakeville may issue a STOP WORK ORDER; withhold building inspections; or, draw on securities/escrows to bring the site into compliance with the NPDES Construction Stormwater Permit (MN R 100001) or erosion and sediment control plan. Signature: ________________________________________________ Date:_________________________ Contact the City of Lakeville with questions at erosion@lakevillemn.gov or 952-985-4500 Rob St. Sauver Robert Thomas Homes 952-292-2419 rob.stsauver@traditiondevelopment.com U of MN 5/31/2019 N R 100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000001)1)))))))))1)1)1))))1)1))1)1)1)1)1)1)1)111111)1)))1111111))))))111111)))1)1111111111111111 ooooooooooooooooooooooooooooooooorrrrrrrr erererererrereerererrerererereeereeeeeereerrrrrreeerrrrrrrrrrrrrrrosooooooooooooooooooooooooooosoooooooooooooooooooooooooooooooooooooooooosoooooooooooooooooooooooooooooooooooooooosion anannnnnnnnnnnnannnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnannannnnnnnannnnnannnannnnnnnnanannnnnnnnnnnannannnnnnaaaaannnnnnaaannnnnaaannnannnanaannnaaannnaannnnnnaaannnnnd sediment control plan. re:______________________________________________________________________________________________________________________________________________________________________________________________________ 10/11/17 Robert Thomas Homes 16236 Equestrian Trail Excavation/construction of single family home 15765