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3871 Palisade Way Use BLUE or BLACK Ink r For Office Use. l I EOUll I Permit#: I I © I City of Ea I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I I I 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 3871 /%A;ecw, why s-sIza Tenant: Suite M RESIDENT I OWNER Name: 149 / 61,o /1 0745CWI? Phone: it y~ ISM Address/ City/ Zip: 38 e'e-I/S''a-ce Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes / 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 &o 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 approv of plans. X ~l ~61 scx x . ) 'SA_0_tz~ Applicant's Printed Name App icant's Signature Page 1 of 2 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 i L n? ? o• t. ??.t . 1 5? c SITE ADDRESS: I J•.tt01 l.?A ;: i N APPLICANT: MnF rrr .`tiqfi I rt i ftli 1 l t+ I N(i H 3d :? A it PERMIT ,SUBTYPE: TYPE OF WORK: :, t T f' itA 7 1 hN Permft No. PertnR Holder Date 7elephone li EIECTRIC PLUMBING HVAC lnspecdon Dnte Inap. Commentn FQOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST FOUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BIDG FINAL ?- BSMT R.I. BSMT FINAL DECK FfG DECK FINAL ol CITY OF EAGAN Remarks Addition Cedar Grove #8 Owner ??--L), Li?Street - `'i i L.9_? , - 10 Palisade Way State Eagan,MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING 5AN SEW TRUNK 17- 125.00 5•00 25 Paid .;? SEWER LATERAL Z 1974 1 9. 10 Pazd WATERMAIN *WATER LATERAL WATER AREA ? STORM SEW TRK # STORM SEW LAT 1974 5 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 300.00 7668 3-28-73 SUILDING PER. sac 260.00 7668 3-2 -73 PARK /D ?6- ,76 7 10 G G -a ,0 ?? VILLAGE OF EAGAld 3795 Pilot Knob Road Eagan, 1Kinnesota 55122 ?'ERt.IT NO.: 379 0 The Village of Eagan hereby grants to aa of . a orinm retn Permit £or: (pkrner) sane y' 1-4-Ot 9Y-'PaUsede_P-t.-4-2-tfj, 3d71 Palieade Way 104,-- ? ¦?? 38fi9-?ive*+?r b?=8-39$p?i'?_?p?ation dated 32UZ3_, Fee Paid: 4120 00 dated this 281h day of _NaMh ? l9-L3L- 3•OG s/c Building Inspector Mu-chanical Permits: t3id To'ual; c. G? .. VILLAGE 0'r' EAGAN 3795 Pilot Rnob Road Eagan, Minne.,ota $5122 PEHMIT NO.: The Village of Eagan hereby grants to of 7-34z c -co-rs _n_sa 12 + c+s. . a Permit for: (Owner) ? at3841 Riderton 11°2-8, 3857 Pali98de Ptg ?i-2-8 ry 3871.P ead Way 10-2-8??j856 ? 8"r?s?;'393? ???C?#i14?$e? Fee paid; ?` dated this ?; 3 day of 1.? s/o ' 9-?-3--, Building Inspectc?-' iliechanical Permits: Liid 'Potal; nLuoe or Eansx 3795 Pibf Knob Road Eagan, MN 55122 Zoning: -- Owner. Cedaz' 1 Address: Si[e AdQc Plumber: SEWER SERVICE PERMIT PERMIT NQ • DATE:1 `/?9 12 3 ,R 73 No. of Units: 3on Co. 1 oqna fo eomply with fhe Villoqe of Eoqan Connection Charge:25O-,()OAd 3L28 O.dinaness. Account Deposit: Permst Fee: 10 00 pd 12/29/72 Surchazge: 50 pd 12/29/72 gY: Miea Chazges: Date of Insp.: Total: - lnsp.: Date Paid: D?rn&i11Gl S,I?-C 1-k EAGAN TOWNSHIP BUILDING PERMIT , ??? ? 1 , - Ownet ......_?--C?-L:_`:_._ ...rX°-.-i '---------....... _ ................................... Addeess (Present) ............. d ............. .?..?........:--.?R..r.?:`?. ---..._.. ..-- Builder ........ Addreas .. ...................----..........------.........._------............. DESCRIPTION N° 2928 Eagan Township Town Hall Date ./..?.-..y'.3 ....-.. 7.z............. . 5lorias To Be Used For Fron! Dapih Heigh! Esl. CosS Permi! Fee Remazki ? 5,e- or LOCATION I-4 O This permit does aot aufhorise the use of siseeis, roada, slleys or eidawalks nor doea it give the owner o: hie ageni the righito creale any siivation which is a nuisance or which psesenis a hesard !o the heal4h, safelp, conveniencs and geaeral weliare 2o anpone in the commuaiSp. THIS PEAMIT MUST BE KEPT ON THE PRENMISE W?HILE THE WORK IS IN PAOG S. This ie !o cerlify. 2hal.....C?z.:?v:...... haeparmission !o ereei a..-!???:s?;:_::::?} ..._upoa the abova desarihad psemise eubjae! !o the provisions of the Building Ordinanae fo: Eagan Tod?nship ado ledApril 11. 1955. ...2i ........ 0.4: par ...................__.ti..?,.-??.<........0??.?,,.? ... ...... . .............. ................ C fj Suildinp Impecfor ? L'ITY Uf= EAGAN CASHZGha S TI'_`RMINA!_ N0: 46 BA7F;; 06/13f97 77MF:r, 15.04:35 ID: NAME:: CUSTOM f;f.::MODEI.,.EhS INC :300 9001 3871 F'ALLSADr 224.75 205 9001 3871('AL.ISADE 7,50 70ta1 RS9Ct37.p1: Amnuni;, i.'.32.'?.'5 CR(:1 i 521.0 1161_:R .T.Dq NANCY ?i CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: n.7,N.a 10-16707-100-02 , ?_ . ;-.- ? i i, DESCRIPTION: s ?? ?? 1' ?•'£;!? }? ?'I? , <i?A+ 1fr..?4?";` ? "' REMARKS: FEE SUMMARY: P3acca Pee Surcharge Total Fee RESIDE/SOFFST/FASC.IA Permit rype sr- (mlSc.) uild.i.ti4 L"k?rk Type ALTERATION ensizs Coder"',., 4:34 ALT. RESXDEN7IAL PERMITTYPE: QuzLoZNG 030244 Permit Number: ? 6/ 1. 3/ 9 7 Date Issued: 3371 PAl.15A0c WAY LOT: 10 BLOCK: 2 CEUAR GROVE 8l'H VpLUATTON 1:'L2A.75 $7.50 $232.^<5 'p- 15,0 00 ?/NFR CONTRA(?TOR: - Applicant - s i. L.1 ?. 0 CUSTOM F2EI?OC7[LERS INC 17842646 0001748 UL??SDZ`f5CH PFlUL 47,1 FlPOLLO DR A 3877. PALISAdE WNY LIN0 IAKES i%N 55014 EHGAN MN (672) 784-2696 (61<)452-4439 I? . . . , . , ., a . .. . T hereby acknawledge thut'I have read thtis ?pollcation and srete that ihe information is correct artd sgre¢ tp cocapiy with GJ1 appli:cable State of 11n. Statutes ahd City of Layari Qr^dinaneec, -, - _JAD ICANT/PEPMITEE SIGNATURE PERMIT IS$ BY: SIGNATURE - - ? 3 Oa qI,? 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) a 3a .? ?' ? cinr oF EAcAN 5830 PILOT KNOB RO - 55122 681-4675 New Construdion ReauiremeMs RemodeVReoair Recuiremenffi ? 3 registered site surveys ? 2 onpies of plan • 2 copies of plsns (inGude beam 8 window s¢es; poured fnd. desipn; etc.) ? 2 site surveys (eMerior addRlons & dedca) • 1 energy calwlations ? t ene igy calwlations for heated adCRions ? 3 copies of tree preservation plan if IM plalted after 7/1/93 . reqWred: _ Yes _ No - • 31 9 7 DATE: 011 /Y - CONSTRUCTION COST: j DESCRIPTION OF WORK: STREET ADDRESS: 3 S" J 1 ??-C! 5?7?? ?c/ ?/{-(p•4n/ ,?1i/ ?t/ ?PA nh ;;fl hm1P- -4v LOT BLOCK ? SUBD./P.I.D. #: ( , PROPERTY Name: //W/- 65gGAo ! 4,5e,14 Phone#: OWNER ,.„ Street Address: A?- -7J G?-Ia-<aek ui45 City: State: ?A-' Zip: SO'/ L2-- ^ CONTRACTOR Company: (,us,fyr" Xe/?,k3r5leZeiS Phone #: y?Y" Z031fo Street Address: ?/ 7V ?L-10 A0316f License 7`/ ? City: L"h-v 4?IL'!!3 State: 0/"/ Zip: j-ro l L/ ARCHITECT/ Company: Phone #: ?- ENGINEER Name: ---? Registration #: Street Address: City: `--' State: Zip: ? Sewer 6 water licer•Fed plumber (new construction onty): Penalty applies when address change and lot change arerequested once permit is issued I hereby acknowledge that I have read this application and state that fhe information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: 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 Duplex 0 02 SF Dwelling ? 07 4-piex 0 03 SF Addition o 08 8-ptex 0 04 SF Porch o 09 12-plex 0 05 SF Misc. 0 10 _-plex WORK TYPE 0 31 New o 33 Alterations 0 32 Addition o 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit 5/W Pertnit S/W Surcharge Treatment PI. Road Unit Park Ded. Traiis Ded. Other Copies Totai: 0 11 Apt./Lodging ? n 12 Multi RepaidRem. ? ? 13 Garage/Accessory ? 0 14 Firepiace n 0 15 Deck 0 36 Move ? 37 Demolition 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous _ Basement sq. ft. MGWS System. _ Main level sq. ft. City Water _ sq. ft. Fire Sprinklered _ sq. ft. PRV _ sq. ft. Booster Pump _ sq. ft. Census Code. _ Footprint sq. ft. SAC Code Census Bidg Census Unit Building Engineering Variance Valuation: $ % SAC SAC Units MASTER CARD OWNER STRUCTURE AND I LAND USED AS eop) j?,7 Z?- Permit No. Issued Issued To Contractor Owner BUILDING PLUMBING CESSPOOL - SEPTIC TANK -- f- WELL ELECTRICAL HEATING GAS INSTALIING SANITARY SEWER ?s- OTHER OTHER I Items Approved (Initial) Date Remarks Distance From Well FOOTING SEPTIC FOUNDATION S 3" 7 3 CESSPOOL FRAMING 5'- 3-7-3 TILE FIELD FT. FINAL ELECTRICAL HEA7ING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING ?j-73 WELL SANITARY SEWER 3 ^ 7 -, Violations Nofed on Back COMMENTS: COMPLIANCE INSPECTION REPOftTS TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. 1:1 ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ITEMIZFD AND DESCRIBED AS FOLLOWS: ? REINSPECTION REQUIRED REINSPECTION REVEALED DATE OF REINSPECTION CERTIFICATION - I cercify that I hwe carefully inspectad the above in which I have no interest present or praspective, and that I have reportad herein all signiticant conditions observed to he at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific requira- ments for off-site improvamenss relating to the property inspected. F-I ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR DATE s? . ? EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, MinnesoCa 55111 Telephone 454-5242 PfiRNII.T FOR WATER SERVICE CONNECTION Date: 3/23!73 (12/29%72) Number: 1746 _ a-8 Billing Name:Cedar Grove Construction Co$ite Address -a_4g..g 3871 Palisade Way Owaer: same Pltmber• Ste'n's 0 er 3/28/73 Meter No. ?PermiC Fee 10.00 pd 12/29/72 Meter Reading Meter Dep. •50 pd 12/29/72 Meter Sealed: Yea_ lAdd'1 Chg. ND ' 1bta1 Chg. Building is a: xx Residence I4ultiple R'o, Unita Comnercial Industrial Other Inspected by Date Remarks: Billing .4ddresa $25.00 RE-INSPECTION FEE FOR iMPROPERtY INSTALLED METERS. By: Chief Inspector In consideration of the issue and delivery to me of the above permtt, I hereby agree to do Cte proposed work in accordance with the rules and regulations of Eagaa Township, Dakota Countq, Minnesota. By: Stein's Please notify the abave office when ready for inspection and connaction. PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA099442 Date Issued: 06/07/2011 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 3871 Palisade Way Lot: 10 Block: 2 Addition: Cedar Grove 8th PID: 10-16707-02-100 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 openings, 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 S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Minnesota Rusco Paul F Gladitsch Jr 5558 Smetana Dr 3871 Palisade Wad Minnetonka NIN 55343 Eagan NIN 55122 (952) 935-9669 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:Building Permit Number:EA112739 Date Issued:08/22/2013 Permit Category:ePermit Site Address: 3871 Palisade Way Lot:10 Block: 2 Addition: Cedar Grove 8th PID:10-16707-02-100 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, 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 $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 - Paul F Gladitsch Jr 3871 Palisade Way Eagan MN 55122 (651) 452-4439 Minnesota Rusco 5558 Smetana Dr Minnetonka MN 55343 (952) 935-9669 Applicant/Permitee: Signature Issued By: Signature 4k' City of hp 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink r For Office Use Permit #: Permit Fee: Date Received: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: (U "3' l 3 Site Address: 3'6 7 I / al i'Sac e 5 I., -)ax Unit #: Resident! Owner Name: o. v.1 6-1 c-c,k;A-Sr_ L Phone: n Address / City / Zip: 3 ' 1 1 I"cAt sc.ct-c $ Lia ctSU Applicant is: Owner Contractor flNark Type o17( Description of work: l -tea. r o K cw w tk ,(e rocr( Construction Cost: 7 a-C»(c“j Multi -Family Building: (Yes / No L----) Contractor Company: Sv`a C a (A )rs, ti Contact: ' at" L G.1. -r Address: VI -00 VA-u�,-b0IE 4 5 City: 711ovw�;.� S State: IMS Zip: -5—S-4/3 l Phone: 62 (2 -373- 7 (e 2-7 License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, Yes If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: _No Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: T:. ,Plans and supporting documents that you submit are'consideired to be public information.. Portions af` the information maybe classified as non p1 11 if you provide specific reasons et would permit the City to cinc lude;:that they; 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.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 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 ` G h LC.L- Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA156038 Date Issued:06/13/2019 Permit Category:ePermit Site Address: 3871 Palisade Way Lot:10 Block: 2 Addition: Cedar Grove 8th PID:10-16707-02-100 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 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 - Paul F Gladitsch Jr 3871 Palisade Way Eagan MN 55122 Haley Comfort Systems 4320 Hwy 52 N West Frontage Rd Rochester MN 55901 (507) 281-0138 Applicant/Permitee: Signature Issued By: Signature FZEC� For Office Use t % 1 • Permit#: /62/ `� f-C" E AG N.• JUN 0 8 2020 Permit Fee: 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: build no nsoectionsccityofeaaan.cont, 2020 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 6 b Site Address: 3 u i / 1 � t , Unit#: J Name: `� , Phone: gVi 3'U 71ST Resident/ / I 0 Owner Addresso /City!Zip: ► � a� I Applicant is: Owner Contractor </ Type of Work Description of work: //: j,11�/, Ai Li Construction Cost q p Multi-Family Building:(Yes /No ) • Company: ;, illContact: 5CID/1 Address: Contractor aq�3 �JO�IL V� M�n� �! City: �a ?s State:Mg_Zip: _ Phone: r!11'a00 -up) Email: 'chitin g kKr E1 0141001 License#: 44 (f 313 Lead Certificate#: 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 and supporting documents that you submit are considered to be public Information.`Portions of the information maybe x classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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.citvofeaaan.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.00pherstateonecall.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 acco ance with the approved plan in the case of work which requires a review and approval of tans. 11141 ata At Applicant's Printed Name Applicant' gnature WRITE B // � S -d( (6)(9-1 / 4� '! 7 qt7 ELOW THIS LINE 30 7 I 1 - /TYPES Foundation eason_ Fireplace Porch 3-S— ( _ Exterior Alteration(Single Family) z4 Multi Single Family _ Garage Porch(4-Season) _ Exterior Alteration(Multi) 01 of_Plex —' Deck Porch(Screen/Gazebolpergola) — Miscellaneous Lower Level Pool _ Accessory Building WORK TYPES New XInterior Improvement — Siding _ Demolish Building* Addition Move Building Alteration Reroof Demolish Interior _ Fire Repair _ Windows Demolish Foundation Replace Repair — Retaining Wail — Egress Window — Water Damage *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation cod Valuation �,:: Occupancy Pian Review VIZI`y MCES System Plan 100% Code Edition 2o20 nti/C SAC Units Census Code Zoning 1 City Water #of Units Stories Booster Pump #of Buildings Square Feet PRV T ype of ConstLength Fire Suppression Required Construction �' Width REQUIRED INSPECTIONS Footings(New Building) Footings (Deck) Meter Size: Final I C.O.Required Footings(Addition) X 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 Xs Framing JC 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick EFIS 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: /4-4-- , Building Inspector RESIDENTIAL FEES44 / Base Fee G lob _ , Surcharge 54 r J Vic G 7' //00 0, cc, Plan Review vc o MCES SAC Il hv� ?dam CitySAC d/rtr ✓ Utility Connection Charge S&W Permit&Surcharge Treatment Plant Radio Meter Read Copies TOTAL Page 2 of 3