HomeMy WebLinkAboutLA108578 PERMIT
Clty Of LakeVllle Permit Type: Building
20195 Holyoke Ave Permit Number: LA108578
I Irakeville, MN 55044
(952) 985-4440
* L R 117 8 5 7 8
www.ci.lakeville.mn.us Date Issued: 10/20/2008
Site Address: 17702 Fieldcrest Ave
Lot: 019 Block: 002 Addition: Kenridge Second Addition
PID: 22-41626-190-02
Use: *22-4 1626-19f~-t~z*
Description:
Sub Type: Res Addn/Repair/Rmdl Construction Type: V-B
Work Type: Alter/Remodel
Description: Remodel master bath
Census Code: 434 - Addition/Bsmt fin/Decks/Porch Occupancy: IRC-1
Zoning: RS-2
Square Feet: 0
Comments: REMODEL MASTER BEDROOM ONLY--UPDATE SMOKE ALARMS AND AD CO DETECTIONS
WITHIN 10' AT ALL SLEEPING ROOMS.
HOMEOWNER DOING HIS OWN WORK.
Fee Summary: Description Amount Revenue Code
Valuation: 1,100.00 1997 UBC Permit Fee $41.80 1000-4151
Electrical Addition/Remodel Fees $40.00 1000-4167
Plan Review $0.00 1000-4170
Surcharge -Based on Valuation $0.55 1000-2127
Total: $82.35
i
Contractor: Owner:. -Applicant -
Bruce HKranz
17702 Fieldcrest Ave
Farmington MN 55024
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
RESIDENTIAL BUILDING ~ ~e
,.-r , , PERMIT APPLICATION
Permit Number
y < \ + -
~ CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT R ceived By
20195 HOLYOKE AVENUE
LAKEVILLE, MN 55044 A~ ~ 1 0-1 '1-~ r~ A 1 1 . 4 0 11J
_ 952-985-4440 ~ Ui ~ V ~ Date Received
www.ci.lakeville.mn.us t
Fee Total
SITE ADDRESS: ~ /7~C (~'°~`t'~ ~c'~'CS~~- ,~~Je
MAILING ADDRESS: CITY: I"`~+'+~^ i nc ~ (J,-1 STATE: ZIP: S
s~~
JOB DESCRIPTION: ~hv~',~~~tti j~lu ~ c; ~ L 1 ~ ~~~~~v,`'crk l frvm S'%n~ (t caw~+~f ~ t/~ii i Vrt uS~~r r/'
sv,,~~..
ESTIMATED VALUATION: PROPOSED START DATE: lC-~l-~/~% ~ END DATE: /~/~~/U
(New Residential Only): LEGAL DESCRIPTION: LOT: BLOCK: SUBDIVISION:
APPLICANT IS: C~CR.ESIDENT OWNER ? CONTRACTOR
IvBW MODEL HOME: ? YES ~ NO IF YES -ADMINISTRATIVE PERMIT REQUIRED ISD #
PLEASE FILL OUT THE FOLLOWING COMPLETELY
NAME: J5 h.n ~ r._ K~~r:..-~~'...
RESIDENT OWNER
HOME PHONE S CELL PHONE: ° ~}~~'"Z~'~G
GENERAL CONTRACTOR CONTRACTOR: LICENSE BC
? Homeowner OFFICE PHONE CELL PHONE:
? Contractor ADDRESS: CITY: ST: ZIP:
ELECTRICAL WORK CONTRACTOR: LICENSE CA
Homeowner * OFFICE PHONE CELL PHONE:
? Contractor ADDRESS: CITY: ST: ZIP:
Single Meter on individual unit Meter Bank at end of building (Requires licensed electrician.)
PLUMBING WORK CONTRACTOR: LICENSE PM
,k( Homeowner OFFICE PHONE CELL PHONE:
? Contractor ADDRESS: CITY: ST: ZIP:
MECHANICAL WORK CONTRACTOR:
? Homeowner OFFICE PHONE CELL PHONE:
? Contractor ADDRESS; CITY: ST: ZIP:
SEWER/WATER CONTRACTOR NAME:
New Construction Only HOME PHONE CELL PHONE:
INTEREST EARNINGS ON THE ESCROW ACCOUNTS, IF ANY, ARE RETAINED BY THE CITY TO OFFSET THE
ADMINISTRATIVE COSTS ASSOCIATED WITH PROCESSING THE ESCROW APPLICATION AND REFUND. I HEREBY
APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT THE INFORMATION ABOVE IS COMPLETE AND
ACCURATE; THAT THE WORK WILL B IN CONFORMANCE WITH THE ORDINANCES AND CODES OF THE CITY AND
WITHT THE STATE BUILDING CODE, THAT I UNDERSTAND THIS IS NOT A PERMIT AND WORK IS NOT TO START
WITHOUT A PERMIT AND THAT THE WORK WILL BE IN ACCORDANCE WITH THE APPROVED PLAN
NAME OF APPLICANT (Please Pr?nt) ~ e' vt ~ DATE /Gl/~ /L'
APPLICANT'S SIGNATURE: ~ ~r-~.d,.~ ~ ~ _
RESIDENTIAL BUILDING PERMIT APPLICATION PAGE 2
OFFICE USE ONLY
BUILDING PERMIT TYPE REQUIRED INSPECTIONS
SINGLE FAMILY DWELLING BUILDING '
_DUPLEX - FOOTING
TOWNHOUSE UNITS POURED WALL
DETACHED TOWNHOUSE UNIT GARAGES
CONDO FOUNDATION
ACCESSORY BUILDING FRAMING
REROOF LATH
RESIDE FIREPLACE
~RES ADDN/REAIR/RMDL INSULATION
DECK DECK FOOTING
PORCH PORCH FOOTING
LOWER LEVEL FINISH BUILDING FINAL
ADDITION LOWER LEVEL FRAME
FOUNDATION ONLY SITE
MISCELLANEOUS OTHER
UNDEFINED WELL SEAL
DEMO SEPTIC TANK REMOVAL
MOVED ~ >
~---~c N~
~ ~ ELECTRICAL
CITY BUILDING VALUATION ROUGH-IN
TRENCH
BUILDING PERMIT FEES ~ FINAI,
$ ~ . ~C~ PERMIT FEE MECHANICAL
$ PLAN CHECK TROUGH-IN
$ . SS SURCHARGE AIR TEST
$ METRO SAC FINS,
$ CITY WATER HOOKUP UNIT PLUMBING
$ CITY SEWER HOOKUP UNIT _~ROUGH-IN
$ LANDSCAPE ESCROW FINAL
$ TREE ESCROW METER SIZE
$ MISC ESCROW PRESSURE REDUCING VALVE
$ ~ •C~O ELECTRICAL SEWER AND WATER
$ PLUMBING FINAL
$ MECHANICAL STREET DRAINTILE
$ SEWER & WATER
$ OTHER B ING INFORMATION
TYPE OF CONSTRUCTION
$ • ~STOTAL SZS ~--ZONING
CODE EDITION
APPROVED BY: FIRE SUPPRESSION SYSTEM
OCCUPANCY GROUP l
BUILDING INSPECTOR: V-2 S d~- DATE: ~ d'
PLUMBING/MECHANICAL IN PECTOR: DATE:
COMMENTS: ~ ~ - ~
Qs,1'A ~C Ar-~~. ~AOLG~ oE.ed-G c~ f w i-~'~,- ~ l d ~ +9 ~ ~ s' ~
t~
(Revised 03/26/2007)
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