Permits - Permit# 01-29 - 3916 Northern Avenue - 1/1/20016124719160 CITY OF SPRING PARK
355 P02 MAY 23 '01 15:09
CITY OF SPRING PARK
P. O. BOX 452
4349 WARREN AVENUE
SPRING PARK, MN 55384
952-471-9051 FAX 952-471-9160
BUILDING PERMIT APPLICATION
Building Permit Application Requirements:
1. Application to be filled out & signed
2. Mechanical Permit Application & Calculation filled out
3. Energy Calculations filled out
4. Furnish a Certificate of Survey - See Attached
5. Furnish 3 sets of Construction Plans
a) 1 set for City files
b) 1 set for builder to use on site
c) 1 set for City Building Inspector
Construction Plans should include:
1. First floor plan
2. Footing & foundation plan
3. Elevations of all aides
4. Wall sections & cross sections
5. Details - stairs & any special connections
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
Date Received
Date Approved
Permit No.
Fees To Be Charged:
Permit
'Z3 i . ZS
State Surcharge
t u •O O
Plan Review
zO%-%I
SAC Charge
Availability Chrg
TOTAL 6-0 Y - Q'b
THE APPLICANT IS (CIRCLE
/ONE) O`WtJ� OR CONTRACTOR
JOB SITE ADORESS �7
NAME OF OWNER 1 �%J �7C l (^ t K HOME PHONE � !-� -5 S WORK PHONE 4- ,- r`/9-6 ? / /
MAILING ADDRESS, �� -CITY S(O t'� y fylfik ZIP
CONTRACTOR -s PHONE MOBILE PHONE
MAILING ADDRESS
CITY ZIP
STATE LICENSE NO.
ARCHITECTIENGINEER -S/ + PHONE
MAILING ADDRESS
CITY 21P
NAME REGISTRATION NO.
TYPE OF WORK: NEW ADDITION yw ACCESSORY STRUCTURE MOVE DEMO
REMODEL/ALTERATION RENOVATE LAND ALTERATION i
PROPOSED WORK (Describe In Detall) GXaA i V i� 1/1eCX� ^}'
ZONING DISTRICT
STORIES SQ. FEET OR EACH FLOOR NO. OF BEDROOMS _ GARAGE STALLS
ATTACHED OR DETACHED _ BLDG. SIZE! LENGTH % WIDTH 3S ` HEIGHT
ESTIMATED CONSTRUCTION VALUATION (excluding land) _ -f' ��! on-0
6124719160 CITY OF SPRING PARK 355 P03 MAY 23 '01 15:09
BUILDING PERMIT APPLICATION
PAGE 2
HARDCOVER CALCULATION WORKSHEET
A_ House '7' n
X = WO S.F.
Iength :af`
X Width
�
S.F.
B. Garage y
X 3 a _ b CY S.F.
C. Driveway �-I-i
X c) _ '� 7 S.F.
X = S.F.
D. Sidewalk .�
X = l eO S.F.
X
S.F.
E. Patio/Deck S
X S.F.
F. Oth�er�
r`ll
X (O ®v S.F.
j
Q- '.(7
1.
TOTAL ��
l,.-) m `y
HARDCOVER -�� S.F.
J 2.
> !J
TOTAL PROPERTY AREA F.F.
1
DIVIDED BY 2 X 100 = 5;
I hereby apply for a building permit and I acknowledge that the Information above Is complete and accurate; that the work will be In conformance
with the ordinances and codes of the City and wnh the State Building Code; that 1 understand this Is not a permit and work Is to
not start without
a permit; and that the work will be In accordance with the approved plan.
�C
APPLICANT'S SIGNATURE 522=
DATE
INSPECTION REQUIRED;
WORK REQUIRING SEPARATE PERMITS:
Footing before a pour
Plumbing
Framing rough -in
Mechanical
Insulation
Well
Wallboard before taping
Grading & filling
FINAL before occupancy
Sewer
Water
WORK BEYOND OR WITHOUT A REQUIRED
INSPECTION WILL BE SUBJECT TO PENALTY
24 HOUR NOTICE REQUIRED CALL 249-4600
Electrical from State
ZONING CERTIFICATE
I do hereby certify to the Orono Building Official that the following described work has been reviewed for
compliance with the Zoning Requirements of the City of Spring Park and will be approved for construction upon
approval of the construction plans by the Building Official.
Name
Date
Name
Date