HomeMy WebLinkAboutLA196360 5801 Upper 179th St W Permit PackCANNOT HOOK TO CITY SEWER/WATER
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:
20195 Holyoke Avenue, Lakeville, MN 55044
952-985-4400 952-985-4499 fax
www.lakevillemn.gov
Sewer & Water Tie Card
Address:________________________________________
Contractor:______________________________________
Permit Number:__________________________________
Final Date:________________
Street Drain-Tile:______
Size of Water Service: 1”
Comments: AIRTEST SANITARY OVER 20’/2 FITTINGS
THIS CARD MUST BE COMPLETED AND ON-SITE AT TIME
OF SEWER & WATER INSPECTION
Secure door closed until deck is
constructed with a separate permit.
*Flipped*
Concept Approval ONLY
Subject to Field Inspection
Inspector Date
2020
MN Bldg
Code
10/01/2021dmathews
UFER Ground
-Provide 20' Rebar in footing and stub
up near electrical service panel.
BWPs
Above
Verify loads with girder
truss specs, may require
removal of top plates at
bearing due to crushing.
5.17' LIB 5.17' LIB 5.17' LIB
4' WSP
4' WSP
4' WSP
4' WSP
3'
CS-WSP
3'
CS-WSP
BWPs
Above
PFH PFH
4' WSP
4' WSP
8' LIB
8' LIB
8' LIB
8' LIB
2.25' WSP 2.25' WSP
-Min. 15" clearance to any
obstruction from center of
W.C., 24" in front(typ).
8' LIB
Date Certificate Post
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-15 x
x
R-20 x x
R-20 x x
19+5 x x
R-49 x
R-49 x
R-38 x
R-38+5 x x
Not applicable, all ducts located in conditioned space
X
x Not required per mech. code
Passive
Powered
Interlocked with exhaust device.
Describe:
Input in
BTUS:
66,000 Capacity
in Gallons:
Other, describe:
AFUE or
HSPF%
93%
Cfm's
" round duct OR
" metal duct
Not required per mech. code
X Passive
x Low: Other, describe:
Low:
Location of fan(s), describe: Cfm's
6 " Flex
" metal duct
Balanced Ventilation capacity in cfms:
Capacity continuous ventilation rate in cfms:
Total ventilation (intermittent + continuous) rate in cfms:
82 High:
Energy Recover Ventilator (ERV) Capacity in cfms: High:
Location of duct or system:
Below Entire Slab
Foundation Wall
Perimeter of Slab on Grade
Rim Joist (1st Floor)
Rim Joist (2nd Floor+)
Wall
Ceiling, flat
R-5 where required
R10 Rigid Exterior, R10 Int closed cell
R10 Rigid Exterior, R10 Int closed cell
R5 Exterior, R19 Batts
New Construction Energy Code Compliance Certificate
Per R401.3 Certificate. A building certificate shall be posted on or in the electrical distribution
panel.
Mailing Address of the Dwelling or Dwelling Unit City
Lakeville5801 Upper 179th Street W
Name of Residential Contractor
MECHANICAL VENTILATION SYSTEM
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):
Combustion Air Select a Type
Select Type
Heat Recover Ventilator (HRV) Capacity in cfms: 192
MN License Number
Brandl Anderson Homes BC604388
THERMAL ENVELOPE RADON CONTROL SYSTEM
Type: Check All That Apply
Insulation Location
Total R-Value of all Types of InsulationNon or Not ApplicableFiberglass, BlownFiberglass, BattsFoam, Closed CellFoam Open CellMineral FiberboardRigid, Extruded PolystyreneRigid, IsocynurateAttic
Residential Load Calculation
Heating Loss Heating Gain Cooling Load
48911 13718 18,746
13 Location of duct or system:
Rating or Size 50 Output
in Tons:2
Efficiency
SEER
/EER
Natural Gas Natural Gas Electric
13ACXN024
Fuel Type
Manufacturer Lennox Lennox
Model ML193UH070
Average U-Factor (excludes skylights and one door ) U: 0.30
Solar Heat Gain Coefficient (SHGC): 0.30 R-value R-8
MECHANICAL SYSTEMS Make-up Air Select a Type
Appliances Heating System
Domestic Water
Heater Cooling System
Duct system air tightness:
Heating or Cooling Ducts Outside Conditioned Spaces
Ceiling, vaulted
Bay Windows or cantilevered areas
Floors over unconditioned area
Describe other insulated areas
Building envelope air tightness:
Windows & Doors
000000Builders Associaton of Minnesota version 101014
40,000
X
X
40,000
1408
40,000
3000
3000
1408 3000 .47
.47 .53
40,000
40,000 13.33
13.33 .53 7.1
3.01
NR
240
375
375
3618
542
542
170
85
09/20/21 X
KP