HomeMy WebLinkAboutBUILDING 08-0219
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04/30/2008 15:52
9524001142
HR HArm\'HAr~
CITY OF PRIOR LAKE BUILDING PERl\fiT,
TEMPORARY CERTIFICATE OF WNING COl\'IPLIANCE
AND UTILITY COl''NECTION PERMIT
I U'h1lC FH.
2 P,nL; CI~'
~. Yetl",,", !.\ppllComt
PERMIT NO. ()
s(, -?~ /Jue,
LEGAL DESCRIPTION (officI! use only)
PA(3E 02/09
Date Rec' d
5: /; 08
ZONlNG (offi~e 0.,,)
f!.-z-
LOT
BLOCK
AD DlTION
PID z...~. 004-. Ol..7 . 0
OWNER
(N.1me)
T@&s('~. LS!)
Sf 'f. - .
(phone)
f)z .- z 2(, -. 326f:.
S~) 3 2-
(Address)
o/"
(Phone) _L) 2-
/,r--
(phone) ..) (,
'x1A1 b~ 37
716 3000
;)"'3. 6;3 2-
CODE: ~I.R.C. OLB.C.
Type of,f;;'\l1'ltruction:
Occupancy Group: A B
Divlsion:
TYPE OF WORK 0 New COlUttuction ODeck OPorcn DRe.Roofu1g ORe-Siding OLower Levl!l Fmish 0 Fifcplac~
DAdditlon DA!tenCion OUtlll(y Connectiun
I2fM,;c: _19 F(()clI'>-_ '~/<..o.... ~
PROJECT COST IV ALVE $_.:!-11 S- 0 0
. (excluding I and)
I II IDrVVA
E @~ ~ ~ :
B
S U
x
r h<reb) cenlJ'y th~, r h~"", '\.lTni.,hr.-d. iJtfurm~cion on thi, appbcation whidl ig to die be.~1 of'my knowlr.rlcr. true and. comct I al,o cemfy that I 31l1Ule Owner or ~ulhorized agrtlt lOr Oil
.bv....",r.t1oonr.d propr.ny !IJId thst all eC>moueoon "'ill ~Ot,/Ql't'll t() all '';'';08 ,tll< IJullor.oIll.".. a.nd ,,~U proacd in ,ccold.ln.:c with ~bmirted pl....o.. I om aware tIllt the bu"ding
olllclal C4n "v.1kc.!l.>.L mir fM ill" <:4.,". Furthermore. I her~by agre. tIlat tile city offid,,! Of" de,ign.. may r.n",r "pon thr. propr."" to pufonu needed 1".pe<<l(IfI.,.
ERJI.~ ')fJ)~;;t 11 f s-- ~.__ f/30/D g
SI811ature Contractor's L!l.'ell.!e No Date
PermIt Valuation
Permit Fee
Plan Check Fee $
Stale Surcharge $
Penalty $
Plumbing Permit Fee $ 5o.tJ 0
Mecl1snieal Permit Fee $
Sewer & Warer Permit Fee $
Ga~ Fireplace Pe.rmit Fee $
Park Support Fee
SAC
#
#
Water Meier Size 5/8"; 1";
Press'.lre Reducer
Sewer/Water Connecaon Pee
#
#
Water Tower Fec
Builde:r\ Deposit
Other
TOTAL DUE
I. Thi~ Application Becomes Your Building Pmnlt '\\'beu Approved
~ ~ s~/6?
I 8\Ji;;;Offici~1 })ale
$
$
$
S
$
$
$
$
111i, j, to "r.rofy Ul~t thr. requr.<t in the .bov~ ..ppbcaoon aM accompmyiog dorumFot$ l~ In ac:n'r~-ia.n~~ ....illl the w~ 7.(\M,lns Old,""n"" ~ntl may procr.C'd S' fr.~ur.'ltr.d TbJ9 dOCII.llenr
when ~igned by thr. City P1allncr c.ofllJritll~! a ~mporary Certlfl~alc of Z"~J1;g C"lllph<lnce and .nnw< r.C'll'[TUr.tlcn t.? C'OIllmencc. Br.fort' oO:Up.lJlcy. a Cr.rotlc.m of Occupaocy must he
'~ ~_ S/z.tES' ~ ~.~
Planning Dlf"'lor ' D.,o Special CondIMM, .fMY
24 hOllr notice for allln.<pection, (!>S1) .4-47-9850, fal: (951) 447.4245 -
46,16 DlIkolll Street S.E.. Prior Lalu. Minne,ot3 55372
Residential Buildin Permit Checklist
~ nterior Alteratio to Single Family Homes
BY: ~6lZJUiG Ii57PT
Date: 5/z/C)[?
Building Permit #
Site Address I (p I 2. I
PID:
S7: fJA-uL. AJ/C-,
Zoning:
Legal: L
B
Subdivision:
Existing strncture:$r NO
I CONFORMS TO ZONING
ORDINANCE
YES
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? tJO
Is the property located within the flood plain? Refer to Planning /JO
Does the alteration include any additional kitchens? Refer to Planning ;JtJ
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? No
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single No
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
PRIOR LAKE ~~~=~r:D~:SPECTION
INSPECTION RECORD
SITE ADDRESS / , 12. 1ST: fA tI (". A JE.
NATURE OF WORK ~ /'N'rOL/~A- 1A1 , hUI~
USE OF BUILDING s,1:-: 0 ' ~
PERMIT NO. -<< ~ ~ 119 DATE ISSUED S"/2-/~"
CONTRACTOR J:ittl "~sr ~PHONE'&SI-Z'-J-'-"z.
NOTE: THIS IS NOT A PERMIT FaR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
-:
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
~
-v6
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
G.(,--~
- ~ tt-~
S~y~'Od
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 shaU be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850