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1443 Balsam St Use BLUE or BLACK Ink r For Office Use 1 • I ! I (]j'11 Permit#: ''7 / 11 I P City Ol Ea~d ermit Fee: ~--//r (~62 1 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: 611,a!q r/ Phone: (651) 675-5675 j staff: M~ I Fax: (651) 675-5694 1 I 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: t~ 4U Site Address: Tenant: ./N6.U-5 0 / J_7 Suite M RESIDENT / OWNER Name: <Q/)eeh JVI o_5o JJ Phone: 661- "/6-5-397Z Address / City / Zip: / Y LAaln, M dtl S S7-_22_ Applicant is: Owner Contractor TYPE OF WORK Description of work: L"V i" Roo. t r / ~e i✓/ar~~l Construction Cost: S Od Multi-Family Building: (Yes I No CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact: Email: 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: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. 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. x Applicant's Printed Name (X plicant's Signature U Page 1 of 2 J~ild 2 2 ZO10 NH~ ea(--snm DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage _ Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) Multi _ Deck Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of _ Plex Lower Level _ Pool _ Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement Siding _ Demolish Building* Addition _ Move Building Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation ~ 0 Occupancy MCES System Plan Review Code Edition SAC Units (25% 100%) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: Footings _ Backfill _ Final Meter Size: Radon Control Erosion Control Reviewed By: J=1 Building Inspector RESIDENTIAL FEES Base Fee 17 Surcharge Plan Review MCES SAC O 'O / 2L7 City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 2 CITY OF GAN Remarks Addition ergreen Park Lot 14 Blk 3 Parcel 10 24880 140 03 Owner t Street 14 Balsam Stt. State Eagan,MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK Z 175.00 8.7 20 Paid SEWER LATERAL 1974 0.00 8.00 Paid WATERMAIN WATER LATERAL WATER AREA Storm Sew Trk 1983' 360.15 15 36o.15 C007617 12-28-81 STORM SEW TRK S1Q81 391 no 21 53 1 S, 301.65 17007111 5-27-21 TORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 300.00 5739 5-18-72 BUILDING PER. 1-1 -73 SAC 240.00 7271 PARK TOWN OF EAGAPI 3795 Pilot Knob Road Eagan, Minnesota 55121 PERMIT NO. 209 The Board.of Supervisors hereby grants to J. F. Farrell & Son of 9N W. Montana Ave St Paul 5,5117 a 2IIMA7xa Permit for: (Owner) Tilsen Construction Co. at - eft1aak--6lr_ pursuant to application dated ~ ale am Fee Paid: 60.00 Dated this 23rd day of May 1972 . 1. 0 s/c Building Inspector J_. TOI:N OF EAGAN 3795 Pilot Knob road Eagan, Minnesota 55121 PERMIT NO. 219 The Board of Supervisors hereby grants to Neil & Hubbard Heating Air Conditioning Co. Of 99 No. Snelling Avenue, St. Paul 55104 a HFATING Permit for: (Owner) Tilsen (Construction Co. t 3 Bs7 ecmr, - t E39 weak & at , pursuant to application dated 6/28/72 Fee Paid: $60.00 Dated this 32?d day of jU2,17 , 1972 ao Building Inspector i EAGAN TOWNSHIP / BUILDING PERMIT N~ 2712 Owner ......oG Eagan Township Address (Present) :.....5%_ Town Hall Builder X.- Dale dS . Address DESCRIPTION Stories To Be Used For Front Depth Heigh! Est. Cos! Permit Feel Remarks .22~Svd 77.•00.11/ LOCATION S a Street, Road or other Description of Location Lo! Block Addition or Tract 4y.5 Gtr _ J / y .3 g.~ This permit does not authorise the use of streets, roads, alleys or sidewalks nor does It give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safely, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE PT ON THE PREMISE WHILE THE WORK IS IN PROGRE S. This is to certify, that.... ! ..:..Lr.~..'^ - ............has permission to erect a e&-1 upon the above described premise subject to the provisions of the Building Ordinance for Eagan Township a opted April 11, 1955. Per (1..!...............:°.... Chairman of Tnwn Board Building Inspector ,6 This request void 18 months from Euek 7w-n 'Pad 8 5 4 7 4 5 Date of this Request 3-30-79 1, as 1i7 Licensed Electrical Contractor ❑Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 144,3 Balsam Str, City Eagan Section Township Range County Da . to Which is occupied by Thomas Dreon (Name of occupant) Is a roughin inspection required on this job? No li Yes ❑ Ready Now K] Will Call ❑ Power Supplier NSP South D; vi si on Address 53p9 w_ 7o+r, e+,._ Fa;,,o Electrical Contractor Total Electric, Inc. Contractor's License No. A6o86 (company Name) Mailing Address 1537 92nd La. N.E., Mpls., Mn. 55434 (Electrical ntraLCt~r a~rpwner Making This Installation) Authorized Signature s t (-c.~..C., ~ fie. c ( Phone No. 786-8484 E~~,+ I~ BOARD ra (Electrical Contractor or Owner Making This Installation) This inspection request will not be accepted by the Stlk' ~~4~ E State Board unless proper inspection fee is enclosed. Minnesota State Board of Electricity, ~3~ 7 q 195-VUniversity Ave., St. Paul, Minn. 55104-Phone 645-7703 / REQUEST FOR ELECTRICAL INSPECTION z. 'R 54745 CHLCK BELOW WORK COVERED BY THIS REQUEST s Type of Building New Add. Rep. Check Appliances Wired Fox Check Equipment Wired For Home ❑ ❑ In Range ❑ Temporary Wiring ❑ Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Fixtures ❑ Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace ❑ Silo Unloader Q Industrial Bldg. ❑ ❑ ❑ Air Conditioner Bulk Milk Tank ❑ Farm E] [:j List List O her ❑ El El O Hehe s~ Oehers# COMPUTE INSPECTION FEE BELOW 1 H 77 Service ntrance Size: # Fee Feeders@Subfeeders: Fee ME s: # Fee 45 0 to 100 Am s. 0 to m res eres 101 to 200 Amps. 31 m s IN[ RWrA, m eres Above 200 Amps. 11 Abo - s. Am s. Transformers 11 RReTrW* CoffflI%~-Ij PI er fee Si ns 11 Speciallnspection e 50 Remarks Od 1, the Electrical Inspector, hereby certify that the above inspection as a e. (Rough-in) Date " (Final) Date This request void 18 months from MASTER/ CARD . LOCATION od'aS OWNER i) s rh STRUCTURE AND LAND USED AS Ca.Q ~I a d s'E 2 D~ Issued To Permit No. Issued Contractor Owner BUILDING , r 316 YK PLUMBING Q~ CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER OTHER • Approved Items (Initial) Date q Remarks Distance From Well FOOTING fSEPTIC FOUNDATION f-30 . CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL DEPTH HEATING OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER • Violations Noted on Back COMMENTS: EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: May 18, 1972 NUMBER 1010 OWNER:Tilsen Construction Co. Address 1443 Balsam PLUMBER Luecken Excavating TYPE OF PIPE Heavy Cast Iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No. of units Location of Connections: Connection Charge -0- Permit Fee 10.00 pd $/40/72 Street Repairs Total Inspected by: Date Remarks: By. Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota Luecken Excavating Please notify when ready for inspection and connection and before any portion of the work is covered. / EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION I I Date: May 18, 1972 Number 841 / '7 -3 cF.p Billing Name: Tilsen Construction Site Address: 1443 Balsam Owner: Billing Address Plumber: Luecken Excavating Location of Connection Meter Size- Connection Chg. /18/72 la'aa as Meter Noaa17yb' I Permit Fee 10.00 5/30/72 X0/72 Meter Reading_ Meter Dep. Meter Sealed: Yes Add'l Chg. NO Total Chg. Inspected by Date Building is a: Remarks: Residence xx Multiple No. Units ~n .r roo Commercial r '.'ETER' Industrial By: Other Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. By: Luecken Excavating Please notify the above office when ready for inspection and connection. so _!O: ~ o. so 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City OF Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit Date 04 / 10 / 06 Site Address 1443 Balsam St Unit# Property Owner Colleen Musolf Telephone#(651 ) 405-3977 Contractor Ron's Mechanical. Inc. Street Address 12010 Old Brick Yard Rd City Shakopee State Mn ( Zip 55379 Teleep-hone# ( 952) 445-8585 Bond R L L 7 6 1 ~ b`l ~1 Expires: 8/1 3 oV The Applicant is Owner x Contractor - Other Add-on or alteration to existing dwelling unit 30.00 furnace -Additional Replacement APR 1 2 2006 air exchanger air conditioner -New -Replacement other State Surcharge $ 50 Total $ 30. L~R) 1 hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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. ~\Y~dA , TeX nwdio V& Y ~W~ Applicant's Printed Name Applicant's Sign c 4W3-,U~0 3 ow~v `aoo.°D q , a~d3o FBC.Otfice lJS@ ~ S7~ I City of Eap D 2008 Pe mit#: 7 -2 Irk OCT 2 Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 Bye--~ I Staff: I Fax: (651) 675-5694 1 2008 RESIDENTIkA,(L BUILDING PERMIT APPLICATION Date: IV 1 Site Address: I AA Ll~`jr c;+ Tenant: ~ l Suite RESIDENT / OWNER Name: l n ~ ( u (N Phon : 7 Address / City / Zip: I \ J~l ,1~ Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: t i~1~V Multi-Family Building: (Yes No CONTRACTOR Name--11\0 C`~151~'(m OF) License ng(V I Addres1:1-0-\ Q C CJ1 II I 1 ' City: State: F l_ N Zip: 5154 W AJ Phone: f 5 Contact Person: l ;m COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted 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: NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to, conclude that the 'are trade secrets: 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 accord( ce with the approved plan in the case of work which requires a review and approval of plans. „ y~~ x \ - x ~l LXW k~ Applicant's Printed Name Applicants Signature Page 1 of 3 Use BLUE or BLACK Ink I For Office Use I LO non Permit 1 MY of Ea Permit Fee: i 3830 Pilot Knob Road i Eagan MN 55122 I Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 staff: i ---••------J 1 2011 MECHANICAL PERMIT APPLICATION Date: Site Address: Tenant: l_k 1 1 - IV ! ~4 Suite RESIDENT /OWNER Name: Pperle: Address/ City/ Zip: 1; J~'rLj CONTRACTOR Name: Rons Mechanical Inc License Address: 12010 Old Brick YArd Road- City: Shakopee State: MN Zip; 55379 Phone: 952-445-8585 Contact: Linda Email: TYPE OF WORK New ✓Replacement Additional Alteration Demolition Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL PERMIT TYPE Furnace _ New Construction _ Interior Improvement VAir Conditioner Install Piping r Processed Air Exchanger Gas _ Exterior HVAC Unit Heat Pump Under / Above ground Tank Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ x1% $55.00 Minimum (includes State Surcharge) $ Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 If the Permit Fee is > $10,01o, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) TOTAL FEE 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.or-q I hereby acknowledge that this information is complete and accurate; that the work will 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 i not to start ' hout 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 plan x 1- ll dad, x MA-Y~ Applicant's Printed Name Applicant's Signat FOR OFFICE USE Reviewed By: Date: - Required Inspections: Under Ground Rough In Air Test Gas Service Test In-floor Heat Final Exterior HVAC Screening Inspection PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA103362 Date Issued: 03/20/2012 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 1443 Balsam St Lot: 14 Block: 3 Addition: Evergreen Park PID: 10-24880-03-140 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Windows Doors-New ; Replacement Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S4K $103.25 0801.4085 Valuation: 4.000.00 Surcharge - Based on Valuation S4K $2.00 9001.2195 Total: $105.25 Contractor: - Applicant - Owner: Home Depot At Home Services Colleen 1\1 Musolf 656 Nlendelssolm Ave. N 1443 Balsmn St Golden Valley NIN 55427 Eagan MN 55122 (763) 42-8826 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 Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA119794 Date Issued:12/18/2013 Permit Category:ePermit Site Address: 1443 Balsam St Lot:14 Block: 3 Addition: Evergreen Park PID:10-24880-03-140 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Chad Bettin 3208 First Street South Waite Park, MN 56387 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 $60.00 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 - Colleen M Musolf 1443 Balsam St Eagan MN 55122 (651) 405-3977 Ecowater Systems P.O. Box 428 Waite Park MN 56387 (320) 251-2505 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA123306 Date Issued:06/03/2014 Permit Category:ePermit Site Address: 1443 Balsam St Lot:14 Block: 3 Addition: Evergreen Park PID:10-24880-03-140 Use: Description: Sub Type:Reroof & Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and house wrap and leave on site. 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 - Colleen M Musolf 1443 Balsam St Eagan MN 55122 Walker Roofing Company 2270 Capp Rd St Paul MN 55114 (651) 251-0910 Applicant/Permitee: Signature Issued By: Signature a� Use BLUE or BLACK Ink ^----------------- � For Office Use � l�� j Permit#: �� /�� j d � I � I of �a a� � Permit Fee: ��- � � 3830 Pilot Knob Road ��,1� I I Eagan MN 55122 � � DateReceived: � Phone:(651)675-5675 �� j Staff: I Fax:(651)675-5694 I I �� ___� J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: f� �� Name: Phone: ��7�5�3 l 7� Resident/ ' /` � wk �si- �3a- 7�� Owner Address/City/Zip: �`7` `y 3 ��,Sct,vv� �-� �q��_ J'�f�� "S/a-� Applicant is: Owner Contractor T B Of WOPk Description of work:�� p(¢,�� c+�r�S D�Q,,��n9 � Yp Construction Cost: Multi-Family Building:(Yes /No ) Company: Contact: Contractor Address: City: State: Zip: Phone: Email: License#: Lead Certificate#: � If the project is exempt from lead certification, please expiain why: (see Page 3 for additional information) Y�-�cJc�w� r,�;l( �' r s ' wi`� ck3s 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 8�Water Contractor: Phone: NOTE:Plans antl supporting documents that you submit are considered fo be public information. Portions,of'. the information may be,c/assifetl as non-public if you provide specific reasons fhat would permit the City to;- conclude that the are trade secrets. 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.aooherstateonecall.orq I hereby acknowledge that this information is wmplete 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 l '€1��-'e v2 0►l 1.�.��j F7�� X Applicant's Printed Name Applicant's Signature Page 1 of 3 �� /c�c�� ,��',,�.1�'a.� �'� � ' a7�l// DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Fireplace Porch(3-Season) _ Exterior Alteration(Single Family) �( Single Family Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi � Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of Plex Lower Level Pool Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* Addition Move Building Reroof _ Demolish Interior � Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION � Valuation 2.� OC?tl, Occupancy �� MCES System Plan Review Code Edition Zv�7 MSi3� SAC Units (25%_100%_) Zoning � City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction "�� Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) �, Final/No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Roof: Ice &Water Final Pool:_Footings _Air/Gas Tests _Final � Framing Drain Tile Fireplace: _Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other: Reviewed By: � �— , Building Inspector RESIDENTIAL FEES Base Fee � Surcharge ��,� ��'�� Plan Review 2��)(7C�F� MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies Q TOTAL Page 2 of 3