3610 Birchpond Rd6P?3?-?-0 4
2006 RESIDENTIAL BUILDING rExMiT aPrLlcaTioq 9u. s o
, City Of Eagan N!p 1-379 2 ??(j, S D
3830 Pilot Knab Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemodellReDair Reauirements Office Use Oniv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, joists Cert of Survey Recd VY _ N
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd Zl' _ N.
2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required VY _ N
1 set of Energy Gaiculations Addition - indicafe if on-site sepfic sysfem On-site Septic System _ Y_ A1
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (buildings with 3 or less uniFs)
Minnegasco mechanical ventilation form
Date
A)- 0 Lo Construction Cost
_
Site Address U 15 IC<- L6 f -t f'6`0 L RO zi 1) Unit/Ste #
`cl;k
Description of Work -'SEJ
Multi-Family Bldg _ Y X N Fireplace(s) ^ 0 ? 1 _ 2
Property Owner Telephone # ( )
Contractor
Address C14'tlt-) b ? City
State M 10 Zip 55 ??` % ? Telephone #
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUtLDING
, . _ _..,. ?
ihnesota Rules 7672
?
? Minnesota Rules 7670 CategorL
Energy Code Category Residential Ventilation Cate9orY ? 1?otkshee??,- ? i?; ?New Energy Code Worksheet
• , ?: ??,
(q submissiontype) Submitted iSubmitted • Energy Envelope Calculations Subr iitteid
1 ?
r ?4
In the last 12 months, has the City of Eagan issued a permit for aNir
_ Y X N If yes, date and address of master plan: _
Licensed Plumber L-,LAA.?DE:/? Mg?,CA,q-L<GA4._
Mechanical Contractor LLA&)DErz_
Sewer/Water Contractor iL er plan?
Telephone # (ySL.) 4q fT '?/? qt_-,??
Telephone # 445'
Telephone # c9? ) ? ?f 44"
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in confonnance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed Name AppIicant's Signature
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 05-piex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
X 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
0 06 04-plex ? 12 12-plex ? 25 Miscetlaneous
Work T es
31 New ? 35 Int Improvement ? 38 Demolish Interior 0 . 44 Siding
'Ir ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant
Description: Water Damage Yes
A
?
??
Valuation ? Occupancy -
. MCES System
Plan Review 100% or
?C 25%
Census Code 7
- Zoning City Water
SAC Units t2/ Stories Booster Pump
# of Units ? Sq. Ft. PRV ?-???-
# of Bldgs ? Length Fire Sprinklered
Type of Const Width j -
? Footings (new bldg)
_ Footings (deck)
Footings (addition)
? Foundation
_ Drain Tile
Roof _ Ice & Water _ Final
Framing
Fireplace ? R.I. 4Air Test ? Final
? Insulation
Approved By: _ fl- , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Totaf
, ,
?
)- 24
j?c)
.?-
? 31,2
?
C"
`
. ?.Ll 0
REQUIRED INSPECTIONS
Sheetrock
FinaUC.O.
_ Final/No C.O.
_ HVAC
Other
Pool Ftgs Air/Gas Tests Final
_ Siding _ Stucco Lath 7K Stone Lath _Brick
_ Windows
_ Retaining Wall
.r
f
Permit Number
REScheck Compliance Certificate Checked By/Date
2000 Minnesota Energy Code
REScheck So$ware Version 3.6 Release 2
Data filename: G:1CAD1EnTraditional\Hampton\xb\2204-TG-eiModel\FIJLLFO-I.RCK
PROJECT TITLE: "ei" Hampton "B" Welcome Home Center
COUNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
WINDOW / WALL RATIO: 0.14
DATE: 05/23/06
DATE OF PLANS: 5-8-06
PROJECT DESCRIl'TION:
3610 Birchpond Road
Eagan, MN 55122
Terra Glenn
DES IGNER/CONT RAC T OR;
Lundgren
545 Indian Mound E.
W ayzata, MN 55391
PROJECT NOTES:
Full Foundation
Std. and Oversized Egress Wells
9' Poured Foundation
"ei" Hampton "B" Base Plan
COMPLIANCE: Passes
Maximum UA = 680
Your Home UA = 618
9.1% Better Than Code (UA)
Ceiling 1: Flat Ceiling or Scissor Truss
Wall - Lookout: Wood Frame, 16" o.c.
W indow - Andersen:
Above-Grade:Wood Frame:Double Pane with Low-E
Rim - Main: Wood Frame, 24" o.c.
Gross Glazing
Area or Cavity Cont. or poor
Perimeter R-Value R_Value U-Factor UA
2195 44.0 0.0 59
82 19.0 0.0 3
33 0.330 11
200 0.0 12.0 20
z
Wall - Main: Wood Frame, 16" o.c.
Window - Andersen:
Above-Grade:Wood Frame:Double Pane with Low-E
Door - Firedoar: Solid
Door - Front Entry: Glass
Rim - Upper: VVood Frame, 24" o.c.
W al l- Upper: W ood Frame, 16" o. c.
W indow - Andersen:
Above-Grade:Wood Frame:Double Pane with Low-E
Basement - Lookout Wall: Solid Concrete ar Masonry
Wall height: 3.5'
Depth below grade: 3.0'
Insulation depth: 3.5'
Basement - Found. Walt: Solid Concrete or Masonry
Wa11 height: 9.0'
Depth below grade: 8.5'
Insulation depth: 9.0'
Floor - Over Outside Air:
All-Wood JoistlTruss:Over Outside Air
Flaor - Over Unheated:
All-Wood Joist/Truss:Over Unconditioned Space
Fumace 1: Forced Hot Air, 90 AFUE
Proposed and Maximum U-Factor Averages
Above-Grade Windows and Glass Doors
Includes Foundation Windows > 5.6 12
Floors Over Unconditioned Space
1896 19.0 0.0 91
295 0.330 97
38 0.067 3
21 0.350 7
214 0.0 110 22
1725 19.0 0.0 89
210 0.330 &9
52 0.0 5.0 6
1647 0.0 5.0 132
29 24.0 0.0 1
334 44.0 0.0 8
Proposed
Average U-Factor
0.331
0.023
Maximum
Allowed U-Factor
0.370
0.033
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,
specifications, and other calculations submitted with the permit application. The proposed building has been designed to
meet the 2000 Minnesota Energy Code requirements in REScheck Version 3.6 Release 2(formerly MECcheck) and to
comply with the mandatory requirements listed in the REScheck Inspection Checklist.
Builder/Designer T Date s -Z-a' ? t1 ko
?
LOT SURVEY CHECKLIST FOR RESIDENTiAL
` BUILDING PERMIT APPLICATION
PROPERTY LEGAL: 44?? Z. w 1a 6 I('MY1 Zrd 140?A
DATE OF SURVEY: S/ C
LATEST REVISION:
d
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O z Q DOCUMENT STANDARDS
? 0 • f2egistered Land Surveyor signature and company
? ? • Building Permit Applicant
0 0 • Legal description
? ? • Address
? ? ? • North arrow and scale
,e( ? ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
? ? • Directional drainage arrows with slope/gradient %
? ? • Proposed/existing sewer and water services & invert elevation
AY ? ? • Street name
z ? ? • Driveway (grade & width - in RM/ and back of curb, 22' max.)
? 13 • Lot Square Footage
? 0 ? • Lot Coverage
ELEVATIONS
Existinq
? ? • Property corners
00? • Top of curb at the driveway and property fine extensions
? f6 ? • Elevations of any existing adjacent homes
?H' ? • Adequate footing depth of structures due to adjacent utility trenches
? JO ? • Waterways (pond, stream, etc.)
Proposed
jd ? ? • Garage floor
,Id ? ? • Basement floor
?? ? 0 • Lowest exposed elevation (walkouUwindow)
,W ? 0 • Property corners
J;` D D • Front and rear of home at the foundation
PONDING AREA (if applicable)
? D • Easement line
? Jd 0 • NWL
? ? • HWL
? fr7 d • Pond # designation
? ,K ? • Emergency Overflow Elevation
? P1 ? • Pond/Wetland buffer delineation
Y . Shoreland Zoning Overlay District
Y • Conservation Easements
DIMENSIONS
? ? • Lot lines/Bearings & dimensions
0 ? • Right-of-way and street width (to back of curb)
? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. aN structures requiring permanent footings)
? 0 0 • Show all easements of record and any City utilities within those easements
?PJ ? 0 • Setbacks of proposed structure and ' e ard setback of adjacent existing structures
? ? ? • Retaining wall requirements:
Reviewed ByDate
G:/FO RMS/Bui lding Permit Application Rev. 11-26-04
ir ' lRpqft
3610 BIRCHPOND ROAD
P.R.V. REOUIRED ?RCHPOND ROAD
B _ ----- ? -
T`-
?
? 2$7 20 » TC 840.3 rc
p,36 cr, 842.9
?2' !° ,
8 41.1 8 SERV 22' 0 843.4
.V ? ?843.
T 2)
? o ? -'INSTALC ? DROPOSED a 7/ iI
i no?N ??_ _ SILT FE?NCE 60 EWAY I aN
L ?
0. 81 3 15.00? 2 0 2. t°? 0.33 $8.50 w
5 ? g?b' (
1845.0??I' /
a329 / 9 d ? p-00°09' 56 H MARK
" p OF SPIKE r--- 11.83 ? /n ? °o
a?2• / R=278. 91 LEV.=840.67 ' :S700 0 ? GARAGE 00 I Y W r o?
2 \ 0? U7= 3.67 TO TOP ?--- ?/ ? N ? q:
?o F LOWEST FLOOR ?t 24.65 N M ^w
6' ? J. C A N T.? c o m ? ? PROPOSED ?
1 16.02 ? ? ? o ?o
, i S sz ?? XB i? O U S E 1.76 ? w p
y o ??6 9? o rn") g 5 ( F U L L) ?.oz I m r- w C) o
0 • sr r? o ? f
? X ?`I`4 ? ? o?
\ 33.? &? s 84.4 ? 17.0 '
? 00 0 ? ^ r -
? TC $33. -? a .5 _0 '13_96cv 22_°_??$
?
?o B9.Q7 ' 2c,4N7.?845.0) 842.0 o y?. ? G I
0 L - - - - 5
-? 0 8414 .?----(844) ?
C ERTIFIC ATE 0 F S URVEY
For: LUNDGREN BROS.
PROPERTY DESCRIPTION: Lot 4, Block 2, TERRA
GLENN 2ND ADD1TlON, Dakota Caunty, Minnesota.
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DRAWM BY
MAL/RWD
DATE
5/12/06
We hereby certifp that this is a true and correct survey of the above
described property and that it was performed by me or under my
direct supervision and that I am a duly Licensed Surveyor under the
laws of the State of Minnesota. That this survey does not purport to
show all improvements, easements or encroachments, to the property
except as shown thereon.
Si gned this /9Z? day of , 2006. James R. Hill, Inc.,
\ o ? x ? ?; Notes:
o A Denotes set spike
0 ?•? X N 1. 8uilding dimensions shown are for o Denotes set iron monument
X • o9 8A2 P? horizontal & vertical placement of structure • Denotes found iron monument
3:1 m ????? ?????? Iros 9 8Sk 2 r? only. 5ee architectural plans for building x927•6 Denotes ezisting elevation
{??j?;,g WaII WIN X x ? ?? (930.0) Denotes proposed elevation
quifed A?OA ? & foundation dimensions. -- Denotes rear of building pod
LOT 4 2. No specific soils investigation has been Denotes proposed drainage
o ? ? TC Denotes top of curb
sFo ? ? ?- - completed on this lot by James R. Hill, Inc.
CN The suitabilit of soils to su ort the s ecific TNH-NW Quad Ashbury Road
?(y -? F? y P? p BenCh Mark: 835.54_and Birchpond Road
??
V house proposed is not the responsibility of
James R. Hill, Inc. or the surveyor. Proposed Garage floor= 844.6
\<
? Proposed Garage Top of Block= 845.0
DRAINAGE & UTILITY Z 3. No specific title search for ezistence or non- Proposed House Top of Block- 845.7
EASEMENT PER PLAT ezistence of recorded or un-recorded easements proposed Lowest Floor= 837.0
has been conducted by the surveyor as o part Proposed Top of Block
? ? j of this survey. Only easements per the recorded at Egress Window= 840.2
O plot ore shown.
4. Proposed grades shown were taken from
,?J
10 ? the grading &/or development plan prepared by Bearings are on assumed datum
oV S / JAMES R. HILL, INC. SCaI@: 1"=30'
LOT 4= 26,138 SQ. FT. SAN. SERVICE INVERT
PROPOSED HOUSE = 2,683 SQ. FT. ELEV.=830.0
WED /
By o OR 10.26 % OF LOT AREA
Date
DRIVEWAY = 871 SQ. FT.
EAGtW EAIGIlYEEttWG DF.P'i'. -'
REWSIONS
BOOK/PAGE
NONE
CONTROL N0.
21192
CAD FILE
261169
PROJECT N0.
261169
FlLE N0.
DRAWER
SHEET 1 OF 1
?
Site address: 0bi(?C?_?1 Pr?,t;b p,?b Lot Block
-?- -,?- Subd. 77;E:fZ/eq
On April 15, 2000 the Minnesota Energy Code, Category 1 Building Requirements for insu(ation protection, air
tightness, and venti(ation, was adopted. As a result, the City of Eagan is requiring that the fol(owing information be
submitted prior to issuance of a Certificate af Occupancy.
, This structure: is constructed to meet minimum requiremenfs of the Mn Energy Code, Chapter 7670
QR
- This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLtANCE GAS ELEC MANUFAC7URER MODEL BTU'S VENTING TYPE
Water Heater
-1
Fumace
- L. ;- v? -2 oCx1' P v
Dryer .
EXHAllS7 SYSTEM
Kitchen
LOCATlON
kitchen
TYPE
MODEL
CFM's VENTED
Yes No
Bathroom 1 ?
'
tn.y r?
c.o dJ
L ?
Baihroom 2
? F A;' 5U ,?C
Bathroom 3 ,?-
Bathroom 4
C C-? ?G) X
Other
FIREPLACE S LOCATION GAS WOOD MQNUFACTURER MODEL BTU'S DIAF rENTt A MOS
r -Y -? G c. ! --) y0(?
MAKE-UP AIR MQDEL TYPE CFM's
? IU ?? c. . y
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Ensrgy Code and City of Eagan
requirements.
8ign re Date
Company Name :
" This form is the responsibility of the General Contractor.
., . . ..... _ .. ... _.. .. .
952 555 ? Line 1 ELANDER MECHA 12:57:32 p.m. 05-24-2006 5/7
,1
Date: 5124l2006 Revision Date: 5/24/2006
Site Information
Address 1: 30 0 Birchpond
Address 2:
City: Eagan County:
App[ication Information
Business Name: Elander Mechanical Inc.
Contact Person: Todd
New Construction
Project #:
Lot: 4Block: .??
Subdivision:-7''?:?fi
MN Contractor License #:
Office Ph: 952-445-4692 Fax: 952-445-7487 Cell Ph:
Address 1: 591 Citation Drive
City: Shakopee State: Minnesota Zip Code: 55379
House Details
Square Feet: 5558 sq. ft. Avg. Ceiling Ht: 9 ft. Number of Bedrooms: 4
Ventilation : Balanced
Total Ventilation Capacity : 219 cfm.
Minimum Continuous Ventilation :75cfm.
Intermittent Ventilation: 144 cfm.
Combustion Apqliance
Water Heater: Power Vent Input BTUs: 75,000 lndependently Vented
Furnace/Boiler: Direct Vent/Sealed Combustion Input BTUs: 90,000 Independently Vented
Other Combustion Appliances
Gas Fired Direct Vent Fireplace(s): Yes Gas Fired Power Vent Fireplace(s): No
Gas Fired Natura! Draft Fireplace(s): No Solid Fuel Appliance(s): No
Exhaust Equiqment
Continuous Exhaust Ventilation Capacity (cfm): NA Clothes Dryer (cfm): 135
Exhaust Fan Rating (cfm): 300
Make-Up Air
No Make-Up Air Required by Code
Combustton Air
Round Rigid Required: 5 inches or ]nsulated Flex: 6 inches
{ 4
Applicant Name (print):4..?,?t. f?dL4_CFo/Zn Signature/Date: 46G,
Code Official (print): Signature/Date: ?
OO 2004 CenterPoint Energy Minnegasco. 2004 Mechanical Code Guidelines. Page 1
Address: 3610 Birchpond Road Zip: 55122
Lot: 4 Block: 2 Subdivision: Terra Glenn 2nd
THE FOLLOWING ITEMS WEREIWERE NOT COMPLETE AT FINAL INSPECTION ON
Yes No Comments
Final grade - 6" from siding ?
Permanent steps - garage
Permanent steps - main ent
Permanent driveway x
Permanent gas X
Retaining Wall or 3:1 Max Slope x
SodlSeeded lawn
TraiUcurb damage
Porch
Lower level finish
Deck .SC
Fireplace J?
• Verify with your builder that roof test caps from the plumbing system have been removed.
• Turn off water supply to the outside lawn faucets before freeze potential exists.
• Call the City's Engineering Department at 651-675-5646 prior to working in right-of-way or installing
irrigation system.
? BUILDING INSPECTOR:
CONTRACTOR:
Lundgren Bros.
545 Indian Mound E.
Wayzata, MN 55391
L _ I . k,
Address: 3610 Birchpond Road Zip: 55122
Lot: 4 Block: 2 Subdivision: Terra Glenn 2nd
THE FOLLOWING ITEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON
Yes No Comments
Final grade - 6" from siding
Permanent ste s- gara e
Permanent steps - main entry
Permanent driveway
Permanent gas .x
Retaining Wall or 3:1 Max Slope X
5od/Seeded lawn
Trail/curb damage
Porch
Lower level finish
Deck ?-
Fireplace JC.
• Verify with your builder that roof test caps from the plumbing system have been removed.
• Turn off water supply to the outside lawn faucets before freeze potenrial exists.
• Call the City's Engineering Departnnent at 651-675-5646 prior to working in right-of-way or installing
inigation system.
BUTLDING INSPECTOR:
CONTRACTOR:
Lundgren Bros.
545 Indian Mound E.
Wayzata, MN 55391
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115235
Date Issued:09/24/2013
Permit Category:ePermit
Site Address: 3610 Birchpond Rd
Lot:4 Block: 2 Addition: Terra Glenn 2nd
PID:10-75401-02-040
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jennifer L Rendon
3610 Birchpond Rd
Eagan MN 55122
(651) 675-5675
Hoffman Weber Construction Inc
3515 48th Ave N
Brooklyn Center MN 55429
(866) 970-1133
Applicant/Permitee: Signature Issued By: Signature
Date:
CityofEaQall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
DEC 222015
r
Use BLUE or BLACK Ink
For Office Use
Permit #: ` 301 1
Permit Fee: h'0` d"11
Date Received: / (2 -)D
Staff:
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
/3-""
Site Address: 7 6 /61 6, /6-4 pdkee
-
Unit #:
Name: 4. 1'ev' moi
,z1t,
Phone: CP -126i- 7377
Address / City / Zip: ?ef t 8, (`'t )7c 2a(
Applicant is: Owner k Contractor
Description of work: ,"� � L erixte✓
Construction Cost: Cbd
Company:
Multi -Family Building: (Yes / No >C )
Contact
State: ///Zip: 5--f4'/' Phone: G/.2 -%a/ 29f'l Email: g a-P�ke�C� `�4 44 a4!�
License #: d' 7- l Lead Certificate #: U /C
If the project is exempt from lead certification, please explain why:
/1 €r, /3 Z df6 G
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes
No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor: Phone:
.ed,
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x ec
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
71
SUB TYPES
Foundation Fireplace
Single Family Garage
Multi Deck
01 of _ Plex A ' Lower Level
WORK TYPES
New _ Interior Improvement
Addition Move Building
4- Alteration Fire Repair
Replace Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% d )
Census Code
# of Units
# of Buildings
Type of Construction
y3y
creL. o r ai
Porch (3 -Season) Exterior Alteration (Single Family)
Porch (4 -Season) Exterior Alteration (Multi)
Porch (Screen/Gazebo/Pergola) _ Miscellaneous
Pool Accessory Building
Siding Demolish Building*
Reroof Demolish Interior
Windows Demolish Foundation
Egress Window Water Damage
*Demolition of entire building - give PCA handout to applicant
Occupancy ,'i46-/ MCES System
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water Final
Framing
Fireplace: _Rough In _Air Test Final
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
3'%/o w✓irL. P/+N Z,yrp
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
'1a3
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
s( Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: _Footings _Air/Gas Tests _Final
Drain Tile
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Other:
, Building Inspector
/ 3 av ,�! A. 4 is, ;) dd ote :r h/
Page 2of3
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