HomeMy WebLinkAboutBuilding Permit 99-1126
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(~ _~ ' Owner of Building
(f'':'! Conlractor'sName&Addre,' Robert Clark Constr., 14905 Manitou Rd., Prior Lake, MN
~.. _\1 "
~i.~~i4j. RO~berl\ll Dn~ :~:~in~s. r )'P1anner Jenni Tovar ~.
~... 'I ( 0...: '1
\ ,;.- Dale: {; '\
:.: 1_ __ I - P T IN CONSPIC~OUS PLACE M _ __ _ _ ____~ :
t ...............~...._,...."'.I...J:._. _...".........".........._ _.........,,_!'.............
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QLtrtifiruu nt cmrmpanry
CITY OF PRIOR LAKE
J)tpartmtnt of ~uflbing 3JnS-ptdion
tfl Final Permitted 0 Conditional C.O. Expires
'.
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various ordinances of the
City of Prior lAke regulating building construction or use, For the following:
Single Family
Use Qassificatiol.'
99-1126
Bldg. Pemtit No
Occupancy Type
R3
Zoning District
Rl
-
, ..."'''' 1 I"\.o..,.......~ .
Type Construction VN Fire Zone
L4, B3, Raspberry Ridge 2nd Addu
N/A
(".,. Address
15036 Black Oak Road NE
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATI~
)!:..eJNAL
o SITE INSP TION
COMMENTS:
Gk
I So 30 BLlV~-K ()..K. ~
TIME
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~G-
FIL-0
l~
~fA~
<:IfVJORK SA TISFACTOfV, PROCEED
o CORRECE~~ND PROCEEO
o CORREC'J: './C ~R REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
I V
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI
._~~
DATE TIME
CITY OF PRIOR LAKE .d-h ,k, n
INSPECTION NOTICE SCHEDULED ~ /'.3eJ
ADDRESS /.5[?--::i) fo 2lLAChC.- O/l k:.. k:C)
o PLUMBING RI 0 EX/GRAD/FilLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASllNE AIR TST
r9 MECH FINAL 0
COMMENTS: '(atrli:> Gar ~;<s of"
,ii)_ fl", <'II . 'P.ev- SY\~'h ~ 'Y"\~ d.ef :
~.. SY.I 8M-- fyee; Yo&\.. d'ivdLoOYY1e..-.J-
~ S,U.A:t-u_u ~/\I,<'f^-J~' .
'~\t02 Plu.Yr\b.V\(. llm/ f
(S) ~ \...)l\rC<; ~YI'nALJ I C"'A, r~ Lc-cl
-
------------
C;S-l-f6 ')
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIO~
FINAL
~ SITE INSP CTION
0=r.
------
c.o.
CONTR.
PERMIT NO.
99 - //2.(0
+0
----
COVERING
Owner/Contr:
THE NEXT INSPECTION 24 HOURS IN ADVANCE,
lN$NOTl
... -T-
j
DATE TIME
CITY OF PRIOR LAKE *
INSPECTION NOTICE SCHEDULED \\.:00
ADDRESS ...1ED3c' 8lo..ekDa..k. Rd
OWNER CONTR.
PHONE NO. PERMIT NO, q9 - U~
o FOOTING o PLUMBING RI o EX/GRAD/FilLING
o FOUNOATION ~MECH RI o COMPLAINT
o FRAMING A WATER HOOKUP o FIREPLACE RI
o INSULATION pI!! SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTf ~ . ..
4A.~ ~l 46 ~(C-- ~,'
Itc T~/ \L- ~- JQ I ~/
~~"
~ aA-
Aorv UtM..... k.""/
{U.... ~.c +0 "^ ~ G....,.J?
~ lMN.. L..f\H", 4L
ho"
<h
Gv-~
I nspeet : Owner/Contr:
CJ ,LL 44~ 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CO~ REQU,lEMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
V INSNOTl
--'''---".-''"-.------r-------~-.
ADDRESS
/;;Q3 0
?/;)o
BL.J:JcK.. MK. ;.20
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
z:~
OWNER
CONTR.
PHONE NO,
PERMIT NO.
rf9-/ / Z-(p
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
SMECH RI
'flWATER HOOKUP
~EWERH007UP .
LUMBING FINA
~ MECH FINAL
tY1~< Ii V k.
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
L...m<A=IT'~~
o CORRECT ACTION A ~D P'3PCEED
o CORRECT w"t. CI J,lA"OR REINSPECTION BEFORE COVERING
Inspector: 1<- 1 '\.. Owner/Contr:
I
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
-~,.-.,,----~-._"--'---"-,.
I i
~~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
OATF RFCFIY.fQ.
9//0/0,1
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2, SITE ADDRESS rJj' ir
j StJ 3 6 J? QJ.. OQ./L
3. LEGAL DESCRIPTION
L/
Rd
;t~G
1. DATE
q!IO (9'1
Je./
LOT
ADDITION ~.d
4.0'Jl1FR (Name)
_ KdJrC!a.,rt Gn..sl-
5. A~}TECT ~me)
f:/ {tLnOJ ~ r
6. BUILDER (Name)
? PID,;?5-3M-()17-Q.
~ .ez'fPk/'f'I/ L;4,
(Address) ..;,.. fft,j
Jf9tJ{, i1JAnf'~"!I ~
(Ad~reSS) n . ~
,?i/]~ /,I.J". <J/J'l;O/~
(Address - /
_~M-aA ~I-
7. TYPE OF WORK Fireplace 0
New Construction)lt. Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 190 PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. I J I '7 'I ~ Width 'l6 Deplh Yes No
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and that all construction will confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building off c~ ~~se. Furthermore, I hereby agree that the C7-1;0 or a designee may enter upon the property to perf9' J;;;~ons.
'4 ~ S"",",,, "".~.1f! PIv- "13-- 7&1-S'{,O'l U~,,,No. . . <fate
FOR ADMINISTRATIVE USE
BLOCK
Ald.",
(2U}f~j'jt)
~~~-t)7.1Y
(Tel. No.)
J'I~TtjJl,~~_, s-s7?2-.
Septic 0 DecktJ Re.roofing O' Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUII.DING
5Ff)
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. 'l:.
State Surcharge ............................. 'l:.
Penalty ....................................... 'l:.
Plumbing Pennil Fee ..9.r?1:::ll.?!#... $
Mochanical Pennil Fee ..'1..'J.::'-;/~ .~. $
Sewer & Weter Penntt .c1.9..-::lI~.. .
Pennil ..9..9..-::!/?.fR... .
Issued
17 ,. City Planner
B.""
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PI.AN
PERMIT VAI.UATlON I 'I ~ """'"' .n'"
S U
City:
WaterTowerFee ........................... $
Water Tap ................................... $
Builders Deposil ......m..........m...... $ / .50-<1 . c9r')
Other ......................................... $
Total Due .............................. $~ cq. ~
Pa,d ?~ /J ., ef(, Receipl,~ 3(;..'2.11:,
Date 4/:ro/tf: By /p-~
that the request In the above application and accompanying documents IS In accordance With the City ZOnln6 Ordinance and tnay proceed Yre~u~ ThIS document when
ner nstitutes a temporary Certill te of onln9 compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be ISSued.
IIM~.?<'"
"Ze4 .1' 7o~.11
70 .00
Inn."'/")
160 ..,c
'"SS-.s-D
q () ", (')
6\J?\a~
1\.'
Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
(f $
Pressure Reducer ..f!i................... $
MeterHom .....~.'Cc...................... $
WalerMeler ......e......................... $
Sewer & Water Connection Fee ........... $
24 hour notice for all inspections 447-9850
Special Conditions W any
1. While
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qcf- /IZ(o
BUILDING INFORMATION
1" SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEAT~
16. PROJECT COSTNALUE
(1-10,000, 00
17. COMPLETION DATE
-------
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY "
SETS
COPIES
PLOT PLAN
"
A"W. d3
/ ,.,5-0. 00
q~-.06
/;2S.oC>
J. 2tX9 . /SlCl
. "'2CO.Cge
.' -''''--'''''''--,.---._'---''-~------r
-,--..'~_n~"f"'Ill
,
- ,---~.,-'-..........~-' ~~-,----,,;.,-..:t:...-....- ~-""'~~:--~~~,~-',
,~~
'r\~
Thr Crnlrr of tht Lakr Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Denied
v
9.t1l ~
Accepted With Corrections
Accepted
Reviewed By:
Date:
q I dB jCj~
.' -
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
CITY OF PRIOR LAKE
16200 Eagle CreekAv. S.E. Permn No. qq-/ /Zf,:;
Prior Lake, MN 55372 '
HEATING APPLICATION I PERMIT
IZ/ ~/q9 PID..z,5-:'30</'- - 0/7-Q...
Sne Address. /.~03fc BLIt~K- OA Ie::.. RD Ie I
Lot 4- Block .:3
Date
Ownefs Name
Address
Heating Contractor
Address
Telephone'
Model Size
Conn. Load
Fuel
III~
Add~ion _-eASP/36.e,et/ ,etO€f6 21./1)
I
Flue Size
.s//
/c;()3f.t:, PiPrduollY./ {l..,J.... AJ.c,
('~.._ I~/ )/t f- A.<.-.
Q60 J iT~~:t:. IJJ
I/V
b 5/- '15'-/- %'tfoC,
Furnace Make & Model .L ~
go tt Gj( /00
Supply Openings /5
Retum Openings ?
Input /00. (M'X) Output, 8'0. O~
Edr,
Cfm.
A~erations
Repair
/6dO
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Cond~ioning
Vent. System
,,//
....---'
............
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
TYPE OF WORK
Replacement
Est. Comp, Date
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
New Construction
~
qq-I/Zb
/-pjt..\O \N\i\'\
\ e\l\\.O\NG PE'i\tJ\\\ ,
Receipt.
Building Perm~ .
.50
TYPE OF STRUCTURE
I. Pink
2. Green
3. Yellow
File
City
Contractor
Single Family
Commercial
Public
Multi-Family
Other
Two-Family
Industrial
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
~t ($39,50 minimum)
~/'
$64.50
($~
$39.50
$39.50
Remember to add the State Surcharge on the bottom of this application,
The price of your heating permit includes one rough-in and one final inspection,
Additional inspections will be billed at $35.00 each,
House Heating Test Record must be submitted with buildino Dermit number before build-
ing certificate of occupancy will be issued.
HEAT CALCULATIONS REOUIRED with number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a,m. - 4:30 p.m,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work which requjres review and approval of plans,
2:::
11/:?~/99
. Date
/2./ ~lq1
I DlIte
~
APp~e
B~Offical's Signature
'"
.
Job Address /J1.;/t" iJkj tJJkt..tlG"
Heating Contractor C tt/ti'r' ~ IIfY
--- -
/ //11
9. -llei'
7/
8".,5
o
J..J /
Name of Tester
Date
Percent 0
Percent CO,
Percent CO
Stack Temp,
Cj~ '/1 L~
"
II i
.j.,
GMt. . fILl!
YELLOW . APPltCANT
GOLD. en.,
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. tjtJ-llzro
APPLICANT: Uff' f[ I ( Joe' L- G-
o .
ADDRESS: /t.JD;lD LOI"'L/)t"tf'C,f'- f/-Oe
SIGNATURE: fJf.h.v-;{) {IJ-
SITE ADDRE": I!.t;03h, R/"d<. tJAK,
NOTE: Sewer and Water
contractors must
be registered
with the city.
PHONE: '/1f7-S;;cf7
DATE: /1/t~I1T:
BLDG. PERMIT # qq- / /2 (p
I2/PID# 2-5-304-- or7-0
FILL IN THE BLANKS
1. Estimated length of water service b~_
feet.
2. Size of water service
)
inch(es) .
3 .
Location of any couplings from structure
cC'
;:/J. feet.
4. Type of sewer pipe. ABS PVC~ Cast Iron
5. Estimated length of sewer line t(). feet.
6. Clean out (if required), located at
structure.
feet
from
BY
~o~~~our permit when approved.
/ A~ . DATE: /0;15/99
This
----------
----------
======================================================
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $t1.~0 plus
$ .50 surcharge. --
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID
AMOUNT PA]? fi\n~~~'\\\
REC'D BY \ "'\.l\\.O\'\~
RECEIPT #
4629 Dakota SI. S,E., Prior Lake, Minnesota 55372 / Ph, (612) 447-4230 / Fax (612) 447,4245
AN EQUAL OPPORTUNITY EMPLOYER
~
~~
I. Blue
2. Gold
3. Yellow
File
City
Applicant
CITY OF PRIOR LAKE
PLUMBING PERMIT
ilLj f5>J PLU,1fl~d~
tfJo' O'J 1 '< I :5. 5 I C\
A . .___Ui...
Legal Description: Lot 4- Block -3 1':,.h f-N; 1/ B02.f--'c1 ,,>> (CG <:::.
Site Address:. 1:S D.3 i, r5 LfJ G f:--, 6A f- )2J) f2- I
Building Permit # O')-//Z,(,. PID# 2(y 3()4----(;rl-O
.
NOTE: This permit will not be processed without complete information.
Applicant. _,
Address:
Signature: .
PPNo. qC; - /12ft::,
Phone: Lj.,,? d.. - 9 b J 9
/J-fcfLf: V4Lu:..V ,<;'<;)J,L)
I
Thr C'tnltr or lht L.kt Counlry
Quantity
I
I
,
~
I
,
i
~
FIXTURE UNITS
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
.3
I
Rough-ins
Water Heater
Water Sollner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
J
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$
$
$
$
.50
\i'oJi\ 'r\"\
GRAND TOTAL ""'1'>-,"0,.. oC,\ ,,'
. ~ ,~\,'l \
\ , ,\\.V IF
\'3'v
,
This permit is granted upon the express condition that said
contractor, shall com p~y ....all respects with the ordinances
of the State Plurnb~'ngl /7l' ame?dmel}l:s ;hereof.
, , (U-";{~/C'/1 DATE
IV; .' . . ~_. ATTEST
Call for all ir/pections 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372 / Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
PRIOR LAKE
,
INSPECTION RE'CORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /')()'7.,(o 1)(c.dr 6~ U ,
NATURE OF WORK ~IPI,1 Cm....6J,
USE OF BUILDING SC:f\
PERMIT NO, q 1.-//2.C: DATE ISSUED CJ-I{,.-'7 i
CONTRACTOR ~I.:w-~ (l[cJ'k. 0~_
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTINar;) I ~, I 10- 7'9J
I FOUNDATION (Prior to Backfill)~ I f;:r I I / () - I t) - 91
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC (/)) /0/1"1/<19
FRAMING Y;)(;;
INSULATION I' n..!7/., 7
ELECTRICAL
PLUMBING I f6 (t;t) I~j j1J I )
HEATING (if required) I CT _ f1J I (2- 1 qq
FIREPLACE I 1~711 ) I 1'Z.,f'-!J I 'j'q
GAS LINE AIR TEST I (;jJ 1J?)(jq '( I I I
COVER NO WORK UNTIL AB4Y{ HAS BEEN SIGNED
I~H4C!;'~ "'1" ,;~, I I
FINALS
G. f_,
GRADING (Prior to SOdding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY
l2J+
-
:'./ S/ dJo
1'} 14--llb
,
I Rid z/tg;'IJ-'
, '/Gf1 zJ~p
UNTIL ABOVE HAS BEEN
NOTICE
SIGNED
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 ~o service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850