Building Permit Application - City Of St. Louis Park, Minnesota

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City of St. Louis Park

Building Permit Application

Job Site Address: _______________________________________________ Unit # __________ Zip __________

Total Project Valuation: $___________________________

Applicant Is:

Owner

Contractor

(must include fair market value of material and labor costs)

Property Owner

Required*

Name__________________________________________ Email_______________________________________

Address__________________________________________________________________ Unit # ____________

City ______________________________________________________________ State ______ Zip __________

Phone (

)

Contractor

Name________________________________________________ Email_______________________________________

Address_____________________________________________________________________________________

City ______________________________________________________________ State ______ Zip __________

Exp. 3/31/20__

EPA # NAT-

Exp: / / 20__

Phone (

)

License #

Property Use

Type of Structure

Type of Work

Single Family Residential

Principal Building

New Building

Demolish Building

Single Family Attached

Garage

Move Building

Remove 50% or

more of exterior walls

Two Family Residential

Accessory Building

Existing Building

Three/Four Family

Temporary Building

Remodel

Addition

Five+ Family Residential

Swimming Pool

Reroof

Story Addition

Commercial

Other__________

Reside

Alteration

Industrial

Windows

Code Compliance

Institutional

Deck

Public

Doors

Miscellaneous Info

Project Information

Building Permit Fees

Vacant Property _____________

Number of Stories

__________

Building Permit Fee _____________

Rental Property

_____________

Total Square Footage __________

Plan Review Fee ________________

Number of Units _____________

Height

__________

State Surcharge _________________

Number of Buildings __________

Length

__________

Investigation Fee ________________

Property Zoning ______________

Width

__________

S.A.C. Fees ____________________

Occupancy Group _____________

W.A.C. Fees ___________________

Type of Construction __________

Total Fees Due _________________

Specific Description of Work to be Completed

Permit becomes void if work does not begin within 180 days or if suspended at any time over the 180 days. Permits issued and inspection made by the City are a public

service and do not constitute any representation, guarantee or warrant, either implied or expressed, to any person as to the condition of the building or conformance to

applicable construction codes. The Undersigned acknowledges that this application has been read and that the above is correct and agrees to comply with all the ordinances

and laws of the City of St. Louis Park regulating building construction.

Some or all of the information that you are asked to provide on the application is classified by State law as either private or confidential. Private data is information which

generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or

the subject of the data. Our purpose and intended use of this information is annually to update our records and records of other governmental agencies required by law. If

you refuse to supply the information, the permit may not be issued.

Applicant’s Name & Signature

Date

Print & Sign Name

OFFICE

USE ONLY

Permit # _____________ Called _____________________Ck________CC

EPA

SAC Units _____

Entered ____________ Zoning App/Date ____________ Building App/Date ____________ CMP _________Issued _____________