HomeMy WebLinkAboutLA183765 PERMIT
City of Lakeville Permit Type: Fire
20195 Holyoke Ave Permit Number: LA183765
Lakeville,MN 55044
(952)985-4440 * L R 1 8 3 7 6 5 �K
www.ci.lakeville.mn.us Date Issued• 09/04/2020
Site Address: 18484 Kachina Ct
Lot: Block: Addition:
PID: �
Use: Park Nicollett * *
Description:
Sub Type: LP Gas
Work Type: New
Description: Temp Heat
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' Descr�tion Amount Revenue Code
FI-Fire(minimum) $45.00 1000-4152
Surcharge- $1.00 $1.00 1000.2127
Total: $46.00
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Contractor: - Appil�ant - Owner:
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.
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Applicant/Permitee: Signature Issued By: Signature
Office Use On�
FIRE PERMIT APPLICATION �',;',��',��
Pernvt Number
CITY OF LAKEVILLE �j�� f �t1_._�y�,�,��
BUII..DING INSPECTIONS DEPARTMENT � a�'
/ + • 20195 HOLYOKE AVENUE Received By
LAKEVILLE,MN 55044 �!�f�- - ��
952-985-4440 Date Received
wwwlakevillemn.gov ' ��
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Amount
DATE YOUR E-MAII,ADDRESS .J i rv� � C�S��c..�'a�a ,[.r�►-�
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SITE ADDRESS �S`f�KQc1•�;+�.n C�
TENANT t'e�� ����f�C� SUITE NO.
COMPANY NAME � � LICENSE#
ADDRESS �/3 ✓�'1 t e'f'��r.c S
CONTRACTOR CITY Gv�G►.�,.�ct� STATE vY�/��ZIP S"S39 1
CONTACT NAME J,�. Jok.�so�n OFFICE PHONE# [./2-4R O^//9 Z
DAYTIME PHONE#WHERE YOU CAN BE REACHED �o I Z• �FS'D- 1�9 2
NEW ADDITION ALTER/REMODEL
TYPE OF WORK
REPAIR REPLACE DEMOLITION
Automatic Fire-Extinguishing Sys Industrial Ovens
PERMIT SUB-TYPE Standpipe Systems LP Gas
Flammable&Combustible Liquids Systems ooth
Hazardous Material
�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 Alann Low Voltage
JOB DESCRIPTION: �Cw�� �,e.�i�" j�r C�✓i cl �19 �cS�nd Oti. T Gr.T
FIRE PERMTT FEES:
Residential Fees: New Construction$90.00+$1.00(State Surchazge)_$91.00
Remodel$45.00+$1.00(State Surchazge)_$46.00
Commercial Fees:
Job Cost:$
Example:$12,000 Job Cost
1-1/2%of conuact 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 urchazge)_
Applicant's Printed Name �i w� � H
Applicant's Signature �-� t Date �/,3/ ZD Zo
FIRE SUPPRESSION PERMIT APPLICATION PAGE 2
OFFICE USE
SYSTEM TYPE: INSPECTIONS:
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:
PERMTT FEE: $
SURCHARGE: $
OTHER: $
TOTAL: $
ISSUED BY: DATE:
COMMENTS:
Revised 12/28/2017