HomeMy WebLinkAboutBLDG 08-0981, HVAC 09-0011
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
/1,z,5. Of;
1_ While file
2. Pink ('jly
). Yellow Applicanl
I PERMIT NO. 08.098/ I
,
ZONING (office use)
I L:8 (7 (J {JUt-v 1 J.I /:0..'-1['.5 F...
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
PID
ADDITION
OWNER
(Name) 1-10' ID/>>'7 <,7"b-1IddSlbI7F., ;HL
(Address)
(Phone) ?s l'H~~{.f-H/J."''/
7
BUILDER
(Company Name)
(Contact Name)
(Address)
w,,~, 0/........' <, I /J- "'/';-,"/.<; 70 ,7/.,
"
; J./t I
(Phone)
(Phone)
~...>- z -8 ~ C? !> l;.,<:.(-/
_TL' 'f (
t> 1-.., rlL
'.....'
7
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition Di!"Alteration DUtility Connection
CODE: oI.R.C. oI.B.C.
Type of Construction:
Occupancy Group:
Division:
A
I~I
BOE F H
I 2
o Misc:
IV V A~
I@R SU
3 4 5
PROJECT COST /V ALUE $
(excluding land)
[,5 L~)
I htreby certify that I have furnished information on this application which is to the best of my knowltdge true and correct. I also certify that I am the owner or authorized agent for the
above.mentioned property and thai all construction will conform to all existing slate and local laws and will proceed in accordance with submined plans. I am aware Ihatlhe building
official can r ke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the properly 10 perform needed inspections.
X<./" /./1..5'k.-'
Signature Contractor's License No. ' Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
$
$
$
$
$
$
$
$
"'fC>O~.-
1~7.'2.S
,\S. , r
;.~O
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
~
Z- ~ '-. "\-G..
Be me. Your Building Permit When Approved
. ,,,-Me
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by Ihe City Planner constitutes a temporary CertifICate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Clccupaney must be
issued.
!'Ianning Direclor
Dale
24 1I0.r notke for allllllpeetlHl (952) 447.9158, fall (952) 447-424S
4646 Dakota Street S.E., Prior Lake, Minnesota SS372
Special Conditions, if any
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGlFlREPLACE PERMIT /. <J. 0;
-:See- C>~- 01'81
~ E;w J~~icanl I PERMIT NO.oct, 00/ II
ll:~M_md:"-
ADDRESS
1<"6lX/ 0 ~ Ave
Date Rec'd
S~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER \ \ .' ., .
(Name) i-\{)\\(Ju.'-'l (t::)vv\~\(\ le.5
(Address) I.~,,- b\ ~ r\ .
(phone) qS~ '82>0 -'6'68L1
APPLICANI....-... . 0 _ -
(Name) .\~~~.\ ,; ~Q.r(f~O"
(Address)(~~q ~ C/)T"I(()n~ ~-!.
(Address)
(Contact Person) ~,c: 't~ <,.p
APPLICANT SIGNATURE
>1v\&Y1 S
(Phone) ~C;~ -LiS,' I~
S. s-lPtACA. (
(City)
5<;07 S-
(Zip Code)
(Phone) b51. LIS) ') )?aLl
DATE \~ ~O O'ls
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT AL TERA TIONS
FURNACE MAKE AND MODEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL 'KEfrti
FEE SCHEDULE
Industrial. Commercial & Multi-Family I % of job cost Residential, Gas Fireplace
1-7. .S""tl $39.59 minimum
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
td
Estimated Cost $ q I~ Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
, TOTALPERNUTFEE
$
$
s
Cj'DCD
.50
cto . '3J
Paid9o.5O
Date I. (P .0 r
24 hour notice for all Inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
FUEL
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS \ (., f>o D Uy,-., 'rl+ A \It; S .6-.
TYPE OF WORK ~~ <> LvA'-""" IN r~c e::z..t$rl2-
USE OF BUILDING \ ( C- A-/,~ J J
PERMIT NO. DATE ISSUED lz... I, log
BUILDER \{Ol,. L~A'1 )'POrr<<:N S~ It-S..... PHONE # C{S2.- elO. as 64-
\
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
_ I.1JC i { 7
PLACE NO CONCRETE UNTIL ABOVE HA BEEN SIGNED
I FRAMING I P.,GI t/l~r
I FINAL I /2 ~ I i J 4",
FOR ALL INSPECTIONS (952) 447-9850
DATE
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STATIONSTORE #198
PRIOR LAKE, MN
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. FIXTURE PLAN I
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