HomeMy WebLinkAboutLA083688 PERMIT
City Of LakeVll~e Permit Type: Building
20195 HOLYOKE AVE Permit Number: LA083688
LAKEVILLE, MN 55044
(9S2) 985-4440 - Date Issued: 02/24/2005
Site Address: 17145 EASTWOOD AVE
Lot: Block: Addition:
PID:
Use: LAKE PLACE 4TH STORM SHELTER
Description:
Sub Type: Miscellaneous Occupancy:
Work Type: New Construction Type:
Description: CO Required Prior to Occupancy Zoning:
Census Code: Other Non Housekeeping Shelter Square Feet:
Remarks' SHELTER MUST COMPLY WITH ALL ASPECTS OF
'NATIONAL PERFORMACE CRITERIA FOR TORNADO SHELTERS"
INCLUDES MECHANICAL PERMIT.
Fee Summary: Surcharge -Based on Valuation 14.00 1000-2127
Plan Review 274.01 1000-4170
Valuation: $28,000.00 1997 UBC Permit Fee 421.SS 1000-4151
$709.56
Contractor: -Applicant - owner:
SUNSET HOMES
9705 63RD AVE NO St. Lic.: 2176
MAPLE GROVE, MN SS369
(763)531-0714
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. A
SEPARATE ELECTRICAL PERMIT IS REQUIRED
Applicant/Permitee: Signature Issued By: Signature
RESIDENTIAL BUILDING PERMIT oftioe use o
APPLICATION ermit Numbei
CITY OF LAKEVILLE
~ BUILDING INSPECTIONS DEPARTMENT
" , I 20195 HOLYOKE AVENUE ~ ~ ' = " ' +r
\,,:u ~ • LAKEVILLE, MN 55044 Date Received
_ 952-985-4440 ~
www.ci.lakev_ille mn.us ee T 1
-/G-or
DATE: ~ / "~~t~'' SCHOOL DISTRICT:
JOB SITE ADDRESS / '
LEGAL DESCRIPTION: LOT"" BLOCK SUBDIVION: ~ C~ ~ IQ C ~ '7
MODEL HOME: YES NO IF YES -ADMINISTRATIVE PERMIT REQUIRED.
APPLICANT or CONTRACTOR: ~D17 r~Q\I h/~YYk°S CONTR LIC a~ J"7 ~
OFFICE/HOME PHONE: ~b3 ~J31 ICELL PHONE: FAx~GV 53I000D I
STREET ADDRESS: `7 ~I DJr t~ 3r~~~2. ~ CITY: ~ ZIP: ~ 3~0~
TYPE OF WORK: (DESCRIBE IN DETAIL): ~~r ?'Y') ~~~.1f%I
VALUATION: ON WORK (EXCLUDING LAND):"jo~~ 622 PID#
NEW RESIDENTIAL BUILDING -PLEASE FILL OUT COMPLETELY
r
Energy Code Category MINNESOTA RULES 7670 CATEGORY 1
(check one) -Residential Ventilation Category 1 Worksheet Submitted.
~ -Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: _ Phone
Plumbing Systems Includes: Water Softener Lawn Sprinkler
Water Heater No. of RI Baths
No. of Baths
Mechanical Contractor: Phone
Mechanical System Includes: Air Conditioning
Heat Recovery System
Sewer/Water Contractor:. 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 BE IN CONFORMANCE WITH THE ORDINANCES AND CODES OF THE CITY
AND WITH THE STATE BUILDING CODE, THAT I UNDERSTAND THIS IS NOT A PERMIT AND WORK IS NOT TO
START WITHOUT A PERMIT AND THAT WILL BE ACCORDANCE WITH THE APPROVED PLAN.
i
APPLICANT'S SIGNATURE: ~ DATE: ~ ~ 3 U
(Revised 07/06/2004)
J
RESIDENTIAL BUILDING PERMIT APPLICATION PAGE 2
OFFICE USE ONLY
BUILDING PERMIT TYPE REQUIRED INSPECTIONS
SINGLE FAMILY DWELLING (10) BUILDING
DUPLEX (20) FOOTING (60)
TOWNHOUSE UNITS (30) POURED WALL (8b)
GARAGES (70) FOUNDATION (67)
ACCESSORY BUILDING (71) FRAMING (62)
REROOF (73) LATH (64)
RESIDE (72) FIREP~,ACE (68)
RES ADDN/REPAIR/RNIDL (75) INSULATION (63)
DECK (76) ~ DECK .FOOTING (80)
PORCH (77} PORCH FOOTING (81)
LOWERLEVEL FINISH (78) BITILDING FINAL (90)
ADDITION (79) LOWER LEVEL FRAME (Sb)
FOUNDATION ONLY (96) SITE (71)
MISCELLANEOUS (98) OTHER (70)
UNDEFINED (99) SEPTIC TANK REMOVAL(77)
DEMO (95)
MOVED (94) MECHANICAL
ROUGH-IN (84)
AIR TEST (69)
CITY BUILDING VALUATION FINAL (91)
BUILDING PERMIT FEES PLUMBING
$ ~Z [ , 5~ PERMIT FEE ROUGH-IN (83)
$ ~i"i . o PLAN CHECK FINAL (92)
$ SURCHARGE METER SIZE
$ METRO SAC PRESSURE REDUCING VALVE
$ CITY WATER HOOKUP UNIT
$ CITY SEWER HOOKUP UNIT SEWER AND WATER
$ LANDSCAPE ESCROW FINAL (93)
$ TREE ESCROW STREET DRAINTILE (75)
$ MISC ESCROW
$ PLUMBING BUILDING INFORMATION
$ SEWER & WATER TYPE OF CONSTRUCTION
$ MECHANICAL OCCUPANCY GROUP
$ OTHER ZONING
$ z~ 5~: TOTAL
APPROVED BY:
B ~
UILDING INSPE T R:
C O ~ ~ DATE.
PLUMBING/MECHANICAL INSPECTOR: DATE:
COMMENTS:
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