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Home My WebLink AboutLA221951 - Residential-Building-Permit-Application-PDF (002)RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF LAKEVILLE BUILDING INSPECTIONS DEPARTMENT 20195 HOLYOKE AVENUE LAKEVILLE, MN 55044 952-985-4440 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) 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:________________________________________ _______________________________ _____________________________ CELL PHONE:___________________________ ADDRESS:____________________________ CITY:________________ ST:______ ZIP:____________ BOND #:_______________________________________ EXPIRATION DATE____________________ SEWER/WATER CONTRACTOR New Construction Only NAME:________________________________________________ ______________________________ _____________________________ CELL PHONE:______________________________ BOND #:_______________________________________ EXPIRATION DATE____________________ NAME OF APPLICANT (Please Print)DATE 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 CONDO REROOF RESIDE RES ADDN/REPAIR/RMDL DECK PORCH GARAGES LOWER LEVEL FINISH ADDITION FOUNDATION ONLY MISCELLANEOUS DEMO APPROVED BY: BUILDING INSPECTOR: Date: PLUMBING/MECHANICAL INSPECTOR: Date: COMMENTS: CITY BUILDING VALUATION: $ BUILDING PERMIT FEES $PERMIT FEE $PLAN CHECK $SURCHARGE $METRO SAC $CITY WATER HOOKUP UNIT $CITY SEWER HOOKUP UNIT $LANDSCAPE ESCROW $TREE ESCROW $MISC ESCROW $PLUMBING $MECHANICAL $SEWER WATER WATER METER PRESSURE REDUCING VALVE $OTHER $TOTAL METER SIZE PRESSURE REDUCING VALVE SEWER/WATER SEWER/WATER FINAL STREET DRAINTILE BUILDING INFORMATION TYPE OF CONSTRUCTION ZONING CODE EDITION FIRE SUPPRESSION SYSTEM OCCUPANCY GROUP MECHANICAL AIR TEST FINAL ROUGH-IN PLUMBING FINAL ROUGH-IN INSULATION LATH DECK FOOTING FIREPLACE FOOTING FOUNDATION FRAMING PORCH FRAMING PORCH FOOTING POURED WALL SITE LOWER LEVEL FINAL OTHER DECK FRAMING LOWER LEVEL FRAMING LANDSCAPING DECK FINAL $ $ ACCESSORY BUILDING EGRESS WINDOW UNDERGROUND