HomeMy WebLinkAboutBuilding Permit 03-0011 & 03-0120
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File I PERMIT NO ~
2. Gold City '0 ~- / .
3_ Yellow Applicant ~ /.
(Please type or print and sign at bottom)
ADDRESS
J:;~ J ~
FI's~
fo ; ~-t
Q(d cJ
~,E
ZONING (office use)
~/ 5JJ
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID ,35- 63 q... /) 0 '1- ()
OWNER
(Name)
Oq,,~
~... Xk-c-
c:l r'l I IL/ 7 LIc' III
(Phone) I .J ,.. Y v
~
POI'~
f) W,M h ,'role,
J(jj+L lfJ.-
(Address)
B~y....,
(~
v V
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
SA )z.e r
(,75 vr
'^ I .
(Phone)
t j'C^. LG)r~
(City)
9,),L cj(j7 cF<J ;1-)
(t1tJ. ';:)]7:1-
. (Address)
J <5;} J~
F~~l
R90C)
f......... Lt4~
(11/-1 .
C~J) 2-
APPLICANT
(Name)
(Address)
(Contact Person)
~
(Phone)
(Zip Code)
~ ~II- 36' t/7$(
DATE f) r ~4.v ~OO.J
APPLICANT SIGNATURE
Quantity
I
Type of Fixture
~
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
:5 9 -S-o
,50
J J ____
..-/0 '
(Office Use Only)
Building Official
Date
Paid Ift)..~
Date 1_ d 9...03
ReW)'?:r
By tJV
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
I I
'i'..-
Ti'
r-.'"
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
/5212. AJH PI.
,eo
LEGAL DESCRIPTION (office use only)
LOT PJ BLOCK
OWNER
(Name)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
ADDITION
/1I1I1GS /.s I
I. White File
2. Pink City
3. Yenow Applicant
Date Rec' d
1--3 -()3
PERMIT NO. 03 -001/
ZONING (office use)
;eISD
PID ZS - tJ3 9-00 1- 0
(Phone)
OE IA....b~ I (!L)NJ 77L. .
" G'-UN;
I
80(/0/N St:, P.I-. 55372.
~&fp7
TYPE OF WORK
o Misc.
(Phone)
(Phone)-1vIZ- <?,y()...O$'30
OLower Level Finish
ODeck OPorch ORe-Roofing
o Fireplace OAddition ~lteratiOn
PROJECT COST IV ALUE (excluding land) $
o New Construction
ORe-Siding
OUtility Connection
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
authorized a ent for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitte ns. I am aware that t)le building official can revoke this permit for just cause. Furthermore, I hereby agree that the city offi. cial or a designee may
enter 0 the prope~pel"'7 Leeded inspections.
X /~ I.~ '!3!O-L
{J II - j - Signature - - Contractor's License No. I I Date
I Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
IK.
I 34;75
.50
This Application Becomes Your Building Permit When Approved
~~~
Building Official
Ij;:~~~
I Park Support Fee #
I SAC #
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC #
I Water Tower Fee #
I Builder's Deposit
I Other
I TOTALDUE~ 1- (,'02--
Paid 35. z,S-
Date 1- /, . d~
R.eceiPt Ho.
By ..4.,
U
$
$
$
$
$
$
$
$
$
~c;". 2-5
~:s+S3
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~ ,
'"
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS / 52.. / L Fln+ f6'NTt'tJ,
TYPE OF WORK U ()Sf:; I {Lt;m..O()tL /1C~oJAT10;J
USE OF BUILDING S.~D,
PERMIT NO. () '? - 00 / / DATE ISSUED --1l3l12.-
BUILDER dJEU ~Jel CotJsr~~';J PHONE # "/z--e~O-05so
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FRAMING/ WSc-< L' /~~H. (~6~ ~p'm~) MJ p..~L.t-rJ3
, (>(u~"..c, ffl-fl-O 11If/ )- ""-f/?
FINAL J/W 3-(p -~
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
. l'
. ,
I I
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
]-t~)
SCHEDULED
ADDRESS
I SUt
~sh (}~~1- /ZeJ
'.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
01-(>>/ /
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
. FINAL
'iJ SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
J8' PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT jO;? CALL FOR REINSPECTION BEFORE COVERING
Inspector. 1!'fS. (, 111 Qwner/Contr.
pALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
INSNOTI