HomeMy WebLinkAboutBUILDING 08-0173
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nmatllln on thIs applicatIOn which IS to the best of my knowledge true and COlTect I also certIfy that I am the owner or authorIzed age tin the
I constructIon wIll confllrm to all eXIstIng state and local laws and will proceed in accordance with submItted plans I am aware that
1St c~urthcrmore, I hereby agree that the city Off~ u; 3lgl6lnt~uzn the propeny to perf(Jrm nee 'd Insr;[:srr' 0 <(
Signature Contractor's License No. Date
u
111 IV V A
HIM R
2 3 4 5
Occupancy Group:
Division:
A
B
E
F
I
abnvc-mcntlOned
(lftlcial can revoke
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $ 1.00
Penalty $
Plumbing Permit Fee $
Mechal1lcal Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
This Application Becomes Y OUT Building Permit When Approved
~~
Buildll1g Uftlcial
'1(/0//07
Date
B
S U
PROJECT COST IV ALUE $
(excluding land)
/ ()OO
j
-
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water ConnectlOn Fee # $
,
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 1/3. 2S
~~t~ ;;,~i~{
~~CCi~.
55~7?
ThiS IS to certify that the request in the abllVl' appliCJtlOn and accompanYIng documents is 111 accordance with the City loning Ordinance and may proceed as requested ThIS document
when Signed by the CIty PI,lI1ner constitutes a temporary Certificate of ZOnIng compliance and allows construCtIon to commence Befme occupancy, a Ccrtlficate of Occupancy must be
issucd
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
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BY: ~_ ,...............
,
~
Date:
1p~~
Building Permit #
Site Address / S' 'I C( 2-
Legal: L__ B
PID:
Zoning:
~
~~
Subdivision:
Existing Structur@er NO
I CONFORMS TO WNlNG
ORDINANCE
I CYE~ I
NO
I
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? AJc
Is the property located within the flood plain? Refer to Planning ,.Ja
Does the alteration include any additional kitchens? Refer to Planning t-JO
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? iJo
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single Alo
family home (office, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLA TE\ALTCHCK.DOC
CITY OF PRIOR LAKE PLUMBING PERMIT
~ 5/~~f?
~ WtbS-Ol73
I. Blu. Fil. I PERMI NO. ./
2. Gold City
3. Yellow Applicanl
I
Date Rec'd
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT ~ BLOCK I ADDITION
'- '"
I~ IJ~ ~
PID
I
I
OWNER
(Name)
(Address)
(Phone)
APPLICANT IA 117 If) .
(Name) rVtA' /, ~
(Address) ~
LLi!/(phone) t.6l-45<- /~
~
(phone)
(Zip Code)
:;;z
DATE
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
I Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
, Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
, Water Closet (Toilet) Other
ANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
..., ()C.:::>
Estimated Cost $ ,j,c9.[)::) -
/
Residential, New One & Two-Family ~ ~"SC>
Residential, Additions & Alterations ~ -4 q ,5D
Building Penn it #
fR. .fr ~f fPj ,
~
(Office Use Only)
This Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE $
81' ATE SURCHARGE $
TOTAL PERMIT FEE $
Paid
Receipt No,
BuDding Official
Date
By
Date
24 bour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave" S.E" Prior Lake., MN 55372-1714
CITY OF PRIOR LAKE
HI:ATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
~: ~ ~!~. I PERMIT NO, Q . ,'13 I
3. Yellow Applicant . U .
I ZONING,_=> I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER _
(Name) ~ ~ ~e!'-L\,\. ~)
(Address)
(Phone)
APPLICANT
(Name)
(Address)
HEAnNO & COOUNO TWO lNo.
1GOOU County Rd. 81
Maple Grove, UN 65389-823.
(~~~=~
(Phone)
(City)
(Zip Code)
(Contact Person)
(Phone)
DATE
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BE
ONEW CONSTRUCTION 0 REPLACEMENT
FURNACE MAKE AND MODEL
FLUE SIZE RETURN OPENINGS INPUT
OW
ALTERATIONS
FUEL
OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
..
Industrial, Commercial & Multi..Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & NC (New ConstructiOllj
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
$eo. c>c::.
Building Permit #
(Office Use Only)
This Application Becomes Your Building Permit When Approved
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
Building Official
Date
Date
eipt No. 55 7 ~()
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 15+42.. I3LA~ bEAK CA~~l6
NATURE OF WORK LOW5f2-- ~EVE1_
USE OF BUILDING ~ Aft
PERMIT NO.. 0 B, 0 Jt3 I DATE ISSUED 4,.(1-, 06
CONTRACTOR T.13lC.Ds. PHONE 1~3.1Jz...e13/
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~ :
I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
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 AS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintainE!d until all inspections have been approved. On buildings and additions
where no serviice cabinet is available, card shall be placed near main entrance.
FOR All INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
8 JtA.G)C
/ S 1-/ ~I ~
Date Rec' d
+, /+--, o;r
I White
Pink
Yellow
I PERMIT NO, 08,6/73
File
City
Applicant
ZONING (office use)
&/rr
G'r-Lk
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
:r- - itf't'J fh-4-j fJ19#1t'
CJ.t ",C)C -:;0 hY1 f>e>V'\
P Dr /j 2-3
...,... 7 /'3 7 /2 ~')7?
A"wy.J(7)I.Jt. J"'lN{Done) -0 .) (f..>
(Phone)
G /1I 553/
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
DAddition DAlteration DUtility Connecl1on
ower Level Finish 0 FIreplace
~ 1W1$
nmatlon on this applicatIon which IS to the best of my knowledge true and correct. I also certIfy that I am the owner or authorIzed age for the
I construction will conform to all existmg state and local laws and will proceed In accordance with submitted plans_ I am aware that l' buildmg
1st cal~Furthermore, I hereby agree that the city Off~ 0; ~lgz: 6lnt~u2n the propeI1~ to pertiJIm nee 'd lI1sr;[:~'r2f' 0 <(
Signature Contractor's License No. Date
CODE: OLR.C. OLB.C.
Type of Constmction:
Occupancy Group: A II
Division:
I
E
II
F
I
III
H
2
IV
I
3
V
M
4
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $ 1.00
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
I This Application Becomes Your Building Permit When Approved
I ~ ~ '1/10//07
! Illllldlllg Official Date
o MISe.
A
R
5
/ ()OO
j
/
B
S U
PROJECT COST IV ALUE
(excluding land)
$
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 $ ( 13. 2S
~~:e f)1~i~{
I ~;"'1i;
55~7?
This IS to certify that the requl'st 10 the above applicatIon and accompanYll1g document.s is 1Il accordance with the City Zoning Ordinance and may proceed as requested. ThlS dllcumcnt
when Signed by the CIty Planner Ctlnstltutes a templlrary Certlticate llf ZOl1ll1g cllmplrancc and allows Clll1structml1 III commence Before llccupancy, a Certificate of Occupancy must be
lssucd
Planning Direclor
Special Condilions. if any
Date
24 hOllr notice for all inspections (952) 447-985ll, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372