HomeMy WebLinkAboutBuilding Permit 03-0073
(Please type or print and sign at b~;;v...)
ADDRESS
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(Address) ,7,7'30
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1- /6- 03
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO. (JS- 0 D7..3
3730
f:6 'X +a ; 1
Iv
ZON~ffice use)
o New Construction
Rower Level Finish
'v (l,f\1.J _
d~ pm%"- 3tS- Ot!tJ-C
~,~~9S~- titj7~ U!.u750
(Phone)
(Phone)
o Deck
o Porch
ORe-Roofing
ORe-Siding
LEGAL DESCRlt'uON (office use only)
LOT ! BLOCK d-ADDITION /1/ /l/fl<J1IJ1 ~
S-r ell s~ rJ
&x ~ 0.-: I /12,4-1' L
PROJECT COST IV ALUE (excluding land) $
o Fireplace
DAddition
OAIteration
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 agent 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~Plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
rn", "f~:~ '" "rlbrm n "". _nM
X I '. 1\ ( ~n..h 11A'Yr1 - }-/6"- ()")
-b _ .-'re Contractor's License No. ",~J~f:'''''''''' ..
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
) 11 J
~is Ap' 'r-ffBilmes Your Building Permit When Approved
filii-+- 1-1')- - 0"'3>
uil&WOfficial Date
'7,,000.00
$ ~Z-z,~-
$
$
$
$
$
$
$
t.OO
'/-0,00
I Park Support Fee # $
I SAC # $
I Water Meter Size 5/8"; I"; $
I Pressure Reducer $
I City SAC and WAC # $
I WaterTowerFee # $
I Builder's Deposit $
I Other $
I TOTAL DUE ('~ (.... ((o"D ) $ /03. zS-
& . /).... 0 -- ~ r? -'1, J f/...,./J
Paid '-Lf' / {/ ,3" cr-:J Receipt No. WO )'-(7
Date i- ((,.. -O~ By 3C-./'
. 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, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I, Blue File I PERMIT NO
2. Gold City . 11.. ......)".. 00 -J "2
3. Yellow Applicant () _ ' /
(Please type or print and sign at bottom)
ADDRESS
2730
r:o k -fcL I / I.r-
ZONING (office use)
12()
LEGAL DESCRIPTION (office use only)
LOT { BLOCK ;) ADDITION
OWNER
(Name)
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WI"}.-J ~ ~y()
(Phone)
(Address)
APPLICANT
(Name)
(Phone)
(Address)
(Contact Person)
(Address)
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~~)
(City)
(Zip Code)
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(Phone)
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Quantity
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)
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 Penn it # 0.1. 001 J
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Building Official
Date
I Date
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
.T.......,
. -,
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS -373 0 FoX -r;q / L 77GA / L-
NATURE OF WORK LOW {~ t.,6VE, L-
USE OF BUILDING eFS /1 /;2
PERMIT NO. ()3 - {J073 ' DATE ISSUED / -IS - 03
CONTRACTOR ...S0Je6II1S0N ,DOUtl PHONE 4-4-7-(nfo 110
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
1!15 I-Z9,
/
I
I
~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
(0 ~
~
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
I
~-~-r:1
J->"
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entmnce.
FOR ALL INSPECTIONS (952) 447-9850
. 11
I I
.l
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
3130
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
"jg FINAL L.L .
o SITE INSPECTION
COMMENTS:
I. \~~ c.J..l
DATE TIME
SCHEDULED .s-tJt{-o3 Ib! 'JO
~ TQ.~\ Tr-
CONTR.
PERMIT NO.
03" OO/~'r
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
t"\~~ \:~lv~
~
o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORr1T WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspect 'Y \ J Owner/Contr:
C~9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTJ