HomeMy WebLinkAboutLA225278-17889 Eclipse Ave-Permit PackRESIDENTIAL 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
I HEREBY APPLY FOR PERMIT AND ACKNOWLEDGE THAT ALL INFORMATION ON THIS
APPLICATION IS COMPLETE AND ACCURATE. THIS IS NOT A PERMIT AND WORK IS NOT TO
COMMENCE UNTIL SUCH TIME A PERMIT IS ISSUED. ALL WORK WILL COMPLY WITH
LAKEVILLE CITY CODE, THE MINNESOTA STATE BUILDING CODE, AND THE APPROVED
PLANS. INTEREST EARNINGS ON ESCROW ACCOUNTS, IF ANY, WILL BE RETAINED BY THE
CITY TO OFFSET THE ADMINISTRATIVE COSTS ASSOCIATED WITH PROCESSING THE
ESCROW APPLICATION AND REFUND.
OFFICE PHONE #:_
OFFICE PHONE #:_
*Entering your name affirms your intent to comply with the statement above.
*
Submit Application To: permits@lakevillemn.gov
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
!"#$"%%%%&’("&$&’("&$&’("&$&’("&Concept Approval ONLYSubject to Field InspectionInspectorDate2015MN BldgCode07/05/2024jnuetzman
WH !"# !"# !"#SDSD"""$"""%&"$"’$"""$"""$"$’"$""""$%""&$"&"$&"’"%"$$""""$&"$""$"$"$’"$’"$"&%"$"$""$"$&%"$&"$’"$’"$’"$"$(()) $& $ $$"$"* $)"$)"$)"’+,+’"-./01* $) % ),&)+ )$’ ),% +$2 )$"#)’$’$) 3& $) $$$’$’$)"’()4+’$(+ ) (,+) !"+-(++)+1&$(+ ) 3) !"+ ) !"+-(++)+1&’))))5))-$"$+1))$"$+++"$)+)$"$+++!!)))(* ’"$)++)+3)+))))+2 !"#$"&’("&!%!%!%!%&’("&&’("&66+* )6" pastend ofwall48" CS-WSP54" CS-WSPUFER Ground-Provide 20' Rebar in footing and stubup near electrical service panel.-Min. 15" clearance to anyobstruction from center ofW.C., 24" in front(typ).SmokeCOBWPsAboveBWPsAbove
REF.D/W’"""$’"&%"$&%"$’"""&"$"$"$"$"$"$""$"% "&"’ "$" "" "’"’""$&"$""$$""""$"$’""""$"$"$"$""&""""%"$’"""&""’"""$"$%"$"$&"$’"$&"$’"$’"$&"$"$’"$"’"$’"$"$, $ )$ $ $ )3
( $ $6"$-*1 ( $6"$( $6"$%" $& $6"$)( $ $’ $ $)(’ $ $,’ $)$"# +3% * 3+) "#$"#% ,+) &% $"#$"#% $"#$"#" %" " 442++))(!"#!"#+’ )))))+)+ %)( )+ ))),( )+ ))(+ ) )6+& )6 )"$ (+ ) )6+& )6((+33+)(+!2(* ,)$&$$$7( ’$$89 3 !’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’<=D/0?#B;##89=0$./0/.@.8:;=E/0/.@.9;=E:>>.G;;8/0D9;#’3@=:E:=/B><;0#/E;#8;<#’ .=/.@.:/#;:5>0>0;#/E;5’’=C>F;8:;=E0>#/0?5./0/.@.*/E89;#/E;08/=B#8=/:#>:.>:;:/#;:#:;I@/:;#=9=0E:=/B#9;;8:>DH;E*9;0;0DB>#;E9;@0E;:#/E;>G#8=/:#3B=0E/0?##9=BBC;D>.<B;8;BA/0/.@.=88/D=DD;##’$B@.C/0?=DD;##:;I@/:;E>0=BB8@C#@BBB;0?895D>08/0@>@#9=0E:=/B#:;I@/:;E5*/89;0E#=:=?;G/:;E>>:5#>B/ED>:;#;BGDB>#/0?>:#<=D/0?:;I@/:;E/:D9@8;#;F;:A#<=D;:;8@:0;E !"#$")$&’("&%%%%&’("&-Min. 15" clearance to anyobstruction from center ofW.C., 24" in front(typ).BWPsAboveBWPsAbove48" CS-WSP46" CS-WSP48" CS-WSP48" CS-WSP48" CS-WSP12' GB78" GB48" CS-WSP48" CS-WSP48" CS-WSP54" CS-WSP48" CS-WSP48" CS-WSP48" CS-WSPPFHPFHPFH48" CS-WSP
SDSDSDSDSDSD’"$""$"$""$’"&’"&$"$"&’"$"$"’"’"’&"’"’"&" " "$"’"%"’"’"$""$"""$"$"%"$"&"$""’"$""""%%"$&"$"$&"$’"$’"$"$%"$"")7)+)7’)7))& $)$( $* ’" 3 ,( $ $ ,* ) $)"#,& $)3
& $)3’ $& $& $& $ , ( $ $& $ $ $ $)(-E1 & $) +* +% $"#333
$"#$"#$"#$"#+ +-’ 1-’ 1-1,) !"#$"&’("&*+*+*+*+&’("&)-Min. 15" clearance to anyobstruction from center ofW.C., 24" in front(typ).SmokeCOSmokeCO24" CS-WSP24" CS-WSP24" CS-WSP48" CS-WSP48" CS-WSP48" CS-WSP24" CS-WSP24" CS-WSP24" CS-WSP48" CS-WSP48" CS-WSP48" CS-WSP96" GB52" GB
’"$"$$&)++)++"$"$"$$"$"$"$’"$’"$"""$"$"$’"$"$"$’))++)+))++)++)++)++&)++)+))++)++)++)++)++)++)++’)+’)+&)+%"""$’"$&"$""$))++)++)++)++%)+)&)+))++)++)++)++)++)++)++)+++"$"$(6$$)+-)1)"+’ * E’+3’>D5$$$/C))),,* E, )+5)),+++-1 * ’ +$"$("$(+* +)),J!J),J!) ))++)$’&))E->:’ 15),J!)+)+)+)+* +)++)++’)++5)+)++$"$+$$7+)+)+ )++) +)* ++’)(6!"5),6!5), !"#$" % % % % &’("&% % % % &’("& &’("&&’("& % % % %
1 2 3 4 5 6 2
Conditioned space1 (in sq. ft.)
Total/
Continuous
Total/
Continuous
Total/
Continuous
Total/
Continuous
Total/
Continuous
Total/
Continuous
1000-1500 60/40 75/40 90/45 105/53 120/60 135/68
1501-2000 70/40 85/43 100/50 115/58 130/65 145/73
2001-2500 80/40 95/48 110/55 125/63 140/70 155/78
2501-3000 90/45 105/53 120/60 135/68 150/75 165/83
3001-3500 100/50 115/58 130/65 145/73 160/80 175/88
3501-4000 110/55 125/63 140/70 155/78 170/85 185/93
4001-4500 120/60 135/68 150/75 165/83 180/90 195/98
4501-5000 130-65 145/73 160/80 175/88 190/95 205/103
5001-5500 140/70 155/78 170/85 185/93 200/100 215/108
5501-6000 2 150/75 165/83 180/90 195/98 210/105 225/113
1. Conditioned space includes the basement and conditioned crawl spaces.
2. If conditioned space exceeds 6000 sq. ft. or there are more than 6 bedrooms, use Equation R403.5.2
R403.5.2 Total Ventilation rate.
The mechanical ventilation system shall rovide sufficient outdoor air to equal the total ventilation rate average
for each 1- hour period in accordance with Table R403.5.2, or Equation 403.5.2, based on the number of bedrooms and
square footage of conditioned space, including the basement and conditioned crawl spaces.
For the purposes of Table R403.5.2 and Section R403.5.3, the following applies:
a. Equation R403.5.2 Total ventilation rate:
Total ventilation rate (cfm) = (0.02 x square feet of conditioned space) + (15 x (number of bedrooms +1))
b. Equation R403.5.2.1 Continuous ventilation rate: Continuous ventilation rate (cfm) = Total ventiation rate/2
Amount Total _________________________
Amount Continuous____________________
TABLE R403.5.2
NUMBER OF BEDROOMS
VENTILATION REQUIREMENTS
160
80
17889 Eclipse Ave. Lakeville
17889 Eclipse Ave
Date Certificate Posted
x Passive (No Fan)
Active (With fan and monometer
or other system monitoring
device )
Location (or future location) of Fan:
Other Please Describe Here
R-5 and R-10 x x
20 x
20 x
21 x
50 x
50 x
30 x
Not applicable, all ducts located in conditioned space
8
Not required per mech. code
x Passive
Powered
Interlocked with exhaust device.
Describe:
Input in
BTUS:
50,000 Capacity in
Gallons:
Other, describe:
AFUE or
HSPF%
95%
Cfm's
" round duct OR
" metal duct
Not required per mech. code
x Passive
Low: Other, describe:
x Low:
Location of fan(s), describe: Cfm's
" round duct OR
" metal duct
S9X1B060UASB
Heating Loss
Manufacturer American Standard
gas
Output
in Tons:
2 1/250
Total ventilation (intermittent + continuous) rate in cfms:
Balanced Ventilation capacity in cfms:
High:
High:
MECHANICAL VENTILATION SYSTEM
160 CFM
80 CFM Capacity continuous ventilation rate in cfms:
All bathrooms
Select Type
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):
24,885Residential Load Calculation
SEER
/EER
Location of duct or system:
Heating or Cooling Ducts Outside Conditioned Spaces
electric
Make-up Air Select a Type
A.O.Smith
Domestic Water
Heater
MECHANICAL SYSTEMS
Rating or Size
Efficiency
13
Building envelope air tightness:
Rim Joist (1st Floor)
AGPVH50 4A7A3030 Model
Heating System
gas
American Standard Fiberglass, Batts Foundation Wall
R-value
Average U-Factor (excludes skylights and one door ) U:
Duct system air tightness:
Installed on the inside
Cooling SystemTotal R-Value of all Types of InsulationType: Check All That Apply
Mineral Fiberboard Insulation Location
Foam, Closed Cell0.32
Describe other insulated areas Fiberglass, BlownTHERMAL ENVELOPE
Foam Open Cell Wall Rigid, Isocynurate Perimeter of Slab on Grade
RADON CONTROL SYSTEM
Install on inside and outside of wallNon or Not ApplicableAttic
Fuel Type
Solar Heat Gain Coefficient (SHGC):
Windows & Doors
Ceiling, vaulted
Bay Windows or cantilevered areas
Floors over unconditioned area
Rim Joist (2nd Floor+)
0.30
Appliances
Heat Recover Ventilator (HRV) Capacity in cfms:
Energy Recover Ventilator (ERV) Capacity in cfms:
52,197
Heating Gain Cooling Load
Per R401.3 Certificate. A building certificate shall be posted on or in the electrical distribution panel.
Place your
logo here
New Construction Energy Code Compliance Certificate
Name of Residential Contractor
Pietsch Builders Inc.
MN License Number
Lakeville, Mn. 17889 Eclipse Ave.
2358
City Mailing Address of the Dwelling or Dwelling Unit
Combustion Air Select a Type
Location of duct or system:
24,885
Installed on the inside
Installed on the inside
Below Entire Slab Rigid, Extruded Polystyrene Ceiling, flat
Builders Associaton of Minnesota version 101014
NEW RESIDENTIAL CONSTRUCTION SWPPP VERIFICATION
This form must be completed and submitted with all new residential permit applications.
New residential building permits WILL NOT be issued without this completed form.
Project Site Address: _____________________________________________________________________
Company Name: _________________________________________________________________________
Primary Contact: _________________________________________________________________________
Phone # (24 hr Contact): ______________________ Email: ______________________________________
Description of Land Disturbing Activity: _____________________________________________________
NPDES Construction Stormwater Permit # C000 ___ ___ ___ ___ ___ or # SUB00 ___ ___ ___ ___ ___
If you are not covered under a NPDES Construction Stormwater Permit administered by the MPCA, an
erosion and sediment control plan MUST be submitted with the residential building permit application.
“The permittee(s) shall ensure that the individuals are trained by local, state, federal agencies, professional organizations or other entities
in erosion prevention, sediment control, permanent Stormwater management and the Minnesota NPDES/SDS Construction Stormwater
Permit.” (NPDES Construction Stormwater Permit, MPCA)
“The permittee(s) must ensure that a trained person (as identified in Part III.A.3.a) will routinely inspect the entire construction site at least
once every seven (7) days during active construction and within 24 hours after a rainfall event greater than 0.5 inches in 24 hours.”
(NPDES Construction Stormwater Permit, MPCA)
Contact information of person CERTIFIED to provide weekly onsite erosion and sediment control
inspections and corrective actions:
Name of Person: ________________________________Company: _______________________________
Phone # (24 hr Contact): ______________________ Email: ______________________________________
Entity that Provided Training: ________________________ Certification Expiration Date: ____________
NOTE: Prior to any land-disturbing activity, all erosion and sediment controls must be installed on the project site and on individual lots.
No land disturbing activity may begin until a residential building permit has been issued.
I understand, the above information to be true and I will have read, understood, and accepted all terms and conditions of the National
Pollutant Discharge Elimination System (NPDES) Permit (MN R 100001). The City of Lakeville may issue a STOP WORK ORDER;
withhold building inspections; or, draw on securities/escrows to bring the site into compliance with the NPDES Construction Stormwater
Permit (MN R 100001) or erosion and sediment control plan.
Signature: ________________________________________________ Date:_________________________
Contact the City of Lakeville with questions at erosion@lakevillemn.gov or 952-985-4500
7/1/24 X
PM