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Permits - Permit# 04-44 - 2478 Black Lake Road - 1/1/2004w ' 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: Date Received O/o�/ 1. Application to be filled out & signed Date Approved 2. Mechanical Permit Application & Calculation filled out Permit No. aIC -4/V 3. Energy Calculations filled out 4. Furnish a Certificate of Survey - See Attached 5. Furnish 3 sets of Construction Plans Fees To Be Charged: a)1 set for City files Permit S %d b)1 set for builder to use on site State Surcharge iS D c)1 set for City Building Inspector Plan Review Construction Plans should include: SAC Charge 1. First floor plan Availability Chrg 2. Footing & foundation plan 3. Elevations of all sides TOTAL o2i) 4. Wall sections & cross sections 5. Details - stairs & any special connections ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED THE APPLICANT IS (CIRCLE ONE) OR CONTRACTOR (DOWNER 4— /-Q (a �Q JOB SITE ADDRESS ip c' //'p NAME OF OWNER— S C -1/0 cc.-' HOM, PHONE 2 ! -'�d WORK PHONE Q`n C L / A 4,1 - CI,T.Y: MAILING ADDRESS Af (4`7_ k c. ZIP 1 ,`pr�p � CONTRACTOR N�f1>�N�-y !e-ef ��'� �� ��PHONE Sf �ro7MOBILE PHONE MAILING ADDRESSAOC- a Y �yq 6�1y CITY- ZIP 5 �T 3--a S~— STATE LICENSE NO. cad g ARCHITECTIENGINEER PHONE MAILING ADDRESS CITY ZIP NAME TYPE OF WORK: NEW ADDITION REMODELIALTERATION PROPOSED WORK (Describe In Detail) REGISTRATION NO. ACCESSORY STRUCTURE MOVE DEMO RENOVATE LAND ALTERATION- " t) P- A C` o Q OPC�ct.1- �© k`m2 9- ZONING DISTRICT STORIES SO. FEET OR EACH FLOOR NO. OF., BEDROOMS GARAGE STALLS ATTACHED OR DETACHED BLDG. SIZE: NGTH WIDTH HEIGHT ESTIMATED CONSTRUCTION VALUATION (excluding land) $ r 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. BUAING PERMIT APPLICATION Y 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 1 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 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 accordance t approved plan. APPLICANT'S SIGNATURE P'� C'LJ` DATE it 'Z D INSPECTION REQUIRED: WORK REQUIRING SEPARATE PERMITS: Footing before a pour Plumbing Framing rough -in TMechanical 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 ti. 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 11aliia.tinn $900 Election Systems and Software 1-800-800-8225 P Permit $ 35.70 „ State .50 Total $ 30.20 ate of Minnesntn, County of. .Hennepin.......... TO U to I b t"" n �II.,o4-44......... City of Spring Park Office of ..B.O.I.di.ng JnsQectur .......... hermit IN CONSIDERATION OF The statements and representations made by ...................... ........... Ne:i ghborhood Blai 1 di n.g. . Reiii.od:el.i n.g...................................................... . in application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY GRANTED To said Nei.ghborhood Bui 1 ng & ..........Remodeling.di.as owner to .....Tear, off, and .re -roof, .garage, per..appl icat.i.nn ... , .......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 ................ 2478 ck oad 19-117-23-12-0021 ..............Bla......lake .....R........................................................................... 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 .SQr.i.ng .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: ..... Ro.Re .O.f..the .fo.l.l.o-Vii.Rg ............................ . (Electrical work, plumbing, heating, plastering, etc., if such there be.) for which special permits must be secured. Given under the hand of the Bui 1 d i n g Inspector ... of said ... City , , .. , . , and its corporate seal and attested by its . C1 erk , , , , . , .. this . 23rd . , , .. day ofSeiltember year..2004 ... Attest: de William D. Weeks Lyle Oman �r ...... �................ ..... Clerk,,,,,,,,,,,,,,,,, Building,Inspector......