HomeMy WebLinkAboutBuilding Permit 08-0757
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I hereby certify that I have hlrmshed mformatlOn on this applicatlOn which IS to the best of my knowledge true and correct. I also certIfy that I am the owner or authonzed agent for the
above-mentlOned property and that all constructIOn Will conform to all existIng stale and local laws and WIll proceed in accordance with submitted plans I am aware Ihallhe buildmg
:licial can~rm~or ~se Furthermore, I ereby agree that the city official o~:lg;e ~ ~~u; :;.propelty to perform ne;~;/o ~
t,/ Signature Contractor's License No. . I 'Date
Permit Valuation
3,ooo.0LJ
$ 74-,.7$_
$
Permit Fee
Plan Check Fee
State Surcharge
$
I.sa
Penalty $
Plumbing Permit Fee $ S- o. 0 0 I
Mechanical Permit Fee $ I
Sewer & Water Permit Fee $ I
Gas Fireplace Permit Fee / $ 50 .00 I
1/
, y"~ ~di~~ P:_mril_W'" ~~ r
D:et Cv
--------
ThIS IS to certify that the request m the above, atlOn and-
when signed by the City Planner conslltutes a temporal
issued
Park Support Fee
SAC
Water Meter
Size 5/8"; I";
#
#
#
#
$
$
$
$
$
$
$
$
I
$/7&;;. zs- I
I
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TOTALDUE ~ 4.f7j)61
/7&.ZS' ~eiptNo. ~85"~
9. 2-1_ CJr' J'" -
Planning Director
Date
24 hour noticc for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
Paid
Date
Special Conditions. if any
companymg documents is In accordance with the City loning Ordinance and may proceed as requested. ThIS document
te of Zonmg complIance and allows construction to commence. Before occupancy, a Certltlcate of Occupancy must be
Residential Building Permit Checklist
, )hS-15ft Finish or Interior Alteration to rgi Family Homes
BY: /10 tit Date: 1/1/06
Building Permit # c>9 ~ 7 S7 PID: Zoning:
Site Address
Legal: L B
Existing Strnctn&o
Subdivision:
CONFORMS TO ZONING
ORDINANCE
~
~
NO
,
Is this an expansion of the existing footprint or
building height?
Is the proposed use of the finished space or
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
YES NO
Refer to Planning
f
Refer to Planning )?
Refer to Planning
y
Refer to Planning
)C
Refer to Planning
X
Is the property located within the flood plain?
Does the alteration include any additional kitchens?
Does the proposed alteration include any outside
entrances other than patio doors?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLA TE\AL TCHCK.DOC
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
9 23,~r
l. Blue File P 0 0 r/ 1
2. Gold City ERMIT N . I. 0 -?5c
3. Yellow Applicant / \ .
APPLICANT - L
(Name) VltfJf..C--{-C Y ? Lvct
/ (j
(Address) 7 (20 Po /\-f,t CA.(, ? L-q t <-
(Address)
(Contact Person) 0 A'; L JA- '1 e u~
~~
...---V . ,. \
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower I Rough-ins
I Dishwasher I Water Heater
I Floor Drain I Water Softener
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (1 or 2 compartment sink I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
(Please type or print and siltn at bottom)
ADDRESS
Jif'iro Fc~x (aiL-
Tvw
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
f3 r f:S 1\ ct ~O- ~
CSct~\
(Phone)
(Address)
ZONING (office use)
PID
(Phone) ;; rr- <iff-- cr J-Cf J
;1'/c ~ J r~ ~. tI'vw.-)j( d--D
(City) ./ (Zip Code)
(Phone) U n - 7SJ ~ S-r ~
C;/;f--J /(/ r
{ l
APPLICANT SIGNATURE
DATE
Quantity
I
f
I
,
Type of Fixture
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$ ~
$ ~ .50
$/
/'
(Office Use Only)
Buildin!! Official
----
~
I .
Date /LJfY-
Date -q ft)
{ -
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
This Application Becomes Your Building Permit When Approved
~~
011\ 0 06(1
{ ~VIV
09/17/2008 WED 14:32 FAX 952 767 1900 GENZ-RYAN
III 0011001
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CITY OF PRIOR LAKE
REA TING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec' d
1 '"ink
2: (ir~"ll
,\ Vclk,W
~~y i PERMIT NO.
Applk'.1l11 I
~..~151
(1)lca'::2.~.1!~I'!i'!.!..:'!~,!~j;\!:.!lIii,~I.O.I',!...... '_.
ADDRESS
:3l \ I IV fCb "i1-0J \ -'~r"V- Cl\ \
__ :t~,_____.._...___....._..~_~. "'_'~_~._____""____'~_""'~'_''''''___''~_'_''''_
r ioNiN(f(~ffi~e~~~)"1
[
.....___..1
LEGAL DESClUPTION (office use only)
LOT
BLOCK
ADDITION
PID
~=~IO('D "l Jlt(lL\._.J~r{SC11LY~K~~--'~;~::~-q5:~~J~r7" ?f37-~!
Q.
(Address) ~) Hrr)~__...._.___
~;;~f.~T (~1-(~::lr\(~___J~?l~)'a.:/n_':'~:-'''-' ,...._"..___ (Phone) _(~.~?(1-;7(j;k....[CLl)~:._:_._..__._.
(Mire,,) 22(8 ....Y'1.. iAll-}'IJ\0\2.___BL\Yq~Y\1~L__C=5,~~
(Con.."P"",n) -=Dlrn T/'....r-.._.:-. ___.. (Phone) _ht=3)_:J_0;~ttl)5J)__..~_
. APPLICANT SIGNATUR.~J'~~2rJrJ;d2jLLLtljJ _ D~I~ .(1JJ-=zLL21i----.c..~-=:=:_
'---........ .
APPLICANT PLEASE COMPLETE BELOW
ONEWCONSTRUCTION 0 REPLACEMENT ~LTERATIONS Flh~':)h IW.J:v \-e\.Je/t
FURNACE MAKE AND MODEL FUEL
'-"'~-~--'-'-----:;'''"i:--_.'-''-''' .....--..- .'" .'~.
FLUE SIZE,.__._..._,.. RETURN OPENINGS 'J ....,.._,___ INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT ----.-------....-.
_"" .. ..._.._.___.J
OWllrm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVen!. System
o Sleam
o Hal Water
o Radiation
o Special Devices.... ..__,.
o Other De\'ices
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Dox Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi-Family
FEE SCHEDULE
I % of job COSI Residential. Gas Fireplace
$49..50 minimum
$149.50 Residential. Addilions & Alterations
$64.50 Residcmtial. AC Only
$49.50
$49.50
$49.50
Residenlial, Heating & Ale (New Construction)
Residential, Healing Only (New Construction)
Estimated Cost $
Building Permit #___.__
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$___.
$
$.
.50
PAID V'l/ITH
BU1LDiNG P~::'hMI r
(Oftice Use Only)
BuiJdinl[ Ollicial
"J\ fiijd (r0 I'" n\'
~II u: lLci ! i !
Date . lrDa~EP ?; ~ 200t
24 hour notice Cor all inspedions (952) 44<9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lak. ~1~_n,~ota=S372
C I. l 'Deceipt No.
11 It
C I I'
I By
This Applitation Becomes Your Building Permit When Approved
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS -3 ++(P rox I rtl L- 7lt.A I L
NATURE OF WORK /_()Wf3K. (./eVR' L- (PL.-I F: ~)
USE OF BUILDING rzeS Ai /L ..-
PERMIT NO. 08.0 7S 7 OATE ISSUED C/../7,08
CONTRACTOR LEtA4 73te-.as. PHONE 4+4-. q~9
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required) LJ( ./
FIREPLACE
GAS LINE AIR TEST €V
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
.-rj)
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10 "Io~
l l
,
t<.. u. / t /n~ I~
aUILDING
E~ECTRICAL
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