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Permits - Permit# 05-22 - 2468 Black Lake Road - 1/1/2005` CITY OF SPRING PARK 4349 WARREN AVENUE SPRING PARK, MN 55384 952-471-9051 FAX 952-471-9160 BUILDING PERMIT APPLICATION Building Permit Application Requirements: I. 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 sides 4. Wall sections & cross sections 5. Details - stairs & any special connections Date Received Date Approved Permit No. '_-Z Fees To Be Charged: Permit State Surcharge �/So Plan Review SAC Charge Availability Chrg TOTAL /%/ ;� ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED THE APPLICANT IS (CIRCLE tONE) - 1 OWNER O�RQ ONTRACTOR ` JOB SITE ADDRESS a "'I Q () UL / ' 3 / �G NAME OF OWNER , �MD`C 1� ,IY GLI� HOME PHONE�-H • �3) &K PHONE MAILING ADDRESS ' CITY ZIP CONTRACTOR2&r._•e PHONE (oS1•aip-4 411+ MOBILE PHONE MAILING ADDRESS1126 Con�c.�'.d.� GuWei CITY 1abe\1tft. rht� ZIP 55113 STATE LICENSE NO. a011Q9 0 5 ARCHITECTIENGINEER PHONE MAILING ADDRESS NAME TYPE OF WORK: NEW ADDITION REMODELIALTERATION PROPOSED WORK (Describe In Detail) ZONING DISTRICT CITY ZIP REGISTRATION NO. ACCESSORY STRUCTURE MOVE DEMO RENOVATE LAND ALTERATION STORIES S4 FEET OR.EACH FLOOR NO. OF BEDROOMS GARAGE STALLS ATTACHED OR DETACHED BLDG. SIZE: LENGTH WIDTH HEIGHT ESTIMATED CONSTRUCTION VALUATION (excluding land) $ I 1 J Poor Quality Document Disclaimer The original or copy of a document or page of a document presented at the time of digital scanning contained within this digital file may be of substandard quality for viewing, printing or faxing needs. BUILDING PERMIT APPLICATION PAGE 2 HARDCOVER CALCULATION WORKSHEET A. House X = S.F. Length Width X = S.F. B. Garage X = S.F. C. Driveway X = S.F. X = S.F. D. Sidewalk X = S.F. X = S.F. E. Patio/Deck X = S.F. F. Other X = S.F. 1. TOTAL HARDCOVER S.F. 2. TOTAL PROPERTY AREA S.F. 1 DIVIDED BY 2 X 100 = % 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 C and with the State Building Code; that I understand this Is not a permit and work is not to start without a permit; and that the work will be In a rdance with the ved plan. APPLICANT'S SIGNATUR 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 Electrical from State 24 HOUR NOTICE REQUIRED CALL 952-249-4600 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 BUILDING CODE PLAN REVIEW Name Date Form No.289 Valuation $8,250 Election Svstems and Software 1-800-800-8225 Permit $ 167.25 State 4.50 ••Total.••••$••171.75 ,ND...05-22 ......... ft #P ofiri11P6II#g, City.... of ...Spring Par.k .............. County of.. , Hennepin Office of .. Building Inspector Nut-lbing Vienuff IN CONSIDERATION OF The statements and representations made by ...................... Renewal By Andersen for Mark Kinter .................................................................................................... in application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY GRANTED To said ... Renewal By Andersen for Mark. Ki nter as owner to ..Replace 12 windows per application- no bedroom windows .a building described as follows: kind of construction (build, erect, install, add to, alter, repair, move, wreck, as the case may be) .................................................................................................... front or width in feet ................ : side or length in feet ................ ; height in feet ................ ; number of stories ............... : contents ............... cubic feet; ............... square feet, upon that tract of land described as follows: Lot ................ Block ................ ; plat or addition ................ 2468 Black Lake Road 19-117-23-12-0020 .................................................................................................... which tract is of the size and area specified in said application. This permit is granted upon the express conditions that said owner and h 1 S.. contractors, agents, workers and employees, shall comply in all respects with the ordinances of the ..City..... of Spring Park that it does not cover the use of public property, such as streets, sidewalks, alleys, etc., for which special permits must be secured; and that it does not cover the following:. None o f t h e f o 11 ow i n g (Electrical work, plumbing, heating, plastering, etc., if such there be.) for which special permits must be secured. Given under the hand of the Bu i 1 d i n g Inspector ... of said . , C i t,y ...... . , , .. and its corporate seal and attested by its ..Clerk ................ this .?1st............,.,.., day of ..July..,..,...,,.. Year2005.... Attest:......... . William D. Weeks (� Clerk ........................ ...Lyle Oman ...........�.................... Bui?ding Inspector ........................ If