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1978 Chipmunk Ct(IPrtifirtt#e nf (Orru,pttnrg Citp uf (Eagan Brpttrtment uf +?uild'mg 3nspertinn Tbit Cnti fitatt ittutd purtwtnt tu tbe nquinmrntr of Sectian 306 of the Unr form Building Cnde cnti fpng tbat at t!x lime a f itluanct tbir rtsuctxre wat in comPliunrr with the va+iaut ardinarura of tix City ngulating 6uilding conn+uttion or ure. For thc folloudng: w.ckwfi?? SF DWG/GAR B„t.N.,No. 6255 O-Uwm*ro. R3 Trac?uw V en? 3 zaNn, ww?, Rl w.John Mahoney Con. Aaa. Rt. 1, Box 239,Prior Lake Wift, ?dd= 1978 Chipmunk L?,r L38,B1, Meadowlands By: 12-1-$0 .e. „ . .,.„e,,. ....1. ?y YiMOiw U 9 s. CITY OF EAGAN ' - 3795 Pilot Knob Road Eogan, MN 55122 N! 6255 PHONE: 4548100 BUILDING` PERMIT Receipt # To be used for Est. Volue Dote , 19 Site Address Erect ? Occuponcy Lot Block Sec/Sub. Aiter ? Zoning Parcel # - Repair ? Fire Zor+e E i of Const T n arge ? . ype W Name Move p ?# Stories 3 Address Demolish ? Front ft. 0 Ci Phone Grade ? Depth ft. 0? o Nume Approvals Fees - ?~ ? Address Ci Phone Name b 'W W rW ?? Address <W Citv Phone I hereby acknowledge that I have read this application and state that the information is rnrrect ond ugree to comply with ali appiicable State of Minnesoto Statutes and City of Eagan Ordinances. AssessmenY - Water & 5ew. Police Fire Er,g. Plnnner Council Bldg. Oft. _ APC Permit Surcharge Pl4n check SAC Water Conn. Water Meter Rood Unit Total Signature of Permittee I A Building Permit is issued to: on the express condition that all work shall be done in nccordcnte with cll opplicoble State of Minnesota Statutes ond City of Eogan Ordinances. Building Officiai ? Pennk # poM Isved PonittN Plumbing ? ,3 /, ? --, /-?C Mechonical ?'c ?? .?` 3 i' ?S/ //- ;7 -td if - •4-?c w ?'?-? :n?. INSPECTIONS DATE INSP. Rough-In Finol Footings Date Insp. Dute Insp. Foundotion Plumbing Frame/ins. 7/-?j?-? -;FO Mechaniwi Final Remarks: -$d Aca?? l 02 I ? So •?,.cp.cr,Gr. Z--? ; CITY OF EAGAN ' 3745 Pilot Knob Read Eo9as, Mlnnesota 55122 No. Phene: 454-8100 PERMIT INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Cl Date: Receipt No.: - l Single _ ?7 Ct . Residential Site Address: Lot Block Sub/Sec. - ? Multi Res., Comm./Ind. Nome 1' ` AdioIley_ {'onstr. New /Alter./ Repair ; Address Cost of Instollation O City Phone: ' Permit Fee Name . T.;- :i?:Ett :I? ' • ? Surchorge ? Address ? V , City " Phone: Total This Pertnit is issued on the express condition thot all work sholl be done in accordunce with oll oppliaoble State of Minnesoto 5totutes ond City of Eagan Ordinances. Buildin9 Officiol No. -;-?' }-?, cirr oF E?c,AN 9795 Pitot Knob Rood Eagen, Minnesota 55122 P,en.: 454-e100 PERMIT INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Date: Receipt No.: Single Site Address: Residential Loi Blxk ? sub/sec. ea.dnwlandF Name - ^neV . ? Address - -v-'?? ? City Phone: - 3 ?6? Nome =' as ton t?eatin? r ? ? Address City ' Phone: This Permit is issued on the express condition thot oll work shall be Minnewta Stotutes ond Cify of Eogan Ordinonces. ^,, l 7 50 x New/Alter./Repoir Cost of Installotion Permit Fee 5urcharge Totol done in actordante with all applitable 5tate of Building Official 7 ? m 3 i O Unit i Air C PRICE: MECHANICAL PERMIT RECEiPT # CITY OF EAGAN 3830 PtLOT KNOB ROAD, EAGAN, MN 55122 1 DATE: - Name Address ?'- Ciry Phone - OF WOiiK d Air M BTU M BTU leater M BTU md. ? M BTU ? Outlets # FEE: S/C: Only: BLDG. TYPE WORK DESCRIPTION Res. New Mult Add-on Comm. Repair Other FEES RES. HVAG 0-100 M BTU -$24.00 ADDITIONAL 50 M 6TU - 6.00 WI1V RV V ? 'Y??' GAS OUTLETS (MINIMUM - 1 PER PERMI7) - 1.50 EA. COMM/IND FEE - 1% OF CONTRAC7 FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMODELS ? 12.00 ,? MINIMUM COMMERCIAL FEE - 20.00 ? STATE SURCHARGE PER PERMIT - .50 $ (AOD $.50 S/C IF PERMIT PRIGE GOES BEYOND $1,000) ? $ SI " F M EE i FOR: CITY OF EAGAN ? CITY OF EAGAN Remarks Addition Meadorland lst Addition - Lot 38 sik 1 Parcel 10 48050 038 01 Owner ?? ?• Street - 1978 ChiIa11Bk QOUrt State_ Eaganr L"1N 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREETRESTOR. mp• ' • • 99 1431.00 C006929 1/21/81 GRAOING 5AN SEW TRUNK * SEWERLATERAL ? 2840.93 C006929 1 21 81 WATERMAIN * WATER LATEFiAL WATER AREA 1973 95.27 6.35 15 STORM SEW TRK 1971 282.92 14.15 20 141.52 -16- 0 * STORM SEW LAT * services CURB & GUTTER SIDEWALK STREET LIGHT 21199 10/2/80 WATER CONN. 305.66 21199 10/2/80 BUILDING PER. 62-55 SAC 21199 10/2/80 PARK Zb Be Used For Site Address IAt -3 $3 Block Parael #: /D ?i City/Zip Code: ? CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevations & BUILDING PEId-iIT APPLICATION 1 set of energy calculations. oav _ Valuation Date OFFICE USE ONLY 2-Z- Atter zoning ?-- ? ? Repair Fire Zone `. Ehlarge Zype of Const. Mov+e # Stories Deqrolish Front ft. 3?L Grade Depth 31 f t. Prone #: -3 6"d Contractor : Address : City/Zip Code: Phone #: Arch. /Eig. . Address: City/Zip Code: Phone #: APPRG7VALS FEFS Assessments Permit 130, s' O [aater/Sewer Surcharge 0 Police Plan Check ? _? a..? Fire SAC .,rss, o 0 Eng. Water Conn.3e s. o D Planner Water Meter &,d ID Council Road Unit ,9 S. o D Bldg. Off. APC - - T= ! 01 ?3, 7j ?? This request void 0e (O 18 months from (? 94251 ?j J Dateoft's Request A4'J- Fire No. I, as ?? ? Licensed Electrical Contractor O Owner, do hereby request inspection of the above electri- cal wiring installed at: ._ _.,. _ D Street Address or Route No. Section Township _ Which is occupied by Is a roughin Power SupF Electrical G Mailing Adc on this job? No O STATE Range County Yes ? Ready Now 0 Minnesota State Board of EJectricity ' Griggs Midway Bldg. - Room N191 EB-00001-02 18-21 University Ave., St. Paul, Minn. 55104 - Phone 297-2111 ? bc G REQUEST FOR ELECTRICAL INSPECTION ;? - CHECK BELOW WORK COVERED BY THIS REQUEST S 94251 Type o[ Building New Add. Rep. Check Applian ces Wired For Check Equipmen t Wired For Home Duplex Apt. f31dg. Commercial Bldg. Indusuial Bldg. F m 01 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? Range Water Heater Dryer Furnuce Air Conditioner L?t ? ? ? ? ? I Temporary Wiring Lighting Fixtures Electric Heating Silo Unloader Bulk Milk Tank List ? ? ? ? ? ar Other ? ? ? p HeielSI - Hehersi rnruwTTF IUCPFrTIfIAf FFF RFf C1Nl Secvice Entrance Size: ? Fee FeedersdtSubf eWtqs: _ Circuits: i ? Fee 0 to 100 Am s. 0 to 30 Am Ctes'" ,???. U'?o 30 Am res ?? s=` O 101 to 200 Am s. I , 31 to 100 Am s `? 31:to 100 Am res Above 200 Amps. Above 100=SAmp Above 100 Amps. Transformera Remote Control Circ. Partial or other fee S' s S ecial lns tion Minimum fee $ Remarks TOTAL F ,3 y. I, the Electrical Inspector, hereby certif?iaethe (Rnnvh.in) (Final) This request void 18 months from been Will Call ? ?? ? .. nse o. eeepted 6y tfie • -^ ? i fea is endosed. .? ? I IW 7'Y OF EAGAN 95 Pilot Knob Road gae, MN 55122 ni ng: ner: - Address: Site Address: -? Plumber. Meter No.: Size: Reader No.: I ogree to eomply wifh the City of Eagan Qrdinonees. By Dote of Insp.: WATER SERVICE PERMIT PERMIT NO.: DATE: - No. of Units: - Connection Charge: - Account Deposit: _ Permit Fee: Surcharge: Misc. Charges: Totol: - Date Paid: _ I nsp.: CITY OF E SEW AGAN ER SEItVICE PERMIT 3195 Pi1of Knob Road PERMIT NO.: Eagan, MN 55142 DATE: Zoning; No, of Units• Owrter: . " Address: Site Address: . Plumber: ?a9ree to wmPl1' with t6e CiFp of Eogan Connection Chorge: Qrdinonces. By Dote of Insp.: Account Deposit: _ Permit Fee: Surchcrge: Misc. Charges: _ Totol: CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, M ESOTA 55122 DAT 19<? wcce? ED FR AMOUNT $ /Q ??-?/ & DOLLARf ? Y ?oo (-]CASH ECK FVND GOOE , AMOUNT 11 k You Than BY ri YMhite-Payers CopY Yellow-Postin9 CoPY Pink-File CopY CITY OF EAGAN ? 3795 Pilot Kno6 Road Eagan, MN 55122 N2 6255 PHONE: 454-8100 BUILDING"PERMIT APPLICATION Receipt # Pllv To ba uaed ior SF DWG/GAR Est. Value 45, 000 Date 10-2 , t 98a Site Address 1978 Chipmimk Erect ? bccuponcy R3 Lot 3S Block Sec/Sub. nReadowl?ndG_ Alter ? Zoning Rl porcyl # - 19 48858 3SE) e} Repair ? Fire Zone 3- Enlprge ? Type of Const. V rc Nome .Tn(1p A Mahnne-jr Constx` Move ? .fk Srories Z Address Rt. 1. Box 239 Demolish ? Front 52 0 _ ft. ci Prior Lake, 5WaWe 447-3360 Grade ? DePrti 39 fr. ? Nome APProvals Fces f ?? Address ? r.«, Name _ Address 1 hereby acknowledge that I have read this application and state that the informotion is correct ond agree to comply with ali applicnble StaM of Minnesota $tatutes and City of Eagon Ordirwnces. AssessrclW Q_l l _80 Water & Sew. Police Fire Eng. Plonner Council Bldg. Off. APC Permit 15U.7U Surcharge 23.00 Plan check 65.25 SnC 525.00 Water Conn. 305.00 Water Meter 60.00 Road Unit 185-00 Totol 1 y293- 75 Signature of Permittee I A 8uilding Pertnit is issued to: JOhTl B. MBYlOriBy COriStY`. on the express condition that oll xrork shall be done in occord ce with all qapplicabig State of Minr?GSOta $totutes ond City of Eagun Ordirwnces. Building OFficial ?s?`;?4jy?.4:? i. ? . . `? u?r+o auRVSVO? ?''-r•? ? ?? , . . , - , ' . i INY41ftwM 51!I?r Lnrt oi Tbr 51410 M Mtnnaota .. ? . lHON@ 012 4ti1?N ? i01t M. NdBgMWtMI'?. tM??T :pA.? ;flt L..Rl ?C•?? ??C: (c' ?? ' _? ,', .?;:x•:' . - ?? : FQ ?i ;_„? ? i/ ? ? : ?- ?? F.••i???c , ?„ u,?w,; v ? , ? ?'? yy j C ? . , e ?I `inoh a °30 fe?t . ? . awLU2ty saaem?st r: " 4 ?? f .? . ? . . . LFl?4 YW• *6 'A Fy? e y - ' L7? ? o ' ` ? ? ? ( ? ??ro ?? Lt[?'i? ? Ad ,pT,?,t z ? -,? 5 7 . x . i ? f ^' ? ? ' u. •. q r?? ? ? ;, ?,.;. _. ..? ? - . • 7 ;_- ; ? ? ? ???1? ` C •d "LrkL?i? •?t? "e'Y?•9?+,?, InB • r ? .. _ S 3r . .4 Dunn & Curry Com»rurrity 1;JS DEVELOPER'S CERTIFICATION Lot: 3& Block: I S ub di v i s i on :MWCOMAqp This is to certify that tMN(a GO, PeA-;;? has complied with the Seller's requirements necessary 'CO obtain Seller's approval for a building permit. ? ' This Approval is by Seller only. Ruilder must comply with all city requirements and must secure his own building permit. qpproved by Seller, Dunn & Curry Real Estate Management, Inc.: BY * ?lR1Y°s RI!EF? ut o ize gent Accepted by Buyer: By ate i4csr Arrraa!v wctt«or ?4T ' c? a? aF Ldt' 151 ??"1 C}tLUPe?-?t?tT t,oT'? • s' 4940 Kking Drivr ;vn Prnragon Office Park Minrtenpolis ; ? ° . MN 55435 * 'Q'u 4-i{s l, t. _? _. r t, r+" t 'P rm,-?^p`"' t ',-?-+r +z°r .1? .? Sx?? ? ? ? ? ? ??"•. ? . ? . _Sx . . ?. rc.f.ea?:vz `nvefcrrip .Iveaa9 e iU G2 i1'1•Il'1C?.fAff ?12/7;71t??C1oCtICC?'ft?o11 U.M@kq 4?i.f4aCfo? CAJST' Il<ti??l'?: kqm¢ ? t s +,r ? r+ ?v ? ?? . . qt!e i;•iLLL ?on.l,faucti.vft;. valtLe x nRe.! ? ??? •? „ S#ur!? R r'aLten " "?y',?r .?? j#. ??<,?` i ,iP ;(L!)1O z? , . . . ./qtt?F'al 1 'NRECt ''` + ? s a.ltdclted ehee.f.s R a t;? urt oZ61.J i ?x ?n )a : iCa ?f?.. qk'?,h?Y'?a.?'` ., - .._._"?.?.?.,...`ilt'r? --•-•-,•?C 4 f? s???+p r.-?-.??L?Jj?'r/ 7 77 a C9?JA?'= C? VQlUQ % Q/1$Q ? pa r 60 •? --"..- . s n:4? U'- val.ue x arte.a' • . Farte4°I??l? ",f,o-?i':r? `.'t?" , y `.x dn:i? s. x A2. -?.-...-.. -? > . . ea?': k ` . ? ? ,. .. . . ?014 x e.n,. LL.!PO ot;?a.? clzoad:ri,a,?a>` "cl" 6 x e?r#: 13 Dh 7.i - , - • K .tr. -,iitt. iu,I r1+i %v.ta.?.e ??• ?#. ` D o. 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'.in.au.'.ute?l cee..L.i.nQ, CouL PERMIT City of Eagan Permit Type:Building Permit Number:EA117981 Date Issued:10/25/2013 Permit Category:ePermit Site Address: 1978 Chipmunk Ct Lot:038 Block: 1 Addition: Meadowlands 1st PID:10-48050-01-038 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Randy Bradach Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Adam M Martin 1978 Chipmunk Ct Eagan MN 55122 Bradach Roofing, Siding & Seamless Gutters Inc 18267 Italy Ave Lakeville MN 55044 (952) 892-6015 Applicant/Permitee: Signature Issued By: Signature r For Office Use %`% � i r rr Permit#: 1 L70 I-70 ., E AG A ���• ..� Permit Fee: 1.7-7. 0 Date Received: . C V`I3830 PILOT KNOB ROAD EAGAN, MN 55122-1810(651)675-5675 I TDD: (651)454-8535 I FAX: (651)67IIECEIVEp FEB 0 6 2020 Staff: `;-� buildinainspections(c�citvofeaaan.com _ L� 2020 RESIDENTIAL BUILDING P IT APPLICATION a-);,-:D a/54.c� /8 _ i iv\UNk V2+ Unit#: r1_1 Date: Site Address: Name: AM cf /�lll - cl r i i A'j�& Phone: ` '4' � Address/City/Zip: 1q?g /p iV41N k4:711TLT ) i'19 , T ;„��`�� �`,„A�Applicant is: Owner '� Contractor FD u , .ci I Description of work: , IT-Cite.' Re/77 Cede `Typ , ;/` 7', , Construction Cost: /� Multi-Family Building: (Yes /No . , 4,14¢4 Company: ��E' /f Company: Ad/ 67,1411S W46100, Yi ,',41 a ��� ' i &9?R 1.44 �Q6100 � Address: �P t��IZ+C�i City: ` ,Zv 1-1 State:AA/Zip: 53//0 Ph6 e: 739— Email: Gr*.6 ,/: aco •KS'6)/ l,, cev� r 4(& h-5-a i License#: AC i9-+}6: Lead Certificate#: AT /E 5/4/ /0 0/4/?_3 If the project is exempt from lead certification, please explain why: 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: NOTE' Plans` s";'orting ocume' ts that you submit are cq% Idere dtoybe public informatio , P,o ont, o `.he!nfa4 r i ;1 A;b red;- 'classif ed asp bn-p ib'if yo provi specific reasons that would pe it the City.to co„nolur a t, � r' a trade secre ¢ t You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaqan.com/subscribe. 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. 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.qopherstateonecall.orq 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 clans. x 51,2,c/'e / 74c5* _ Applicant's Printed Name Applic. • s Signature DO NOT WRITE BELOW THIS LINE illy C p ` D\1 0 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 1r 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 q, f /� l V D OccupancyjT) -(,I- MCES System Plan Review � /I Code Edition 04 E10" SAC Units (25%_100% N( ) Zoning 1'Q City Water Census Code ��`` Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of ConstructionTb— Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test,'Hood Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: _Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Iv Insulation Windows Sheathing Retaining Wall: _Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: 1-11 , Building Inspector RESIDENTIAL FEES 6r) Base Feeg Surcharge 41° i it Plan Review yl,r. 'ry' MCES SAC City SAC Utility Connection Charge 30y )-0.--;S&W Permit& Surcharge 14/ 00-0 Treatment Plant Radio Meter Read Copies TOTAL Page 2 of 3 For Office UseE AGA N Permit#: /(go �J Permit Fee: g-o Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: L 2020 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 6^ c2. Site Address: /97/ Cfir s,r.e1 u v K C'Z' Tenant: /f f Z ) ,9 r c.4t' - Suite#: Resident/Owner Name: !1'��,Q��,� Phone: Address/City/Zip: /478 CA t (4y4"CZ-• 688/9,, / ,�f,,v ,,S22Z Name: /?iee,/"/9- / /4E4 7,47 License#: PM 65 9 D Ll Contractor Address: a�6�//ep71/lipcp City: a� � Z�, State: Ad Zip: ..c5-//C) Phone: Coa 777—6Z/C) Contact: ,&///C( Email: / 1Z486e,QI, ,r2 Type of Work —New Replacement Repair —Rebuild —Modify Space _Work in R.O.W. Description of work: }/CfeJi:v S,s' Tankless Water Heater (stmt e Ace Mx.) Lawn Irrigation( RPZ/_PVB) Standard Water Heater DeScri tlOn Add Plumbing Fixtures( Main/_Lower Level) p Water Softener Description: Septic System New Abandonment Connection to City Water from Well RESIDENTIAL FEES $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 New fixtures, adding or removing piping (includes State Surcharge) $60.00 Septic System Abandonment $100.00 New Residential(fee collected with Building Permit) $115.00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well*+$290 for Meter and$200 for Radio Read =$550 *Sewer&Water Permit also required for connection charges TOTAL FEES$ 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. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at 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 T'GSS /�uv Applicant's Printed Name Appli is Signature l' Page 1 of 2 ritIAC Y1 4c" _ BY Smoke and CO detectors affidavit for Building permit final I aa—, dhave tested all the required smoke detectors and Carbon Monoxide dli7 detectors, 147 'C40n-►-,Ik cT y/� At address , on this date ( �� They are correctly located as per the manufacturer's installation instructions and operating. There are working smoke detectors in every sleeping room, in every hallway leading to a sleeping room and on every level of the house. There are working Carbon Monoxide detectors outside of every sleeping room,within 10' Permit# 4;4 / a Il a Signature 1 Z A40/ iZe •aw >peg puss pue lno Hu apueup e}a8 noA ua4M •;uawnoop fey}q ei;e III •seaiie aigeD!Idde ale ui pue Aipaaaoo paiielsu! aae saopaaap oVa)Jows Ile saijnaap leyl l!nepi}}e ue se somas ley};uauanoop e;no Suipuas aa,aM suon4nsaa aye anp'aanaMoH leun aye Jo awn ague uoi;Dadsu! oD/a)ows e op osie pinoM am onols oiapala JO se2 e}!si os d! pue panow anols an sem 8upline3/2uneas aadoad 8uiMoys eaae lane;pue yselds)peg paanDas Apadoad s,;i fey;Bu!Mogs aayseMgsip ayn Jo mild y saopauuoo pue 8uigwnid lie 2u!Mogs)u!s ayn aapun :Bu!MolioJ aye JO sologd apinoad noA mop •sologd 8u!sn ;no pasop siq a8 o;aiqe aq Aew am Num. •13>iunwd!qo 8L61 uoi1.Dadsui 8uimnq pue 8uigwnid leun ay;8uipae8aa newa inoA pew ;snf -uewApuy 3