HomeMy WebLinkAboutBuilding 04-1219
5" 0 0 0 000000 "0 0 > -0
UI :z: ~ c z_
~ ~ 0 en"TIZ"TI"TI"TI 0 C ~~
g 0 Sl '0 3: =izen~OO z m ;:u mO
> 0 :::0 3: ~>c3:i~ m ;:u m O"TI
I"" :-! :" zl"">zcz z en ::!"O
tt! I"" l:n m 9 en
:.a t :~ z ~ ::!C)~C) O;:u
z-
tt! '-4 -i m 0 - zO
lC:l ..... ~ o z 0
. en 0:::0
S CD '" -I Z
co :~ 5 ::!>
>:i U'I n
~ 0 '-4 Z o;:ll;
"TI 10 mm
~ 0 ::0
;:u ;<
~ -l "TI ."
~ :z: 0 ::0
~ m ;:0 10 000000
Z :::0 I:')
"!l m m I" 3:."en~il:'"
~ >< z m ml""~>ml""
-I l::::l OC -IOc
en
,. C5 Z ~ ." :z:3: m:z:3: "0 0 en
~ en m "TI!!:!;:U;:U;:u!!:! m 0 0
Q ~ ." :J 0 ZZ:Z::Z:-Z ;:u z :z:
::! m (1) -I >C)oo C) 3: -l m
0 ~ 5 I"""TIOO ;:0 =i ;:0 c
~ ()
-I 0 Z -;:lI;;:lI; - C
~ 5 a l:ll Zc:c: z I""
~."." 9 m
z :-! m c
~ "TI
N 0
"..
~ :z: ;:0
m
~ 0 0 ~.
C
;:u 0
en < 000000 I --t
m
:i! z ;:0 C)"TI"TIom l"- 0
z , >
> >;;a;;ao~ ~ -l
~ G'l ~mm3:G'l m
c
~ ~ -.".".,,~ ~
~ z ifi>>>c
0 >ooz:;;
~ !'T1 _mm-l_ -l
;:U"TI:::o I""
-1-- I"" i
enz z m
-I~ C)
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/2-, 7.04-
(Please
ADDRESS
at bottom)
White File
Pink City
Yellow Applicant
I PERMIT NO. 04-. /2./9
I
ZONING (office use)
5770
(!A1z..L) 1/1./ /tL
/24 D /Pc.
T/zA/ L
R.//C)
LEGAL DESCRIPTION (office use only)
LOT /6-BLOCK .3 ADDITION {!1-1n4J / /L-tffL. k~"( 0 6'--6' /.1/
PID z.-(: 21'9. {)4/- ()
OWNER _
(Na'Fe),\ Y. I"i' ~t>... .L~)
(Address)
r.:~ UD.l .. J ) 'l. 1 ~ j
BUILDER
(Company Name)
(Contact Name)
(Addtess)
(Phone) 9s';) - '1'1(] - 'i'i{c, ,~
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe. Roofing
OAddition OAlteration OUtility Connection 0 Misc.
CODE~' .R.C. DI.B.C.
Type of onstmction: I II III IV V A B
Occup cy Group: A B E F HIM R S U
Division: I 2 3 4 5
ORe.Siding
o Fireplace
Lower Level Finish
PROJECT COST /V ALUE $
(excluding land)
I hereby certity that I have hlrnlshed Information on this applicallon which is to the best of my knowledge true and correc!. I also certlty that I am the owner or authonzed agent for the
above-mentIOned properry and that all construction will conform to all existing state and local laws and will proceed in accordance with submllted plans I am aware that the buildmg
otticial n revo this permIt for Just cause Furthermore, I hereby agree that the Clry official or a deSIgnee may enter upon the property to perform needed mspectlOns.
Signature
Permit Valuation .' 2.C'OO,CO
Permit Fee $ (p z, 2-<:)
Plan Check Fee $ -
StatetSurcharge $ /. 00
Penalty $
Plumbing Permit Fee ~ 4-c .' c (.
L>!f c,.'/~
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permi1!,je /e-\,. $ 4-t', t..V
. (',w.f-/
I
This Application Becomes Your Building Permit When Approved
~~~ /~/9~tj
Buildlllg Otlicial I Da(e
Contractor's License No.
IJ. - ~ - () t.f
ate
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other 6f...-l:/-r!A. $ I e, ()
TOTAL DUE $ /4-4-.2-5"
I~;~S-
Paid
Date
. f4-' '2--5
~. ~/ 04-
ThiS IS to certity that the request m the above apphcatlOn and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested TIllS document
when signed by the City Planner conslllutes a temporary Certificate of Zonmg comphance and allows constructJon to commence. Before occupancy, a Certificate of Occupancy must be
issued
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
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink
2, Green
J. Yellow
File
City
Applicant
I PERMIT NO. '( - 1/1 {.; I
I
ZONING (office use)
at bottom)
S-/"j/ ' ~ i J'
. (C/ rJ "";,,
I'
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) ,-:.
, ,'.^,
(Phone)
"
...i -,..'
~[.c:-'c.
(/'<'
..I ,"
/ ...-'
(Address) r) :; ()
,
j'-- /
t,
/ .
..(
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
~ ..I
;':; /:;~~-
(Phone)
APPLICANT SIGNATURE
/'J
DATE ,~/ ,/ ~ J.S
//'
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM REA TING OR POWER PLANT
DWarm Air Plants o Steam PLEASE NOTE:
DGravity o Hot Water Air Conditioner Units
D Mechanical o Radiation Cannot Encroach in10
DAir Conditioning o Special Devices Required Side Yard
DVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64,50
$39,50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39,50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(Office llse Only)
This Application Becomes Your Building Permit When Approved
I ::rei~ No
Building Official
Date
.
I Paid
Date
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 5770 CA /COIA//)L l2IoGG" 7/ZA-/ L-
NATURE OF WORK [OW67L L-6v6l-
USE OF BUILDING /?6S /I/;L
PERMIT NO. {)4. /2-/~ DATE ISSUED /2, q. 04-
CONTRACTOR B,4;v~S PHONE 44tJ. ~93
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT '
...... :
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
F".REPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
-of?'
: r t
i'
it
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