HomeMy WebLinkAboutLA178072 PERMIT
City of Lakeville Permit Type: Fire
20195 Holyoke Ave Permit Number: LA178072
Lakeville,MN 55044 �
(952)985-4440 * L R 1 7 8 0 7 z *
www.cilakeville.mn.us Date Issued: 03/17/2020
Site Address: 18484 Kachina Ct
Lot: Block: Addition:
PID:
Use: Park Nicollett * *
Description:
Sub Type: LP Gas
Work Type: New
Description: Temp Heat for tent for COVID-19 testing
Construction Type:
Occupancy:
Zoning:
Sprinkled Area Updated Building
of Permit Totals
Stories: 0 0
Square Feet: 0 0
Percent of Bldg: 0 0
Comments:
Fee Summary' Descri�tion Amount Revenue Code
FI-Fire(minimum) $45.00 1000-4152
Surcharge- $1.00 $1.00 1000.2127
Total: $46.00
Contractor: - Applicant - �Wner:
ES Energy LLC
2213 Meeting St
Wayzata MN 55391
(612)490-1192
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
Office Use O
;�:�_���e} -�
FIRE PERMIT APPLICATION �.
�Permit Number
CITY OF LAKEVILLE ����J��
BUILDING INSPECTIONS DEPARTMENT
/ • 20195 HOLYOKE AVENUE Received By
LAKEVILLE,MN 55044 �; ' �� . -' �� ��.a
952-985-4440 'Da e Received
www.lakevillemn.eov �^,�'�t„ �-�v
t ,
Amount
�-a,i�� i,i:�:� V�i ��i(,� j;%�✓C���i��J�
DATE ,3//!s/ZO YOUR E-MAIL ADDRESS � i vK Cd �,_,S {Cne��t.c o w�
SITE ADDRESS /��p'� �g i� C'�.
TENANT SUITE NO.
COMPANY NAME k^S �htr�� Ll_L_. LICENSE#
ADDRESS o�d�/3 ✓11�c��S-k.
CONTRACTOR CITY STATE l�Yt N ZIP S�S3g I
CONTACT NAME�J%w. , a�wso�. OFFICE PHONE# (Q/2- 4�q0—r 14 2
DAYTIME PHONE#WHERE YOU CAN BE REACHED ��2"�'FQO "!1�i 2
EW ADDITION ALTER/REMODEL
TYPE OF WORK
PAIR REPLACE DEMOLITION
Automatic Fire-Extinguishing Sys Industrial Ovens
PERMIT SUB-TYPE Standpipe Systems �P-�'ira�
Flammable&Combustible Liquids Systems Paint Booth
Hazardous Material
1�TY FIRE ITEMS �TY FIRE ITEMS
Dry System New Sprinkler Heads
Wet System Relocated Sprinkler Heads
Preaction System Spare Sprinkler Heads&Wrench
FIRE ITEMS
Deluge System Underground Fuel Tank
Compressed Gases � Above Ground Fuel Tank
Fire Pumps&Related Equipment Fire Alarm Low Voltage
JOB DESCRIPTION: S�� �-'f?e�� LP q0.s �� � l�.T�.•c1 �nr TG�-1 �ra'h�3L�a Lo,r
-��5�►� bo,� ��;� rg
FIRE PERMTT FEES:
Residential Fees: New Construction$90.00+$1.00(State Surchazge)_$91.00
Remodel$45.00+$1.00(State Surcharge)_$46.00
Commercial Fees:
Job Cost:$
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$45.00+$1.00(State Surcharge)_
Applicant's Printed Name ���►�►� Jo4Y.Sc•�
Applicant's Signature in,So Y—�- Date 3�l�.�2p
FIRE SUPPRESSION PERMIT APPLICATION PAGE 2
OFFICE USE
SYSTEM TYPE: IN5PECTIONS:
NEW AIR TEST
ADDITION FINAL
REPAIR FIRE PUMP TEST
DEMOLISH FLOW TEST
REPLACE FLUSHING
ALTER/REMODEL HYDRO-STATIC TEST
MAIN DRAIN TEST
OTHER
ROUGH-IN
TANK/PIPING REMOVAL
TRIP TEST
PERMIT FEE:
PERMIT FEE: $
SURCHARGE: $
OTHER: $
TOTAL: $
ISSUED BY: DATE:
COMMENTS:
Revised 12/28/2017