HomeMy WebLinkAboutBuilding 02-1049
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White File
Pink City
Y cHow Applicant
t' ;a;7
I PERMIT NO.OZ-(04'/ I
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
60 ue r:9
ZONING (office use)
ISJJ
55 J, cf atvn rL
LEGAL DESCRIPTION (office use only)
cX<; i 0S-
LOT BLOCK ADDITION
~e)
)o.c~-e
..J
(Address)
()~~
(Phone)
'''''tiName)
t.. ,. .1)
,.l't
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95;2- C/7((___ 7/;;2/
q 5:2 - q7t!~ 7(~ I
-co2,. :2. -f;l ~
ODeck
OPorch
OAddition
ORe-Roofing
ORe-Siding
TYPE OF WORK
o New Construction
o Fireplace
o Alteration
OUtility Connection
OLower Level Finish
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
submitted plans, I awar that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city 0 lcial a designee may
enter upo e to perfo n ed inspections.
omes Your Building Permit When Approved
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
PROJECT COST IV ALUE (excluding land) $
~~~LN6.
$
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
Water Meter
Size 5/8"; I";
5'$2. ./1
3'1. 60
Pressure Reducer
City SAC and WAC
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
~;~~ - Oz....-
/'7 ,;211, 'f!- I ReodE' 1f!-CJY Cf3
9-~ 13.- By
8 - Cj -tJ2-
Date
I Paid
Date
"his 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
lten 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
'ed.
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
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
1. Pink File
2 Green City
3. Yellow Applicant
fl.-( S \)
, -5- (1 L(
I'
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L (..\ r\ A.. > j
LLVC
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z .-
.0
OWNER
(Name)
(Phone)
(Address)
APPLICANT---
(Name) , ..+t",~\-( ~'\\
(Address) )Lj,JJ l:
S '1' ~ \-t:-- rv\ ':>
/\)c'l ~-DE "V
(Address)
(Phone) 7~'? - '--\ ;} ~J
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-t<b<t:'i'~
(Ci
-d-~J. k,
S':J'l
(Zip Code)
APPLICANT PLEASE C
DNEW CONSTRUCTION 0 RE EMENT
FURNACE MAKE AND MODEL r'i)- ',~ 0 Q'
FLUE SIZE RETURN OPENIN~S ~ l\iL INPUT
TYPE OF SYSTEM (' G ':'0 ~ REA TING OR POWER PLANT
OWarm Air Plants '"'\ 0 Steam
OGravity 0'" O), \ ) 0 Hot Water
o Mechanical \ \J 0 Radiation
OAir Conditioning 0 Special Devices
~Vent. System 0 Other Devices
, C,'\ \ C,:;~''f:- \0 \' + ~ V" (r, ',,:> I: .... <..
FIREPI::ACFMAKlrANb MODEL
(Phone)
- ). ~. J \...
(Contact Person)
APPLICANT SIGNATURE
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
_ .~, L__\~
Estimated Cost $ yo ~.;?
Building Permit #
en Approved
$ St( - ) 0
$ .50
$ fo.
Paid
(l/)fr:
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
ur notice for all inspections (952) 447-9850, fax (952) 447-4245
White - Building
Canary - Engineering
Pink - Planning
-
The (t'nlt'r nr 'hl' I.akr ('ounlf")
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 0~ ~ &~
APPLICATION RECEIVED {-"'-- f-eJ d-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
5S~Lj 0+OV(c7~
Accepted
Accepted With Corrections X
Denied tZll!? - d
Reviewed By, ~ ._~
Comments:
-ilp~~.. gMok ~.\.eckr~ ~u~ .oJ- ~.lAocJ~
Date: ~-S--OL
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~1
White - Building
Canary - Engineering
Pink - Planning
rht' Cenlrr or .he t.kt Counll')'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
/
//
~j
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
;.-
~; ....-/
L/
" /.
'1 /'
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>>.
Accepted
Accepted With Corrections
Denied
Reviewed By:
Date:
#', Comments:
r
:'
, .,
\~?;,
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
FROM Thompson Plumbing
FAX NO. : 952 933 8949
Sep. 20 2002 11:29AM Pi
/fPR~~
~
CITY OF' PRIOR LAKE ~ ~~w ~iU'ADI
PLUA1BIJVG PERMIT PPNo. 02-t64L
APPljCan~mf:~:'" \;~~~:~. Phone:q ~- q ~:'/'7/~' L_
Address: \'5cd '0r\~I__ __~_\ cJ... Rd... . \'n-~-~ ~4-'S,_~
Signature:.:]::)" ~ .i..Q(lih.A.!J\
Legal Description: Lot _.__._ Block Sub
Site Address:5'5~4 C'l\'~l~ CJ.~\JI.L\ra.\.\ S't _
Building Permit # _. \ 6lJ;' ~IJA1 PID #~k- \ \ S - c~.:t.
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
n.. C....4n ., I". U"'C c........,,.,
Quantity Type of Fixture Quantity Type of Fixture
8ath Tub with or without shower Rough-ins
I Dishwasher Water Heater .
.
Flcor Drain Water Softner
LavatolY (bathroom sink) Stand Pipe (washing maChine)
Laundry Tray (1 or 2 compartment sink) Sewage Ejector
Shower Stall Baclctlow Assembly (RPZ, Double Check, PVB)
/ Sinks Backilow Assembly Test
Bar Sink Lawn Sprinlcler
Water Closet (toilet) . c::< Other - l.l:Lrt:~ 11.....Y..-
t
FEE SCHEDULE
Industrial. Commercial &. Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
:~j~ i; LJ ..-J 0-
)ost~lt" Fax Note
$99.50
$39.50
$
S
$
'5' .. .50
GRAND TOTAL
PAID WITH
BUilDING PERMIT
; UpO:1 the upress condition that said
contr"l.:tor, snail comply in iJI n:spccts ~ith the ordinances
cr the Stale PlumbinE Code and the ~ dmcnts thereof.
RECEIPT NO. (. ATE
ATTEST
Ca..Il for aJI inspections 2
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55~72/Ph. (612) 447-~130 /F.~X (612) 447-4245
An Equal Oppcrtuniry Employer
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 5S-~~ C'~ ()OlU lr
NATURE OF WORK T", LAu~, cA..
USE OF BUILDING ~~D
PERMIT NO. Z -~ DATE ISSUED /3-7 --a2-
CONTRACTOR Lc...~ PHONE (,12. ~O -7t,tA2.. ~Zl.,
NOTE: THIS IS NOT A PERMI FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
~ : ~f I V1j<//b?- I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
DATE
r------- -
. =------ ---
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
~
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
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 entrance.
FOR ALL INSPECTIONS (952) 447-9850