HomeMy WebLinkAboutLA108955 PERMIT
Clty Of LakeVllle Permit Type: Fire
20195 Holyoke Ave Permit Number: LA108955
Lakeville, MN 55044
(952) 985-4440 %K L R 1 (C7 8 9 5 5
www.ci.lakeville.mn.us Date Issued: 11/18/2008
Site Address: 16345 Elm Creek La
Lot: 001 Block: 002 Addition: Fieldstone Creek 3rd Addition
PID: 22-26702-010-02
Use: 16345-47-49-51-53-55 Elm Creek * Z 2 - 2 6 7 !7J 2 - (d 1 - D 2
Description:
Sub Type: Automatic Fire-Extinguishing System 116 New Sprinkler Heads
Work Type: New
Description: 6 Unit Townhouse
Construction Type:
Occupancy:
Zoning:
Sprinkled Area Updated Building
of Permit Totals
Stories: 0 0
Square Feet: 0 0
Percent of Bldg: 0 0
Comments' Call 952-985-4706 to schedule inspections.
Fee Summary: Description Amount Revenue Code
Valuation: 15,000.00 FI-Fire $200.00 1000-4152
Surcharge -Based on Valuation $7.50 1000-2127
Total $207.50
Contractor: _ Applicant - Owner:
Metro Fire Protection DR Horton Inc MN
8145 Lake Drive 20860 Kenbridge Ct Ste 100
Lino Lakes MN 55014 Lakeville MN 55044
(651) 784-0417
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 Only
FIRE SUPPRESSION PERMIT APPLICATION
' Permit Number
CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT
• 20195 HOLYOKE AVENUE Recei d By
LAKEVILLE, MN SSO44 ~ - ~ ~ P ~ ~ ~ ~ ~ ~
952-985-4440 Date Received
www. c i.l akev i 11 e. m n, us
Amount
DATE 10~I,OB YOURS-MAILADDRESSO~(J,M12~Tb~1t'tOTt~}tt~l-ior~.tdw~
SITE ADDRESS 14345- 1V355 6uM CRE6iG W
TENANT SUITE NO.
COMPANY NAME ~ntoF=~c~ t`~af~tTSeN. zNC. LICENSE# G-crt4
ADDRESS 8145 lrt,~ 'DIC.
CONTRACTOR CITY L2No I.pKES STATE vH~ ZIP 55014
CONTACT NAME~`~gk'Ig~py,) OFFICE PHONE l= 'Ig4-O.41"I
DAYTIME PHONE # WHERE YOU CAN BE REACHED 51--184 - [r! 1'I
(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 ? Paint Booth
? Hazardous Material
QTY FIRE ITEMS TY FIRE ITEMS
Dry System 111. 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
JOB DESCRIPTION ~1S~c- CowtPt.6T6 NFPA 1'3R Qt)'tOwlATtt. SPRtNk{.Et ~I5'rErvl
FIRE PERMIT FEES:
70B COST: $ 15, one . on
Example: $12,000 Job Cost
1-1/2% of contract cost up to $10,000 and I sp . OCR $10,000.00 x 1.5% _ $150.00
1% of cost above $10,000 plus surcharge. + $p . DO $ 2,000.00 x 1% = 20.00
(Surcharge =Contract Cost x .0005) + T . $D $12,000 x .0005 = 6.00
TOTAL = L07.5a TOTAL $176.00
Minimum of $40.00 (39.50 + .5~0
surcharge)
Applicant's Printed Name '~A-[11C=ck ~IGEnC~'Gt~~
Applicant's Signature _ ~.;,~c~lu~-w Date _ 1~
~ 1 , OS
I
f
r r
FIRE SUPPRESSION PERMIT APPLICATION PAGE 2
OFFICE USE
SYSTEM TYPE: INSPECTIONS:
NEW ROUGH-IN
ADDITION AIR TEST
REPAIR ~ HYDRO-STATIC TEST
DEMOLISH FLOW TEST
REPLACE TANK /PIPING REMOVAL
ALTER/REMODEL FIRE PUMP TEST
MAIN DRAIN TEST
' TRIP TEST
FLUSHING
OTHER
FINAL
PERMIT FEE.
PERMIT FEE: $
SURCHARGE: $
OTHER: $
TOTAL: $
~ ~ l
ISSUED BY- DATE: / 7{~
COMMENTS:
Revised 01/19/2007