2020-00525CITY OF MONTICELLO iiiiiiiiiiiiiiiiiiiiiillillillillillillilliilign
505 WALNUT STREET *
2 0 2 0- 0 0 5 2 5
DATE ISSUED: 06/23/2020
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
Permit #: 2020-00525
ADDRESS 4168 87TH ST NE
PIN 155252002010
LEGAL DESC FEATHERSTONE 4TH ADDN
LOT 001 BLOCK 002
PERMIT TYPE MECHANICAL & PLUMBING
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE NEW CONSTRUCTION
NUMBER OF MECHANICAL FIXTURES 9 NUMBER OF PLUMBING FIXTURES 16
APPLICANT MECHANICAL BASE FEE, RESI 50.00
MECHANICAL FIXTURES 81.00
B & D PLUMBING & HEATING
STATE SURCHARGE, MECH FIX 1.00
4145 MACKENZIE COURT NE
ST MICHAEL, MN 55376- PLUMBING BASE FEE, RESI 50.00
763) 497-2290 PLUMBING FIXTURES 144.00
STATE SURCHARGE, PLBG FIX 1.00
TOTAL 327.00
Payment(s)
OWNER CHECK 562085 327.00
PROGRESSIVE BUILDERS INC
17207 198TH AVE NW
BIG LAKE, MN 55309-
AGREEMENT AND SWORN STATEMENT
I agree that the work will be conducted in conformance with
the ordinances of the City of Monticello and with the
Minnesota State Building Code. I understand that the work
will be in accordance with the plan that has been approved by
the Building Official. I agree that any damage caused to
public property including but not limited to curb, sidewalk,
public utilities and signs will be repaired at my expense.
Applicant
Date
Bldg Official Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF
Montido
BUILDINC SAFETY PERMIT #
505 WALNUT STREET, SUITE I MONTICELLO, MN 55362
City Hall (763) 295-2711 Building Inspections (763) 295-3060 Fax (763) 295-4404
Property Owner Name: Progressive Builders Phone: 763-263-2227
Address: 17207 198th Ave City: Big Lake State: MN
Contractor Name: B&D Plumbing, Heating & AC
State License t PM059287
Address: 4145 MacKenzie Court NE
Eng./Architect Name:
Phone: 763-497-2290
E-Mail: ccullinan@bdplumbers.com
City: St Michael State: MN
Address: City:
Plumber Name: B&D
Address: City:
Mechanical Name: B&D
Address: City:
Tvpe of Work Tvve of Construction
El New El ' Single Family
Addition Duplex
Alteration El Multi -Family
Repair Commercial
Move Industrial
Other Other
Description of work:
New Construction Home - Providing all Plumbing & HVAC work
Zip: 55309
Zip: 55376
Phone:
State: Zip:
Phone:
State: Zip:
Phone:
State: Zip:
Building Information
Use of building
of stories
Floor area sq. ft.
Estimated value
of construction $
I hereby apply for a permit for construction as described and acknowledge that the information I have provided above is complete and accurate. I
agree that the work will be conducted in conformance with the ordinances of the City of'Monticello and with the Laws of the State of Minnesota;
and that I understand that this application is not a permit and that the work is not to start without a permit. I further understand that the work will
be in accordance with the plan that has been approved by the Building Official. I agree that any damage caused to public property including but
not limited to curb, sidewalk, public utilities and signs will be repaired at my expense.
SEE BACK FOR PLUMBING
detP .ti . r L AND MECHANICAL INFO.
Appllcant Signature Application bate
APPLICANT: Please show fixtures that are applicable.
Fire Sunpression : (if applicable) Plumbin,: (if applicable) Mechanical: (if applicable)
No. Fixture T%ne No. Fixture Td oe No. Fixture Tdae
Sprinkler Heads 3 Water Closet (toilet) 1 Furnace
Other/Special FS Device 2 Bathtub t Gas Meter
3 Lavatory (wash basin) Range Hood
t Shower t Gas Range
1 Kitchen Sink Water Heater
1 Dishwasher 1 Air Conditioning
Laundry Tub Mech. Fireplace
1 Clothes Washer 2 Bathroom(s) Exhaust Fan
Fire Alarm: (if applicable) 1 Water Heater I Air Exchanger
Urinal 1 Dryer
No. Fixture T% Pe Drinking Fountain 1 Gas Opening w/o Fixture
1 Floor Drain
of Devices Slop Sink
Other 2 Outside Faucet
16 TOTAL 9 TOTAL
FOR CITY USE ONLY
Future Owner Information• Tree Ordinance Handout Yes No
Other Handouts Yes No
Name:
Address:
City: ADDITIONAL INFORMATION:
Valuation:
State: Zip: Construction Type:
lOccupancy Group:
Phone #: Division:
Square Footage:
of Stories:
of Residential Units:
Maximum Occupancy:
Fire Sprinklers: Yes No
Off -Street Parking Covered:_
Off -Street Parking Uncovered:
Building Official
IBPT: _/`/_