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File
Cily
Applicant
.@ ~ ~ReC'd
u:; 0 il{/ IF' i
l'J Gin
III,
NOV 0 4 2004 ! VIi
--' ~
04-~/1p8
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPL
AND UTILITY CONNECTION PERMIT
at bottom)
ZONING (office use)
~Ii-
LEGAL DESCRIPTION (office use only)
ADDITION 4,e~. 3 ~
LOT
BLOCK
- -
/., lIS
~ "2- So .
PID:J,sfj
~-o 0 /7)
OWNER
(N ame)
~
(Phone) W 7 - 'r 8" 2-
(Address) / () .3
A-Ae ~,.,,J ~
~+
BUILDER
(Company Name)
(Contact Name)
(Address)
S 4-Me,
Ai- ;:,;;, ~J~ Es;..
,
(Phone)
(Phone)
~~7 - #!f B~ Z-
TYPE OF WORK 0 New Constr~on ODeck OPorch ORe-Roofing
DAdditIon )lmAlteration DUtility Connection 0 Mise
ORe-Siding
OLower Level Finish
o Fireplace
CODE: DI.R.C. IEJ:.B.C.
Type of ConstnIction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV
I
3
&:>A&
M R d> U
4 5
PROJECT COST /V ALUE $
(excluding land)
/ t). ()f) 0
/
-
I hereby certify that I have furnished mformation 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-mcnl1oned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
on~e thIS permit for Just cause Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the property to perform needed mspectlofiS
X
Contractor's License No,
Date
Signature
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
Paid 5.00
Date 1/. /2..o~
# $
# $
$
$
# $
# $
$
$
$ 5.-
I ~~+O~
Permit Valuation
Permit Fee
G. -
Water Meter Size 5/8"; I";
Pressure Reducer
Plan Check Fee
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
ThIS IS to certify that the request 10 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 temporaty Certificate of Zonmg compliance and allows construcl1on to commence. Before occupancy, a Cerl1ficate of Occupancy must be
IS' ~_~ \ll/v/t)t-{ ~~ ok.~
bate ~ 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
The Center of .he L.kr Coun.r)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
6 Jry 01= Pt2A 0 t2- LA IL€"
II. +- ~ 04--
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I {p 0 0 0 M A I tJ A VB. S IE; .
Accepted
Accepted With Corrections ~
Denied
r
Reviewed By: ~:::t:.- ~ ~ Date:
r
Comments: &<< fr., ~
1/ //0/0'-/
"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."
Thf Ct"ntt"r of Iht" Llkt Counlr)'
White - Building
Canary - Engineering
Q"mk ~lanf'finJ:>
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
/
Accepted With Corrections
Denied~
Review B' " tn .~
Date: ll-f
10/'0'1
I
Comments:
"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."
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS --1~~~ Av'~ .nG, .
NATURE OF WORK G~ JCac.~~~
USE OF BUILDING - 2... /I. C C.
PERMIT NO. 04 .(15.[3 DATE ISSUED - ..
CONTRACTOR 14' _ PHONEh1""e-.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUfLDING AND INSPECTION
~:
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
OUGH - INS
INSPECTOR
DATE
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
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
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GYPSUM WALLBOARD, WOOD STUDS
Base layer 5/8" type X gypsum wallboard or gypsum veneer base applied at right angles to
each side of 2 x 4 wood studs 24" o.c. with 6d coated nails, 17/8" long, 0.085" shank, 1/4"
heads, 24" o.c. Face layer 5/8" type X gypsum wallboard or gypsum veneer base applied
at right angles to each side with 8d coated nails, 23/8" long, 0.100" shank, 1/4" heads, 8"
o.c.
Joints staggered 24" each layer and side. Sound tested with studs 16" o.C. and with nails
for base layer spaced 6" o.c. (LOAD-BEARING)
Thickness:
Approx. Weight:
Fire Test:
Sound Test:
61/8"
12 psf
FM WP 360, 9-27-74
NGC 2363, 4-1-70
-r:;;5 4lA/ ~ /
GYPSUM WALLBOARD, WOOD STUDS
Base layer 5/8" type X gypsum wallboard or veneer base applied parallel or at right angles
to each side of 2 x4 wood studs 16" o.C. with 11/4" Type W drywall screws 12" o.c. Face
layer 5/8" type X gypsum wallboard or veneer base applied parallel or at right angles to
each side with 17/8" Type W drywall screws 12" o.c. and offset 6" from screws in base
layer.
Joints staggered 16" each layer and side. (LOAD-BEARING)
Thickness:
Approx. Weight:
Fire Test:
Sound Test:
61/8"
12 psf
SWRI 01-5920-614, 12-5-94
See WP 4135
(NGC 2363, 4-1-70)
GYPSUM WALLBOARD, WOOD STUDS,
MINERAL FIBER INSULATION
Base layer 5/8" type X gypsum wallboard applied at right angles to each side of 2 x 6 wood
studs 24" o.C. with 21/4" Type S or W drywall screws 24" o.c. Face layer 5/8" type X
gypsum wallboard applied at right angles to each side with 21/4" Type S drywall screws
8" o.C. 51/2" mineral fiber insulation, nominal 3 pcf, friction fit in stud space.
Joints staggered 24" each layer and side.
Tested at 5,506 Ibs per stud or 100 percent of design load. (LOAD-BEARING)
Thickness: 8"
Approx. Weight: 13 psf
Fire Test: ITS J20-06170.3, 12-00
This Space Left Blank
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