HomeMy WebLinkAboutBuilding 05-0960
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White
Pink
3 Yellow
File
City
Applicant
Date Rec' d
-----
fJ--r;}9 --05
I PERMIT NO. ()5 - 9061
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Lv... ~~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOTI BLOCK
OWNER
(Name)
ADDITION
7-,"~~{
(Address)
41~ 3 rd
PID 300- 0;)- ~
(Phone)
I, BUILDER vJ \ \: b
(Company Name) ~ U( .lV\..L& -r ^'c.
(Contact Name) ~l...o WtA- l
(Address) 0 ~ ~A l
(Phone) (. I ? -,5<f( ...() ~(~
(Phone)
kt. rn AJ
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding
OAddition OAlteration OUtility Connection
ower Level Finish 0 Fireplace
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III
H
2
IV
I
3
V
M
4
U
PROJECT COST IV ALUE
(exduding land)
$
A
R
5
o Misc.
.-
B
S
3()OC>-
lication which is to the best of my knowledgc true and correct. I also cerl1fy that I am the owner or authonzed agent for the
form to all eXlstrng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildrng
r 'by 'e that the Clry official or a designee may enter upon the propelty to perform needed rnspecl1ons.
S~i Z~ . oS
Contractor's License No Date
x
Permit Valuation
Permit Fee
$
$
$ /-5
$
$ L/O.--
$
I $
$
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fer1tJ
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
l3uildllll! Ot1lcial
Datc
Park Support Fee # $ (
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ (I (, r;). ,,-
Paid
Date
'~(" .~ I RcceiEtNo "'-OCCCJ
- ~ . 5 By ~
ThiS IS to certify that the requcst m the above applIcation and accompanymg 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 Zonrng complIance and allows constrUCl1on to commencc. Bcfore occupallcy, a Certificate of Occupancy must bc
isslIed
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
FRDr'1 : FARr'1 I tlGTOfj PLG &, HTG
FAX tn : 6514637835
Sep. 30 2005 09: 57Ar'1 Pi
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
5 -9t:D
I, Dlue filo
1 (".aM (lIy
1, V.fl<lw Ap?'i~'i1
I PERMIT NO,O'P cJ:f -CJ<lbO!
Plea.~'?!.P.rint .ll1d si~ at bottom)
ADDRESS
14
..~.~.:!L-.
.J
ZONING (office U~;).
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
EWNER -
(Name) 1) Ot-'-a
(Address) !YS fo5
A3;lI\o-~f"
Sr. r-r(J ~.......
......._._...__....-..,..,,.,.'...-_._._~
'.
(~,.... ... CJ
(Phone) J:J.:6..:...!.:l::.lJg -/8'J..~_,
APPLICANT
(Name) ~v f'V'; V\dto'^ --
(Address) 8103 1:...( Cr,., ;pppv\.cl(,t..l~
(Addi-e'ss)
(Contact Person) ~^'::-
APPt.ICANTS!GNATIJRE D~ L ~
APPLICANT PLEASE COMfLETE BELOW
._,~.
,
,
(Phone) _~ I -l./ It>3 - 7 g'J- 4
Far~b-__--5.S0~~
(City) U (Zip Code)
(Phone)
DATE
'1-&-8'-OS
\. ., ..
~:Q'U~'nti.!,y Type of Fixture Quantity Type or Fixture
,~:..."..-.. .... Bath Tub with or WithOut shower < Rough-ms
Dishwasher . Water Heater
Floor Drain ..-._............., Water Softner
Lavatory (Bathroom Sink) - -.,...,.....- Stand Pipe (Washing Machine)
.
Laundry Tray (lor 2 compartment sink Sewage Ejector
( Shower Stall Backflow Assembly
--...
I Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
J Water Closet (Toilet) -.. Other
"' --
~
rl\"'V11,',,~ -k-r- 3)q ~ ~ "'-
~ESCHEDULE
,Industrial. Commercial & Mulll-farnily 1 % of job cost with II $39.50 minimum Residential, New One & Two-Family
Rc!:idenlial, Additions & Allerations
ce><N1 p l-e{~.
LL.
S99.S0
$39.50
(omtt tl.e Only)
Estimated Cost $ BUil~~!lg Pennit # . .,-~ "Y1T1-I
PLUMBING PERMIT FEE $ DING P1EPI~
STATE SURCHARGE $ .50 rrlVirr
TOTAL PERMIT FEE $ 1
\ i,
Building Omdlll
Dille
Recelpt No.
This Application Beromes Your Building Permit When Approved
By
14 hour noUee 'or .11 Intpeedons (951) 4E.,oo991850. Cll.. I (9S2). 447-42.4!1 .!
16100 Eagle Creek Ave.. S.E., Prlor~...!L~:J_~B:-1114 _...____!
FRDr-1 : FARf'1 I rlGTm'l PLG & HTG
FAX NO. :6514637835
Sep, 30 2005 09:57Af'1 P2
CITY OF PRIOR LAKE
flEA TINGI AIR CONDITIONINGfFlREPLACE PERMIT
Date Rec'd
....
5-Q"6
: ~:n ~:~y l PERMIT NO't;lp L.- ~()q bO]
1 Y~Uaw ^f1pho..", U O-v .
(Plcase type OT print ~!!.~!&!! at bottom)
I ADDRESS
145 Co 5 ""....Sc...r rj
...=
ZONING (office use)
/-.a ~.\ ~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
.
PID
OWNER
(Name)
(J, .3 i It"' tJ.,e. c__________-
<-
(Address) J u. f" r d 1-"" -
APPLICANT_. .c.-k>"", L ..Q
(Namc) l-1;\.r YV\ " 1~_.___E.L~~f.2_.~~.J~__..~..._;_
(Address) d.- ( c) 3 '-l C h 'f () ~.vt &~ (E:. LA 'V ~
(A~drm)
(Contact Person) J ; V\..o\
(Phon c)
APPLICANT SIGNATURE
,,_ "), - (-,..., u
(Phone) (p<; ('liw.:i -.} 6)-1
furrV\iHJi .}o"" L).r.;O;) tf
(CJ.ty(J (Zip Code)
__ (Phone)
J-') C>..A/'-.i1D J-~__. DATE
DNEW CONSTRUCTION o REPLA~J.NT lJtl AL ~ TI~NS ~r LL
FURNACE MAKE AND MODEL Sc.ff1(L~_ FGID!,UV~6
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWIlI1l1 Air Plants o SteMl PLEASE NOTE;:
OOravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
OAir Conditioning o Special Device5 Requlrtd Side Yard
DVent Sy~tem o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
--, ,. -.".-.
APPLICANT PLEASE COMPLETE BELOW
Industrial, Commcrcial & Multi-Family
FEE SCHEDULE
I % of lob cost Residential, Gas Fireplace
$39.50 minimum
$99.S0 Residential. Additions & Alterations
$64.50 Residential, AC Only
$39.~O
$39.50
$39.~O
Rosldential, Heating & AIC (Ncw Construction)
Residential, Heating Only (New Construction)
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
PAID IAI
Bu/LOIN IfV'IIH
G PERMli
.50
Estimated Cost $ Building Permit #
Dale
(Office \14e Only)
This Application Becomes Your Building Permit When Approved
BulldlnE Omdal
14 hour notice for .lIln~pecllonl (9~1) 4 t,,~.aso..fH-(9~1)+t1;"'(24~
PRIOR LAKE
INSPECTION RECORD
s ""'1' re V LN
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /,tfSi,,$.
NATURE OF WORK J- . L ·
USE OF BUILDIN~~ -
PERMIT NO. o. 0 DATE ISSUED ~. ~- 5
CONTRACTOR W4_1't:1!Y 1Io~ PHON~''''''f''oB'4'B'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~ ]
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
E -..",..
, '~/ :
~ .. "
--------------- -
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
COVER NO WORK UNTil ABOVE HAS BEEN SIGNED
[ I
FINALS
Blh 'JING
ELE(' TRICAL
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