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4349 Medary AveCITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eaga ' PHONE: 454-8100 BUILDING PERMIT Te be wwd ier '•,i)?: Est. Value ` i f' ,: GO Site Address Erect Lot Block Sec/Sub. ?' ". `: , i.; • Remod Repair Parcel No. ? Name W ; Address b City Phone o Name Ou Address - - 1- Ciry ' Phone - - u= Kw Name i? Address t?.Zi City Phone I hereby acknowladge that I hove read this applicarion and stare that ihe intormotion is correct and ogree to comply with oll opplicable Stata of Minnewto Statutes and City o( Eagon Ordinances. SipnMurc of Permittes A Building Permif Is issued to: oll work shall be done in acoadonce with all onoliwble State of Mir MN 55121 ? ? 11 ? ? # MOVB I Int Im Install Occupancy _ Zoning _ Type of Const. No. Stories Length Depth Sq. Ft. 11169 Fess Woter b $ew. Police Fire Erq. Plonner _ Council _ Bldg. Off.. v. APC Var. Date Permit " '-' . J U Surcharge 5 , fi (J Plan Review SAC Water Conn. Weter Meter Road Unit _ ; LI Tr. PI. Parks Copies Total on the exprcss condition Ihot and Ciry of Eopon Ordinonces. Buildirp Ofilciol Permit No. Parmit Holder Daes Telsphone ? Plumblng H. V A.C; Electric Sottamr Intpeetion Dats Insp. Other Footings I Footings II Foundation Framinq ,yw Roofiny Rouyh Plbg. Rough Htg. Insul. Flroplace Flnal Htg. Final Plbp. Flnal CwVOcc. ? ?`(JS ?:U W?or Descri6e Location: Well Sewsr pr. Disp. CITY OF EAGAN Addition OwnerL Remarks Improvement Date Amount Annual Years Payment Receipt Date STR EET SUR F. STREET RESTOR. GRADING SAN SEW TRUNK SEWER LATEFAL ' WATERMAIN * WATER LATERAL 1976 WATER AREA STORM SEW TRK * STORM SEW LAT ? CURB & Gl1TTER SIDEWALK STREET LIGHT 1980 _,' $0 13.56 ? WATER CONN. Brnsvlle 205.00 BUILDING PER. 16 SAC PARK ? CITY OF EAGAN k 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: ? PERMIT SUBTYPE: CTION RECOR] PERMIT TY Permit Number: Date Issued: f,f APPLICANT: , M1 TYPE OF WORK: 'I I ,.rI I I Nt, I I I ?41,1 14 11 1 1 11 t nri 0 " 1 z 1 t, cif. /.Ir, /tv"! ? ? Permtt No. Permk Holder Date Telephone # S/MI PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Inap. Commenta Footings 1 Foundation Framing Rooflng Rough Plbg. Rough Htg. Isul. Fireplece Final Htg. Orsat Tes[ Finel Plbg. Pibg. Inspector - Notiy Plumber Coast. Meter Engr./Ptan Bldg. Final Deck Ftg. Deck Final l? - r Wall Pr. Disp. io a 26. 02 cz Tt OF Far:-?N 37C? _nj.1:0't I'Y?Oil ia;',F?Ct i23;;I':,, t`?a jJ?-2 Pi Pw'/LIi NO.: 29 T:,e Ci.ty of La..?an heieLJ gra:zts to ? Lindsay Water Conditioninq Co. a WATFR SOFTENER F 3' 2 Vallev Ridge at 434 Medary Ave._ s/c.. 4215 Cedar Ave. So?, Eaqan R. I?nodel ? e?'Mit for: (Owner) M_ r,eVake ?r. pt:i°.uant to a.pplication dated 3/16/76 _ "?llis 22 day of March , 1q 76 lruiidir._- Insrector CITY of EAGAN BUILDIN[3 PERMIT own.r ..::?.......?`Q.`..?'.:- .:................................ L /c U ZU _77 Addreas (Presen!) .•T• ................................................................. ...... Builder .... Addeess ...... DESCRIPTION I .., r. N2 3792 3795 Pilot Knob Road Eagan, Minnesota 55122 454•8100 Dale S?-. 7,.f 63orias To Be Used For Front Depth Heigh! Est. Cos! Permi! Fee Ramsrlu l/? I ?- y I '?k? _S ?? /33• e-c? Lc ? .atc LOCATION /SL- S O Stree2, Road or oihee Description of Locatiox+ I Lo! Block Additioa os T:ac! /3 c/ Thia permit does aot suthorise the use of steeels, roads, alleys or sidewalka nor doas it giva the owner or hle agea! the righ! !o create any situation which is a nuisance or which presents a ha:ard !o tha health, safetp, eoavenieaca and general welfa:e !o anyoae in the commuaity. ' THIS PERMIT MUST BE KEPT?ON THEaPIREMISE WHILE THE WORK IS IN PROG8ES8. Thia is io eertifp, ................ has permission !o erect' a.. r..?..... d. ..?`"? upoa `.`:?.?. ......._ the above described premise subjecf fo 3he provisions of all applicable Ordinances for the Cif? of Eagan. t I ?7 ° ......................... 2! .......... ..... ...--- ? ? :-:. .................................... per ................ ._....-.9=": G`-----.._e..........':_::...... . ......................... Mayor Sufldiag Inapeetor 43 ? CITY , OF EAG:u,?' 3795 Pil.ot Knob Road Eagr:.n, Niinnesota 55122 7-3 ?, //' % YL?= NO.: 778 The City oi Eagan hereby grants to Ray P7. Wlelter F.eating ? ;,f bipls a sF.AmzrrG Permit for: ((h,.n-,er ) windsor at _4349 Mgdarv ? pursuanc tc opnl-cat_or, dat'Upd y12/22/75--•.-- Fee Paids g?p,ppdated this 23 cs?; or .50 s/c ` nec , Euilding Inepec-L-or Mechanical Perrr;its: Bi:? Total; , . CI'?'Y CF EaGa.J 3795 Pilot Knob Road Eagan, Minnesota 55122 ?? /) 03 //i/iS PERvIIT NO.: r,; r, The City of Eagan hereby grants to my,o?,Tcnr ;- •r;n?, cn_ Of Minnntnrka Windsor nev. a *! Permit for: (Nmer) ca?rAi tr-•cr i nr, 4349 14e3ary Ave,i at ,. .• r,r,?, ? pursuant to applicaticn dated 1 1/1 c;i7, . Billed Fee iffi?y}: <. ;.,-)q dated this 1`; day of r,,v, , 19 7S • Building Inspector Mechanical Permits: Bid Total: CITY OF EAGAN N° 1 1 16 9 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ' PHONE: 454-8100 BUILDING PERMIT Receipt # To 6e wed 1er ADDITION Est. Value $10 PO00 pare OCTOBER 24 19 85 SiteAddress 4349 MEDARY AVE Erect ? Occupancv Lot 7 Block 3 Sec/Sub. RIVER HILLS 9 Remodel ? Zoning Percel No. Repair ? Type of Const. Addition ? No. Stories MARVIN LEVAKE Move ? Lengtn W Name Demolish ? Depth ? Address S?E Int Impr. ? Sq. Ft. City Pnone 890-0790 Install ? ? Approvols Faes o Neme O CARLSON CONST ?? Address 13621 V N .NT IR Assessment _ ? City BLTRNSVTT.T.j?'hone 890-0339 Water & Sew. ? Police Name Address City _ Phone 1 hereby acknowledge that I hove read this opplication and stote thot fhe in(ormafion is Correct ond ogree to Comply with oll opplicable State of Minnesota Stotute and City of Ea9an Ordinances. Signoture of Permittee < </$4,eS,G "e/E,( -? A Bufiding Permit is issued ro: O. CARLSON CONST ' all work sholl be done in ocwrdance with oll ooAliwble Stotelfof M Fire Eng. Plonner Council BIdg.Off.lO 23 85 APC Var. Date Permit a o V.Z)v Surcharge 5.00 Plan Review SAC Water Conn Water Meter Road Unit Tc PI. Parks Copies rotal $85.50 on the ezpress condition Ihot Statutes and Ciry of Eagon Ordinonces. Building Official ' REQUEST FOR ELECTWCAL IWSPECTION Eg00001 -°° tsee ;n?t.uct, -? o?.'?conplaiiqu this form m back of Velloa copy. A -YY"Be/aw Work Covered by This Request ?°??- Add Rev. TvPe of BuildiFog /hppliaxes Yved . EquiPruent Ypired Commercial Bldg. Fumace Silo unloaAer r?TTrxlustrial Bldg. Air Corditioner Bulk Milk Tank_ mnute insnection tee N Fee ServiceErRfent9Siie A Fee Faedars/Subfaeders Jt Fee Circuits omzoo AnWs 0 m30 Antps omsoam Above 200 Amps 31 tu 760 Amps 31 to I00 ARUM Swirtonirg Pool Above 100_Am?s Above 1Q0-A? Tra?sformers Irrigation Bowrs Partial•' ee Sigis Special Inspection 5 Remarks f S[J TOT ? e d••-•^ ? --- 1. lecti 1 r f ???? I?pec e6y ce?tify tlm; the above Final ?a? t:on has been . ? .?,??. ?yus mis revtmW This request wid ? ? ? ?j ? / ? 18 months from 6 ( A 079697 -- Q A ca A . tn) Reque t Date ? ' Fire No_ Rouph-in I?specNon Required? []ReadY How?Will Notity. InsPec- Wh ?Y 1 d ?YCS ?No en ReadY ? ? Licensed Electrical Contrac[or I beweyv feyuest ynspe?VOn of abwe ?Owner electrical sork insblled at: Street Address, Box or Route No. Ciq. 3 ?{ ?,r ?e, . rfgAii ecuon o. Towmhip Nanff or Nn. nge No_ - ouory C ? A ? ..?)TK0r1+ ' . Occupant (PRINT) ? ?' Phwre fVa, ' ? .l ril-?V? a ia-a75 4 Power SuPDlier ?A<6fA Address FA2,o(1MG-TG AJ Electrical Contracmr (Compa n y Namel Cmtrac:roi s Gccnse No_ y ? ? QW,1'?. Wl,?p) n, e wj fc,t +?a Mailing Address IContractor a Owmer Making InsIDGlation) Authori ed Signature 1 on[ract fnu Incmtla[ian) Plwm N?miher ? a."03 1 n Q- cr7f6 MINNESOTA STpTE BOARD OF ELEC7RICtit ' THIS INSPECTION BEQUEST MILI NOT Griggs-Midwrav Bldg- - I1oom q-791 BE ACCEP7FD BY 7HE STATE 80ARO 7827 UniversflY Ave., SC Peul, YN 55104 UNIESS PROPER 17dSPEC710N FEE 1S PMnre 18121 297-2111 ENCLOSED. VILLAGE YiF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 Zoning: RII Owner: WindSOr Address Site Add Plurnber: Meter N( a 7i / Re?er No.: I agrae to comply with the Villoge of Eogan Ordiiwn? ?/ Cic 17 6 v... °tr.+-a[V[ By Date of Insp. WATER SERVICE PERMIT"? PERMIT NO.: 1?Bts .- DATE: 11/19/75 No. of Units: 1 Connection Charge: ?u:)• Uv yu Account Deposih Permit Fee: 10 ,.f1p billed Surcharge: -._ Pd Misc. Charges60.00 Total: ? Date Paid: Insp.: t\' riKaoE QF eaaaN SEWER SERVICE PERMIT 3795 Pilot Knob Rood PERMIT NO.: 2645 Eogan, MN 55122 DATE: 11/19/75 7.oning: RrT No. of Units: 1 Jwner: Wi ndcnr l1aY 1 f nrp 4ddreas: iite Address: 4349 MPdarv Ave L7II7 -A Ri 9 ?lUmbCi: ThUmpSOri P1UIIlb].Rq CO ogroa to comply wit6 tM Villaga of Eapon Connection Chazge: 425.00 Pd 3rdinancoc Account Deposit: Permit Fee: 10.00 billed SO billed ? Surcharge: ? ;y. Misa Chazges: ,. )ace of Inap.: Total: nep.: Date Paid: Dty of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ?----------------- ? For Office Use I j Permit ? Pertnit Fee: ? ? Date Received: ? I I I Staff: I I I ? ___J 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 4?4?? ?y I127;. Tenant: vG 4" `i 12e f _ZajU Suite RESIDENT / OWNER Name: ?Wveg' iz 4m Phone: :?"/ Address / City / Zip: _L,-WW6r64 ?[./ Ag- Applicant is: _ Owner ? CoMractor TYPE OF WORK Description of work: _?? Construction Cost.'r aJL?? . ? Multi-Family Building: (Yes No CONTRACTOR Name: License #: Zt7S $? Z?? ? '/ . Address:.$?o. f?leG/?Sf?jrlQ r;,0?l?1 City: Li?CJ??. ?ob1.OL? H?? State: Afl-/ Zip: _???Z41 Phone: IS J 6T'J? !O O Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A PIEW BUILDING _ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residential Ventllation Category 1 Worksheet . New Energy Code WoAcsheet Category Submitted Submitled (4 Submis5ion type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a perm(t 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: P/ans and supporting documents fhat you submit are considered to be public information. Portlons of the information may be classlrted as non-public if you provide specffic r+easons that would permit the Ctty to conc/ude that the are bade secrets_ -o,o?y a?Kilummye mat mis irnormanon fs comptete and accurate; that the work will be in confortnance with the ordinances and codes of lhe City of Eagan; thal I understand this is not a permit, but only an application for a permit, and work is no to starl 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 pl s x A7/'??a-.f? x_ Applicant's Printed Name ApplicanPs Signature Page 1 of 3 j Yo. C'0 2005 RESIDENTIAL BUILDING PERMIT APPLICATION 'i ?? L (+ City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Constmction Reouirements Remodel/Reoair Requirements Offite Use Ortly Gert of Survey Reed Y N 3 registered site surveys showing sq. fl. of bt, sq. R. of house; and all roofed areas l li d 2 copies of plan 1 set of Energy Calculations for healed addilions Yree Pres Plan Recd 'F N; ot coverage a owe ) (20% maximum 2 copies of plan showing beam & window sizes; poured (ound design, etc 1 siie survey for additions & decks Vee Pres:Reqm[ed , ?1 ' t set of Energy Calculations Addition - indicate if on-sife sepfic system Onsite:5epiic Sysiem :; -? N ? 3 copies af Tree Preservation Plan if lot platted afier 7l1193 Rim Joisi Detail Options selection sheet (buildings wiih 3 or less units) Date ? O E Construction Cost2 .4f D(J Site Address 3`1 1 VIec)a w Ti VP o Unit/Ste # Description of Work I 1enp'Q IP oIt6 C?dLII_IrL?2 Multi-Family Bldg _ YY_ N Fireplace(s) _ 0 2 r O P t Il I e7kt?l` l{'Y)b'f'1 FAMI\ Telephone #(65' )?"I wne roper y contractor GreatLai?es Wivia4,w 1- sid?nq - Address APPie W . MN 85124 City State Pk Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 CategOrv 1 _ Mumesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. - - Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone #( Telephone # ( I hereby apply for a Residential Building 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 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;requir.es_a-Leview and approval of plans. l-77 [i , l, "I iI ? ?<? 005 ? Applicant's Printed Name Applicant's i nat re i„ OFFICE USE ONLY 5ub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_Y or_ N ? 25 Miscellaneous Work Types ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Muiti Misc. ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors •Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Census Code SAC Units # of Units # of Bldgs Type of Const Occupancy MCES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Width .. ., ..,?,. ,. ? ?..,?•. -;?s: ?? a•???u:?•?-*,??,.;s.ri1; .x_? REQUIRED INSPECTIONS FinaUC.O. FinaUNo C.O. Plumbing HVAC OtYter Footings (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof Ice & Water Final Framing _ Fireplace _ R.I. _ Air Test _ Final Insulation Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Pool _ Ftgs _ Au/Gas Tests r,iw Siding _ Stucco _ Stone _ Brick Windows Retaining Wall Building Inspector CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: LoT : 4349 MEDARY AVE RIVER HILLS 9 PERMIT SUBTYPE: DECK 7 sLo c K: 3 APPLICANT: FITTERER (612) 890-5048 TYPE OF WORK: DESCRIPTION ausLoxNe 021315 06/25/93 MICHAEL NEW 5 X 19 & 16 X 20 INSPECTION .. • .A FOOTING FINAL INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: PERMIT ? CITY OF EAGAN 383dPilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT TYPE: Permii Number: Date Issued: SITE ADDRESS: 4349 MEDARY AVE LOT: 7 BLQCK: 3 RIVER HILLS 9 P.I.N.: 10-64400-070-03 DESCRIPTION: . , 5 x 19 & 16 X 20 8-u'ildirt+g,, Permit Type , DECK ?Buildirsg 4ittrk Type NEW ?.?.?) (?' ?s L.fu U REMARKS: FEE SUMMARY Base Fee $25.00 COPIES $1.00 5urcharge ,50 Total Fee $26.50 Subtotal $25.50 CONTRACTOR: BUILDING 021315 06J25/93 OWNER: - Applicant - FI7TERER I MICHAEL 4349 MEDARY AVE EAGAN MN (612)890-5048 ? I hereby aeknowledge that I have read th3s applicat3an and state that the i infarmation is cnrrect and agres to compiy with all apRlicable 5tato at Mn. Statutes and city af Eagan ord3nanees. 7 ? AP ANT/PERMITEE SIGNATURE ? SSU BY: S ATURE ._ ._ .. .?. _ ..._ . _ . . _ . . RE;ICTIYATE _ PERMIT # , a/13?s u?si??E?, V E DD .f J N 16 1993 --------------- CITY OF EAGAN 1993 BUILDING PERMIT PPLICATION S(? 681-4675 QIy SI NGLE & MULTI-fAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Ti.,A2 57 / 1113 Yal uati on of work Site Address: 4349 Me.a•-rv Av".,.v-, STREEi SUITE * Tenant Name: (commercial only) LOT 0-70 BLOCK 03 SIIBD: P.I.D. v? q *& c-d, ct.?' i o?n Descri tion of work: e.c.k The applicant is: L? Owner 19 Contractor ? Other (oes«;be) Name F i1'1?zirev- MicLaet A"w.6--r14 Phone 970 ?c,_oyg Property LAST fIRST Owner Address 4349 Medavy Ave- STREE7 STE # City F?o-ti avN State Mnl Zip SS? ;t-a- Company L'Phone IMn - 504 8 Contractor Address 14 34 9 Me-X d/y Av-t- License # 1JA Exp. City ? aVk State ,44 Al Zip 5517. J_ Company - n oA.t- Phone"76$ - 30S0 Architectl Engineer Name vQ. Registration # IJ, 4. Address o3 City ?-ei.J P94+4 (-C State fill ?V n+ . Zip S&OZ ? Sewer & water licensed plumber . Processing time for sewer & water permits is two days once area has been approved. 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. j 5ignature of Applicant: ??//t V OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation 0 02 SF Dwg. ? 03 SF Addition ? 04 SF Porch ? 05 SF Misc. WORK TYPE ? 31 New ? 32 Addition ? 06 Duplex ? 07 4-Plex ? 08 8-Plex 0 09 12-Plex ? 10 Multi. Add'1 ? 33 Alterations ? 34 Repair GENERAL INFORMATION ? 11 Apt-./Lodging O 12 Multi. Misc. ? 13 Garage/Accessory O 14 Fireplace lew- 15 Deck O 35 Tenant Finish ? 36 Move 1 • ? 16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Cotmn./Ind. Misc. ? 20 Public Facility 0 21 Misceltaneous O 37 Demotish Const. (Actual) Basement sq. ft. MWCC System (Allowable) lst F1. sq. ft. City Water UBC Occupancy R2nd fl. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pum p # of Stories Footprint Sq. ft. Fire Sprink ler Length '57? 1g' On-site well Census Code 93 y Oepth On-site sewage SAC Code ? APPROVALS Planning Building Assessments Engineering Yariance REGIUIRED IN SPECTIONS ? Site Footing O Framing ? Insulation ? Wallboard ? Oraintile ;Final ? Fireplace Permit Fee ZS,ov I v.tLoc;«,: $ Surcharge Plan Review . License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units ?i t0 1n?1(c?i, t???1wd n-1" Lt;??s ?_loL?1/v _. ._._.._. ??'._?._... ..__._._._._. _?' . _ ....._ .. . "..' .. ". `.'? tIz? I ? ? i ----_4?,#S_ Y*'f ? .i. if ftTt ' t y? n • ¢7 f?':R a o , •? ° 5, :f?? ? . ? • ? .a,f; 00 ' . .. '?. ?. • . •.j? ? ? ? i _? N ?•,'. ?' PR? s ? ? . , ? „ . 1 ?I I'D ? ? ' ????'a ? . ? .. .•y f?P?+ . ' . . . . ? r ? ?? O • . ? r , I. t/.,? ?!'? 4?? ?t?? ' . `?° '/ ' ZSr?r • ?,•,_?? 90orX i.?? }??: r 15"0 ; 9? ' ? 900• 2cA ?. ?;H'floo?- J a?? ?; „ > ^f( ?j rT, Ga ? PottGA ? y•,:•?s. w + rca??'? • `V N S?or??h a?; i ?ar???, e 00'. 4 2 7 % , ? Z•L . =?-? _? . ... .r .. _ ? f? Y .' ?1?.$,(?:n:l O 0f., x...,6' ' 016 G M 016 N . .. ? ' ? •-- .. , ., ? \p J . _ _ ..__ ._. _.. "_?'.? --- - -•• ? '?ti?'? . ..?--?,---=--s- ? p?o ? os ?d ? f ot ?, i ? . , ? ? ?? „? ? ; ;: ? ? 1 „?•?E • i , ?- ? ? O ? ?? ? ??'. ? F° r - ?, •???tf x -.?' , --+a ny ? 2? -Yl<g , : ??:.. _ ..._ - . ._ _ ... . _ . . _ ----• -- ` .i f?? 1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL) CITY OF EACAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Conshud(on Reauirements Remodel/Repair Reau(remenfs ? 3 regisfered sRe surveys showing sq. ff. of lot, sq. H. of house 2 copies of plan and all roofed areas (20% maxtmum loi eoveraae allowed) 1 set of energy calculafions for heated addifions D 2 coples of plans (show beam & wlndow aizes; poured Ind. des(gn; efc.) 1 sNe survey tor exterior oddHions 3 decks ? 1 set of energy calculations A 3 copies of hee preservaNon plan 81ot plafted affer 7/1/93 2//' ? ? DATE: D? J"!"/ CONSTRUCTION COST: 9 DESCRIPTION OF WORK: _ IW`DD? `? ? VY ?? STREETADDRESS: J? L ? - c LOT: ? BLOCK: SUBD./P.I.D. #: VW Name: )""i 4y e/'' /lt-? Phone #: 56 PROPERTY Lost First OWNER ?? qcg fi-k-b Street Address: Ciy State: Zip: Company: LM 0i4'L W-0 Phone #: &G CONTRACTOR (area code) f? / _?,_ ??J S Street Address: 6) / ?- License #q853 Exp! City State: Zip: ARCHITECT/ ENGINEER Company: Name: 7elephan2 #: craa coaie ( Streei Address: Registration #: City Sewer 8 water licensed plumber (reautred for new eonstructlon onlv): State: Penalty applies when address change and lot change is requested once permff is Issued. Zip: I hereby acknowledge that I have read this applfcaNon, sFate that the tr?formatlon is cortect, and agree to comply wHh ail applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signafure of Applicanh C7G?? v w1µ' C) - OFFICE USE ONLY Certificates of Survey Received _ Yes No Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) OK02 SF Dwelling O 07 5-plex ? 12 12-plex ? 17 Garage 0 22 ' Porch/Addn. (4sea. ? 03 1 of _ plex ? OS 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level --M.24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool /b 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr O 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alte°atian ? 37 Demoli.eh RI^!ca.* rJ 41 Wor,el c+nye !'[ 45 rir;; P:;pair ? 34 Repair ? 38 Demolish (Interior) M?42 Reroof * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. (Allowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning sq. ft. # of Stories sq. ft. Length sq. ft. Width Footprint sq. ft. Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee Surcharge Plan Review License MClES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/VN Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: valuation: $ ?530 7 SAC Units °k SAC , 1985 BUILDIHG PERIiIT APPL ATION - CITY OF EAGAH NOTE: ALL CONTRACTORS HUST BE LICENSED ifITH THE CITY OF EAGAN COMMERCIAL SINGLE FA!lILY DWELLINGS INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1?SET OF ENERGY CALCULATIONS' $2,000 LANDSCAPE BOND To Be Used For : Ac(LQ[ f( r--4'X Valuation : (0,60d- Or-% Date : ? Site Address 47? (t N Lot ? Block,3 Parcel/Sub Owner ! d f/4- lC -e Address `/ 3 Y w City/Zip Code t= A- q 2 w Phone Contractor Address neL ? City/Zip Code ?-? ur ?? r`rC4, Phone _F! 0-F2U- 6 33i Arch./Engr. Address City/Zip Code Phone !/ INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS (? a .- 2. 3 - ?-I OFFICE USE ONLY Erect ? Remodel ? Repair Addition ? Move Demolish Int.Impr. ? Install ? APPROVALS Oecupancy Zoning Type of Const # of Stories Length Depth Sq Ft F'EES Assessments Permit Water/Sewer ? Surcharge Police Plan Review Fire SAC Engr W 'ter Conn Planner ater Meter ' Council Road Unit Bldg Off ia Treatment P1 APC Parks Variance Copies TOTAL , ? I (?? K ( ? ` 2j () 4- X 2c) ° (an vo ., ,? -•?, . "s. ,. , ; '46 .' ? . _. 0 lrI ?1?7 V?. ?A?IqAl obtr M?- Djql.e- PeTT?-saw o 11//2/ 75 Vi G! 0 SIfA4 ?,? i i GL C-? P G rl /?!? t? -2 1g" Yn CJ U t-. ? d? 1026 b???(d,?.? ??P- e s, 30 C j S k/ CD h k PG ?o w19 h dA eTe y- a? < 7 6[OGr1 3 r41 l?s??? eJA?Y ?vee ko t-,-e, W-(? )1. "! Ci W l Y 1 "' l' ,, l ?/ Lin> Ir / y Zf, C3 ??J J w E r?? / l('r? G ? V ?/ ? ?/l d ? ? X? Z S(?' 6 O ?/5 0 w l? ??(rl.? ?i !!? C] "PJ ? he,6 owL k,-)??6 c v ( o c, L? e. o ? e ?r - e c- e U 0 c, c O L _, . . _ ._ .. . _.?.,?.. , __ __ ... _ _ _ _- t « . .. , ? . . ? :.,;. ? .,, _ • .r •x?, , •?y? , . . , rx sAk, ?.':p . . . . #??, .6 ' ?(+ •I- ¢ / / ,j? ' / /? l • ? ,• ?14 h? ? ---- ?S-},p,L,,,,-4=e9[-.-_ , ,. W`iJ G . . ? - ? . -- -;'f?,= .hr•, J ? . . ? .__.. .? , . __...._ . . .. . . '. Y ':? , \ ? ? 1 - ? , ?•-y? ? ru Cf, ?.,. ?. i ?p Y'i ? . j, . ?J r• ' ti' .? ?'? ° M i ry?gs 4ER r IoXIG / ' ? tlu? ?Y + ? x qao ??r / =.?V?_?` ? F?4c•w, +ICAH? ly ??. ? r nl Q>o hc h ?0?, 2 n t' r't ? _ _ o t r }r O e O`?- , ?3 R1 o c k? 61 ?,,,, to 4 ??'q7j ? (ZOU Nrl, ?? ? I, O /0 O ? k" ? J ' , ...v., . ? ?'? !U e• __".. ??jx? r+'? -3 ?n „?. -. ,4 , f7 ?1 01 . , . . - . . f?.._?: 1 ". , ,., < ?pN S06 MASTER CARD LOCATION OWNER (qA h pI D I DQ Ll STRUCTURE AND LAND USED AS mp b 7J - 3 b Permit No. Issued Issued To ConTractor Owner BUILDING PLUMBING j? M_ '7j 0000 r?I,. r?d s?r CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER I 07HER I I Items Approved (Initial) Date Remarks Distance From Well FGOTING ? ?I-/g- 7J' FOUNDATION CESSPOOL FRAMING ? TILE FIELD FT. FINAL ELECTRICAL - HEA71NG 3 - DEPTH OF WELL GAS INSTALLATION _ SEPTIC TANK CESSPOOL DRAINFIELD 9- /(O ? PLUMBING a ? WELL SANI7ARY SEWER _.?[A? •• ? Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OP OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION a NO EVIDENCE OF NON-COMPLIANCE OBSERVED. ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REIIRSPECTION REQUIRED REINSPECTION REVEALED DATE OF REINSPECTION CE RTI FICATION -1 certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site imprrnements relating to the property inspected. ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING I COMMENTS: DATE _4DO 23 -- ? ? n,? RESIDENTIAL BUILDING ?? Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX 4 651-675-5674 New Construc6on Reauirements RemodeUReoair Reauiremenls Office Use Onlv 3 registered site surveys showing sq. ft. of lot, sq. ft, of house; and all roofed areas 2 copies o( plan Cert of Survey Recd (20°k maximum bt coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan ReW 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey tor additions & decks Tree Pres Not Reqd 1 set of Energy Calculations Additlon - indicate if onsde septic system _ Onsile Septic System 3 copies of Tree Presenation Plan it lot platted afler 711193 Rim Joist Detail Oplions selection sheet (bldgs with 3 or less unifs Date Site Add? ConstructionCost UniUSte # Description of Work +``PrN. U U?C f ?} >?4 }• i- )?? ) 1> I?J?n /) '- f-.lpiS" a' JSle'f Multi-Family Bldg _ Y-j/N Fireplace(s) _ U _ 1 ? 2 Pro er Owner P tY '" / ?/ •?-? ??-et /` ? -J Tele hone# t?.?f ) ?1 ?.- ? ? p ' ( v ` ? Contractor peilcl?ke c) Ft' i 'Lf Address State ?y7? 3'1 Zip City ?DO Yl+ n? JrS I /.ZJ Telephone #1?/„2,) S'AQ oZ? ? 4 liq a?9 (0 (? kt.Lct 66Lt COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber Telephone # ( Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the informatio4ris`comp ete and accurate; that the work will be in conformance 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 rk which requires a review and approval of plans. A19 7 j 4?2G3 1-, ?? I4 ApplicaR 's Printed Name Applicant's i ure OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 i 6-plex ? 20 Pool ? 30 Accessory Bldg ,U 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 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex O 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New z)('?35 'A 32 Addition ? 36 ? 33 Alteration ? 37 ? 34 Replacement Valuation Sf VQ Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const Int Improvement ? 38 Demolish (Interior) ? 44 Siding Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors 'Demolition (Entire Bldg) - Give PCA handout to appllcant Occupancy MClES 5ystem Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Width _ Footings (new bldg) Footings (deck) V Footings (addirion) Foundation _ Drain Tile Roof _ Ice & Water Final ? Framing _ Fireplace _ R.I. _ Air Test _ Final Insulation REQUIRED INSPECTIONS FinaUC.O. ? FinaUNo C.O. _ Plumbing HVAC OWer _ Pool Ftgs Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (newheplacement) _ Retaining Wall Approved By 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 Total 1/1 C?, Z) a C:) . D a u_r r_?,? co?-? u7: to 7JG4JG ((bb > ?F J JL Wh ? J.L wHITE ( VYELOINO - FAORICATI gtBB WnT 125rn St S/?YAOE, MINfll80TA, S (812) 880-8331 // GARY OTIS ? • ? DESIGN • BWLD • REMODEL i P1e ken B U I L D E R S, I N C. 407 Ensr 78tH SmeeT OFFice 952.888,2225 BLooMwGTON, MN 55420 Fwc 952.888.2259 www.plekkenpol.com Moeae 6723282338 HoMe 612.861.8948 efefax He, MNLic p1797 ACCEPiED 'Y C N??me: /7'J? ? s Faa ? le 12 _6: 70 +Campany: Z ?•- k'hane # rr? ? ( !2-F'7c, _c,) FRaM Name: of?? Fas ik ?S'2-Y912, 7?? fr ? Company: Phone # qJ' ?? - YS? Z- 7 7 y ? DESCRIPTION . ,? ? m ?u !s C f 1% ? ..,.. , ? ? l ? f G Glt-a r L f?I'1 -- G? .Q L ? o(i 7.s) ??- 3 8, 2 Sr k_? sr- /y, ? , Z C G ?l / ?'i/7 eL S Vi L p 3 S'Y Zpaa0 /iI+/ i ' Z? f/o Ga 3Ga S ? ?-2?`"°? / f ! Na. of Pages (includiag cover): ? ? S Aate: 2/ y jc? ZYme: ? F ? If there are any problems receiving th.xe NaL'a'e; ey '?002 %?Y ! transmission call: phone- t i - I _...?.._ zo?ze•d zr:?e seez-be-a?-? FEB-06-03 08:09 AM 100 VV*l ?. J l? ?f ' , , I f - ? . i -' 4 { ' I I •` .;y y. I ?., „ > . . ?_..,. . ? ... ... ...._ ? _ .._.,... _ . ._... . .. .._._. . .-. 1?_,_._ ....... ... . ... .. ... . _ . ? ??r,'.• ;': ?. r; , ?- s a ?-'*?+-?? ?F _vf r •.' . s?w•,rn,=? ?-.. ,v .- .. . .. I _ l t °P° ?•.___ :: ...,. . ? . . ? {'. . ,... . ... ' ' , ' - . ' ?. .I GARY OT15 Oes .r+ I &mo • RcMOOei B U:?......??..r..,.?,?•. N G. ? 401 Lvt 781?1 Sir•rei Oorite962.888.2225 gi,oo"iwc: l,w+. MN 55d26 Fwrz 052.688.2254 www.pl?WenFK?i c?nn, Mo6u 612.328.2938 Ftcxwt 612.061.8948 i y 6128886768 PLEKKENPOL BUILDERS 6128$86768 ?'jcCA r, ti+q w?11 ? ? o1,OPP M . &--,/ . ;, y ,? X l 2 .i or _e;D . . ?C?. . , ._ .... :1+. .._.. .. . J/ .. ?'?yr . ?_,?? ?.?..'.? ; •.,. (r' , ? i1 -i ? ..? ?. __ .. -- . _._. .. _?• . 1 -----_._.......??..f,?_ ? . . , . _ ... . . ? 1 ?" ? ? ??? flpr.. ?J.'?'• , ? ? .. r?.r:; 14.4K P.91 . 7-y"N t? ?J? F? ' MECHANICAL (RESIDENTIAL) ? ? ?? Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when pernriu are required for each unit Date C) ?- / ):-? / 6 _? Sit Add alP42 l3q9 AL, Q Unit # e ress / U GLC?2N Property Owner Telephone # ( ) Contractor ANW&'C4^j /¢;t c-?/Jly Street Address ?7? ?-? iU' 4i, City ?l1 v e2 State MZip -S S 3?0 Telephone #((Q4?- )6Wd-" 7Y?U_ The Applicant is Owner 2-4- Contractor _ Other Add-on, modification or alteration to eaosting dwelling unit $ 30.00 furnace replacement air exchanger air conditioner ? other i ?,;; FFf3 2 7 7_00"j State Surcharge By $ .50 Total $ 32>0 - ?9D I hereby apply for a Residential Mechanical Permit and aclrnowledge that the information is complete and accurate; that the wark 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 pemut, and work is not to stazt without a permit; that the work will be in accordance with the apJed plan in the case work which requires a review and approval of plans. ?P Applicant's Printed Name App cant's Signature MECHANICAL (COMMERCIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: commercial/industrial buildings multi-family buildings when sepazate pemvts are not required for cach dwelling unit Date U a / c? '7 / 0 3 Site Address `-t 3 1q N( Pgqo }iV{ Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor b'?m< <6v A? Sc• t StreetAddress ,qQ7?k A;C City RiU-ed( State /vAN Zip S1r33o Telephone# The Applicant is _ Owner ? Contractor Other Work Type _ New construction Underground Tank _Install _Remove ? Interior Improvement Call for inspection durin g installation/removal of tank _ Processed Piping Nature of Work: QQ -po.ii.ed J /CQ??v j ?v f iv? ?u6 PLnsY%_ , Permit Fee $50.50 Minimum Fee (indudes State Surcharge) ContractValue $ x .Ol% PermitFee • If permit fee is $1,000 or less, add $.50 =:> $ 3tate Surcharge If pernvt fee is over $1,000, add $.50 per $1,000 Pemrit Fee $ Total Fee 1 hereby apply Yor a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conforxnance 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 applica6on 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 ans. ?I?V. v ??eauc. ?? ? ??-- ApplicanYs Printed Name Ap4cant's Signature Approved By: , Inspector Date: (?I -?w 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 9 651-675-5694 $ --?-o,0 New Construction Reauirements RemodeVReoair Requirements ..:...:.::..... f?fFxe Use {?t 3 regisiered site surveys showing sq. ft. of lot, sq. fl. of house; and all roofed areas 2 copies of plan C PA b f?'u?!e!' ¢ X ? (20%a maximum lot coverage allowed) 1 set of Energy Calculations for healed additions Tree?te5 Pf?rf E?ecd Y. t?. 2 copies of plan showing beam & window sizes; poured found design, etc. . 1 site survey for additions & decks ?reePres3?ec7Ui{Ed ?'. ?,;N 1 set of Energy CalculaGons Add'dion - indicate Aon-site septic system t?asde SeplrCSystem :: 3 copies of Tree Preservalion Plan if lot platted after 7l1193 Rim Joist Detail Options selection sheel (bldgs wilh 3 or less unih "Date o? Construction Cost „7 SaD' SiteAddress Unit/Ste# ?!;'?; u-u i' In Description of Work II " ? f! J ZUOq ,u (<c? 1 Multi-Family Bldg _ Y? Ir?y Fireplace(s) _ 02 ?- Property Owner Telephone # (lo?l) ?0 -`1Z YcF--- Contractor e lla(G?-s" Address ?20J--I.S- City Z/w [ - State mov Zip ?DYyTelephone # (1??) t - ..71?2? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cate¢orv 1 _ Minnesota Rules 7672 Enefgy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Conhactor Telephone #( Telephone #( Telephone # ( I hereby apply for a Residential Building 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 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 an . Name OFFICE USE ONLY 5ub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? 08 06-plex ? 16 Firepiace O 21 Porch (3-sea.) ? 03 01 of_plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screeNgazebo) ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_Y or_ N ? 25 Miscellaneous Work Types ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement Valuation Census Code SAC Units # of Units # of Bldgs Type of Const ? 30 Accessory Bldg ? 31 Ext.Alt-Multi ? 33 Ext Alt - SF ? 36 Muiti Misc. ? 35 Int Improvement ?- 38 Demolish Interior. ,O,; `44- ? 36 Move Building ? 42 Demolish Foundation ? 45 ? 37 . Demolish Building' O 43 Reroof ? 46 •Demolition (Entire Bldg) - Give PCA handout to applicant Occupancy MCES System _ C't Wat Siding Fire Repair Windows/Doors Zoning i y er.. Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered - Width - _ Footings (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ R.I. _ Air Test _ Final _ Insulalion Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utilify Connection Charge S&W Permit & Suroharge Treatment Plant License Search Copies other Total REQUIItED INSPECTIONS FinallC.O. FinaUNo C.O. _ Plumbing - HVAC Other _ Pool _ Ftgs _ Air/Gas Tests Final _ Siding _ Stucco _ Stone _ Brick Windows _ Retaining Wall Building inspector