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HomeMy WebLinkAboutBuilding Permit 12. 1056 u, 0 < � P 5 �LL �| ) Zww� z § & CD � )� § k 0 7 0 WW 0 2 § 2 .. w o o @ § _ �� 00000 0 �1 N 0 �- lu m \ O d aaa w L 0 D � • z 2 2? z 0 g w k r Fe oo -� o 0 0 ■ o oo0< ` §§ w t I �' z zzzzz- « 0 2 D o w itireCLm11" I.� 'Fo c z. ® 41 0 D 0I 0 0 0 2 e ::: } )2 § ® 000000 4 11 o o u ` — E a E IIIIILA � � 0 < 0 § \ z k " ��) k 0 9 ��. \ 0 z o 0 S 1 \ « r-� ' a.§ 2k2§ ) Z '' � j cc o w 2■ w § §� ■ 0 0 0 ) < 2 / 0 0 oo 0 II : 0 0 E Q ? < 0 a OOOO�O C.) 11116. - 'Eli/O 0 — of PR /p� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec • , TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /3 /2-- � AND UTILITY CONNECTION PERMIT U fr M/HNESD'sR I White File Pint: city PERMIT NO. / L , � 6 6 , 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS Q "� ZONING (office use) 1 0 C3 l R C^� �terr7 A i( i d .4 , g- � � 9 LEGAL DESCRIPTION (office use only) LOT 5 BLOCK L(' ADDITION PID OWNER (Name) 6 { q d' Ley / "< 14(411 I'ii y in (Phone) (Address) / BUILDER c � qq ,/� (Company Name) 5 TAC kl t1 1L. 12{ e 1t Li_ C.-- (Phone) (Contact Name) . r'Ct i 0, 'S 4w,tC-/AOl•tSZ / (Phone) 6 re- -�(? j` - © /Jc, (Address) '30 7 L Cti1 r' 61(rl A -e i /V , 4e t_L) 1 u�t ✓v 5 TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re- Roofing DRe-Siding [Mower Level Finish ❑ Fireplace _ddition DAlteration ❑Utility Connection CODE: 11.R.C. ❑I.B.C. ❑ Misc. Add ,eife, L° Type of Construction: I II III IV V A B PROJECT COST /VALUE $ 2 ( ` 0 Occupancy Group: A B E F HI MR S U (excluding land) f Division: 1 2 3 4 5 t 1 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 conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revoke tys.permit for Just cause. Furthermore, 1 hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X — BLe 1-/z--/z_ Signature Contractor's License No. Date Permit Valuation 4 1, OQ, Park Support Fee # $ Permit Fee $ SSZ.1S SAC # $ Plan Check Fee $ 3 qz 04 - Water Meter Size 5/8 "; I"; $ State Surcharge $ Z ©. 50 Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ 5-4, S p Water Tower Fee # $ Mechanical Permit Fee $ .9r 4 . So Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE alto) LI 7 ,4 $ O This App io ecomes Your Btt,ildingPermit enAp sved Paid 10 `/ 2- R- pt No. 1, ` Date S. /L A . _ 9 L T0 i I ` i 1 - DDate This is to re that • request in the above application and accompanying d uments .. in accordance with the City Zoning Ordinance and may proceed as requested. This document when signer he ' y Planner conshtutts a temporary Certificate of Zonin, complia' e and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued t Ii # Thing Director MOW b ate Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street Prior Lake, MN 55372 4 PR/ Date Rec'd H i 0 TY OF PRIOR LAKE PLUMBING PERMIT 1/ 0 /Z.._ v %7E0 1. Blue File 2. cola City PERMIT NO./ Z . / 0 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 4eg 7 gaits t/, e=-4.__ ei LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) /J I (Phone) / � -7 4 (Address) ` 4 r� APPLICANT -� / r �^ 2 / /� (Name) f ► e tL vW► � ' (Phone) � - 6 w1S 7 (Address) 3 1( L,'-,-- ---_-_604 / 4X.eJ erc l---t- � (Address) (City) (Zip Code) Ci Z -?7Z-- g7 (Contact Person) / x-�C ,' e � � (Phone) is APPLICANT SIGNATURE it-- DATE // ' Lo — Z. o / 2 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins Dishwasher Water Heater Floor Drain Water Softener 1 Lavatory (Bathroom Sink) / Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector 1 Shower Stall Backflow Assembly I Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler 1 Water Closet (Toilet) Other 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 # (3 / The Minnesota Statutes § 326B.148 p� rj `3 L "SURCHARGE" has been extended PLUMBING PERMIT FEE $ / until June 30, 2013, STATE SURCHARGE $ .50 T 1.--0 ) The minimum surcharge for a TOTAL PERMIT FEE $ "fixed fee" permit is $5.00 11115 1 llUU DCCUI1UC5 1 oul Dullding Permit When Approved Paid Receipt No. Date By Buildine Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 P R I R LAKE BUILDING AND IN SPECTION INSPECTION RECORD SITE ADDRESS 1-7 / sp, 6/??I / &DO& NATURE OF WORK /V . ,1t USE OF BUILDING or 4//L.. PERMIT NO. /2- . /D DATE ISSUED CONTRACTOR S KIf JSS /EMaO &� PHONE C� /Z• 3(1, . 0136, NOTE: THIS IS NOT A PERMIT FOR ANY OFT E INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTO DATE I FOOTING We' I � 13 5 1 FOUNDATION (Prior to Backfill) 1 -� 1 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS FRAMING "((7 g_ (c(. I 'b 1- INSULATION ELECTRICAL PLUMBING k(4 ! 4'Z HEATING (if required) (0 ((L C>as� tr.ht. 1 lb (0' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED 1 g Li- 1 `I (0117 FINALS BUILDING ELECTRICAL 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