HomeMy WebLinkAboutBuilding Permit 08-0956 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED (
ADDRESS ���p� ,�c� � _
OWNER CONTR.
PHONE NO. PERMIT NO. �._ �p
� FOOTING ❑ PLUMBING RI ❑ EXIGRAD/FILUNG
❑ FOUNDATION O MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
� FINAL ❑ PLUMBING FINAL � GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS:
(� 2iN5 �� � t,r,e� � G�� J'�: rC
❑ WORK SATISFACTORY, PROCEED
�CORRECT ACTION AND PROCEED
� CORR T , CALL FOR REINSPECTION BEFORE COVERING
Inspect r: OwnedContr:
C L 447- 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
nvsiror,
o F PR/p� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� , � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �� �7 ��
�' �+ `� : x AND UTILITY CONNECTION PERMIT
U � ' C�
M��'NES��P i wn��e File pERMIT NO
2 PmA City O �1 �
3 Yellow Applicant (�
Please e or rint and si at bottom)
ADDRESS ZONING (oetice use>
( (0 2 � `� �� tDF � � , �2 /S�
LEGAL DESCRIPTION (oftice use only)
LOT BLOCK ADDITION PID . 0 y(� •(7/�. Q
OWNER ,! n �
(Name) >��- d- J��- La o� "�� (Phone) 9S Z"'T y 7 � g� L�"
(Address) L �-`' ��=�1� I�tJ C' • S �i
BUII,DER ����5 t�Q��T• LL 1.�. Q �'
(Company Name) (Phone) 7 5 Z�� / Z"' s�
(Contact Name) ��92K �I!!�� � � (Phone)
(Address) �� � U u��.Q� (.. ^�� � s� SZ-
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding Lower Level Finish ❑ Fireplace
❑Addition ❑Alterat�on ❑Utility Connectson
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Cons�uction: I II III IV V A B pROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished mformauon on this applicahon whuh u to the best of my knowledge true and correct I also certify that I am the owner or authonzed agent for the
above-menhoned property and that all construct�on will conform to all exisnng state and local laws and w�ll proceed m accordance with submitted plans. I am aware that the buildmg
official can rev e this perm t cause Furthermore, I hereby agree that the c�ty official or a designee may enter upon the property to perform needed inspections
X v� Zo�2fl35"S t l 8
Signature Contractor's License No. Date
Permit Valuation � Q d(� � b � Park Support Fee # $
Permit Fee $ � s SAC # $
Plan Check Fee $ �� ��t, ¢ Water Meter Size 5/8"; 1"; $
State Surcharge $ Z� Pressure Reducer $
Penalty $ � Sewer/Water Connection Fee # $
Plumbing Permit Fee $ 5"O O Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permi Fee $ TOTAL DLTE $�
.
This 1 0 omes Your Building Pernut Ap oved Paid � ; R ' t No. /
Date
� r a�
Bw n t'ri a� ate
Thts �s to cerhfy that [he request m and accumpanymg documents �s m accordance wrth the C�ty Zoning Ordmance and may proceed ac requcstcd This document
when s�gned by the Ciry Planner consutures a temporary Certificate of Zonmg compl�ance and allows construcnon ro commence Before occupancy, a Ccrnficatc of Occupancy must be
issued
Planning D'uector Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Residential Building Permit Checklist
a ment Finish or Interior Alteration to Si le Family Homes
By Date: �� �,� ��
,
Building Permit # PID: Zoning:
Site Address t� L � �, (�,��S � 6� ,
Legal: L B Subdivision:
Existing Structure YE or NO
CONFORMS TO ZONING NO
ORDINANCE
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? �
O
Is the property located within the flood plain? Refer to Planning
0
Does the alteration include any additional kitchens? Refer to Planning
r'.4�/!.7' /k�i
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? �
r°
Is the proposed use of the fmished space or Refer to Planning
altera.tion for anything other than a normal single
....
famil home office, ou home, da care, etc. ?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMTT kILE TO \
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLATE�ALTCHCK.DOC
4 P Rip CITY OF PRIOR LAKE Date Rec'd
° '� HEATING/AIR CONDITIONING/FIREPLACE PERMIT 2 ZQ , O�
� "�'� �
�' x
�
� °�
'�,� ' �'"" '-''` PERMIT NO
NES ? Grcen ( �n
3 Ycllow Apphcant
Please e or rint and si n at bottom
ADDRESS ZONING (oefi�e use)
W ��
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID -
OWNER '"�'., ,� � l�-�� � ) =1-J�c� ' ��F� " 0�(.��
ame Y.l .r \ Phone T —
(Address) a. �.Q. (,Q �id �
APPLICANT ��� _�/':a _ ��7�
(Name) (Phone) �
(Address)
(Address) (City) (Zip Code)
(Contact Person) � 1�1''1 �YY� -� (Phone) ���-- � � - 9a � �
APPLICANT SIGNATURE DATE a
APPLICANT PLEASE COMPLETE BELOW
�NEW CONSTRUCTION ❑ REPLACEMENT (�ALTERATIONS
FURNACE MAKE AND MODEL ' FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM I3EATING OR POWER PLANT
PLEASE NOT . ir Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces �ncroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation Fireplaces with Box Addirions or
❑Air Conditioning ❑ Special Devices
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL -
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1% of job cost Residential, Gas Fireplace $49.50
� $49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residenrial, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $ / � SO
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ �Q
(Oftice Use Only)
This Application Becomes Your Building Permit When Approved Paid Recei t N
Date B
Buildine Official Date �- • a � � �
24 hour notice for all inspections (952) 447-9850, fax (952) 447-424
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
�
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�
P R i � R LA K E BUIL�ING AND INSPECTlON
IN PE TI N RECORD
C O
SITE ADDRESS ��Z � � +.5� �I� N�/E
NATURE OF WORK O L
USE OF BUILDI G
PERMIT NO. . D E ISSUED . � O
CONTRACTOR . PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTI NS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING � �3 �5�
INSULATION
ELECTRtCAL
PLUMBING �/� �'j � Z� �
HEATING (if required)
FIREPLACE �
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
_ _ _ FINALS
BU�LDING � � � �
EL�CTRICAL
PLUIVIBING
HEATiNG
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This ca�d 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