HomeMy WebLinkAboutBldg Permit 03-93 & Mech 03-62
CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
L Pink File PERMIT NO
2. Green City .0 ~_ / rJ
3. Yellow Applicant J 0 c7'-
(Please tvDe or print and sign at bottom)
ADDRESS
3! '1 t)' .<ak t:! !3LM {t (J /V C/ ~
ZONING (office use)
1</50
LEGAL DESCR1t'TlON (office use only) ;:;/lJ:J-.
LOTd1aLOCK I ADDITION Y1r!Y1;tilJvOOJ (120/0/4 b<;f PID;'S-g-;/-OJ!;'-O
OWNER
(Name)
~ f5(;( y- +011
'3{Cfr; "'ake Olu+'; ~,'vc/e
(Phone) Cf7,j -fill/) -8$67
(Address)
APPLICANT . \ 11n\J'I:1 /l,^ J / f>/\~
(Name) p('t-P~Jd!Q ~~~4/(/-e(}{l2('rI2.JI'rI() (Phone) q s-,tt- r1 '-1''(1- 07Sg
(Address) "3 % ~() /1/. I/fr_4 Bit IJ{ \iLl 'It (J, # ./1141.- -~ 3.3:l
(Address) (City) (Zip Code)
(Contact Person) rJJ i! 1/f\fOt I J /' (Phone) 95:J-jt;>/J--o ?~R
APPLICANT SIGNATURE h:JAA/~j_t('~ DATE 1/ 9 J C;l
1/ .' '-
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
o Steam PLEASE NOTE:
o Hot Water Air Conditioner Units
o Radiation Cannot Encroach into
o Special Devices Required Side Yard
o Other Devices Setbacks
Ilea i- rv-tJ~: IUctltJJ~' UtftJO-m LOtlJ h"~I/IOc'fJ
./ /:}/Yt} t:'I v{JH~cf
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ <.-::S 9 -.s-o
$ .50
$ Ul1r-
lice Use Only)
Building Official
Date
Paid
I/o, ----
Date 1'1 r. ~
1- 7 -u-.-J
Re~e!p.t No. :3
Lf .'=3 /} 5-
By
'JC
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
81/38/2884 18:54
9524481748
AL I A CL EARI..I.,I A TER
PAGE 81
01)29)02 11m 11:lQ FAX Sl~447424S
CITY OF PRIOR lAK:E
~002
DlteRee.~d
LIJ'} OF r'.t<lOR LAKE PLIJMBING P~lll
~
(/ V
~::~;; - .t~J NO.:.i'. ~ J
,. ,,~ ""'~ \J .,.~
ZONlNG (aIIIeIalllJ
_c.,v.
LEGAL. D1!SCR.u- J. ~ON (oma Ute cmly)
LOT BLOCK
ADDmON
ruJ
~':e~K .J nhr\ +T11 \ ~~L/YI
<~) ~ I 0 ~~KL\ ACt (-~Y~_'
. \, I,
. APPUc.A.m r:~
(Namo) L ~-B:,-y-) A =/tr -<-" i-t&l or -J....I to
(Add~~) )q}, (; Q rn ~f~J1v---y1 f4il
(Add.~)
.---
(Conma :P,-~~...n) -::::::,r~~ t' -- (Phone)
APPLICANT SIGNATURE~f/2.2'7-.~~f?j!)
(Phone)
(Pbooe) _ Cje-,;), - ,L.;~ Y- ) - l? '7 ..~ ()
~(-; tv- L~ /nn Q-..,~J?-
(City) (Zip Cadc)
1'S;),- lj.L;.7-f9SCJ
/ l,~19// 0 (l-
I
DATE
~
\
I
\
APPLIC.ANT PLEASE COMPL~ 1 JL BELOW
Typt of l'l.~v.. 'c< , Quality
Batb Tub with or without sill" I fC'
Dishwasher
Floor Dr3in
Lavatory (B~\,j~~ Sink}
Laundry Tray (] or 2 COIIJpartmeDt !ink
Shower Stall
SioJcs
IBM' Sink
Watm' Clotet (toilet)
Type ot J.rt.l....:.
Quntity
Rough-iml
. W.:...i..... H....6ol-
VI ~fA;4 Softner
Stand Pipe (W~ Machine)
Sew3~ ~eetor
Backfto,v~ kgembly
lhclc60w ~--..btY r~
uwn SprinJder '
Odter ~
~ LlI.. SLtu.DULE
. Indu~vi81. CommerchJ &. Mulrl-eunily, \ % of job ~olrt.....-i1h a $39..50 minirmm1 Re.sidn1!tfAl..New One de Two-Fumily $99.50
~OOt'Iri31. Ad4itians .t. Altt:nItio~ !39..10
E$cimated Cost S
Building Perroit #
PLt.J1wwu'JG PERMIT r l:.t:. .$
STATE SURCHARGE $
TOTAL P.!!.~ FEE $
50
(Of'r.cr Ut.t Oftty)
This AppUcactoa .ButJmes YOllr Buildin~ :fenuit WM:n App~
Dsl~
I It..-::pt No.
By
I P~ic1
Ihritdttlg QfIid.C
.~
fr""
J
14 "Gar notidl fGr 11l ilIlIlJl."diou, (952) <U7-98S0. fI-x (952) "7-t245
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
j-Z4-tJJ
(Please tvDe or vrint and sign at bottom)
ADDRESS
..3/Q9
L-A~ 5c"V'?"r-
I. White File
2. Pink City
3. Yellow Applicant
V;e.??-C
LEGAL DESCRIPTION (office use only)
Lo1ZiBLOCK I ADDITION ;Vt:)~vlrlJJ:::J d~ Ztvo
OWNER
(Name)
~ J h~ K
:?>a r-\-o~
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
'~wer Level Finish
(3JeMJ.
o Misc.
(Phone)
(Phone)
(Phone)
ODeck
o Porch
ORe-Roofing
OAlteration
o Fireplace
OAddition
PROJECT COST IV ALUE (excluding land) $
PERMIT NO. 03 ~ OoCZ3
ZONING (office use)
~/JO
PID7S- 37/ -027- 0
96-Z- YL/() - 8fit:,t/'
ORe-Siding
OUtility Connection
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 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 this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upo~propftr to pe~ need~S~ectiOn~.
X ~ IL<: K~ 1-2'1-0$
."/ Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
..3,000.. 00
$ '7 '-I. '7 S-
$
$
$
\$
I $
$
$
1- S7)
4-0.00
Th"R": -,=:r;;/pttnllll-;:;:;<d
~g Official /... Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
111.b'!::;'
/-li./- tJ~
# $
# $
$
$
# $
# $
$
$
$//7.ZS-
ReceiPt,42. 4'...34--G /
By ...-(.
U
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~/qt:fJ 4Aee A"Vl1'r NL.
NATURE OF WORK ~/) ~ ~
USE OF BUILDING ~~
PERMIT NO. ~3-- IJf) . DATE ISSUED /. , ~ fJ3
CONTRACTOR ~ -::rfJ!b.,/ PHONE ·
NOTE: THIS IS NOT A PERMIT r=6RAN"YOF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
J Pi ,-...,
raw -IJIIIJ ~. . .-. ..- ___IJIII) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~.- no JJlfl : ..P1<18
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE ~ I i
GAS LINE AIR TEST /IJ/ p- dl(,2...
,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
f$
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,
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1f17 (
I
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17
1- J()
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
1-"$0
L~ 1;/ off (I,. r-
CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDULED
ADDRESS ~'? I q 7'
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
/.
0~ ~~ ft;
Q~ f,j l.h, f,f'
. -
DATE TIME
o ?"-Q5C{?
/
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
"'"'
lr~_
o WORK SATISFACTORY, PROCEED
;A CORRECT TION AND PROCEED
o CORREC K. ALL FOR REINSPECTION BEFORE COVERING
Inspector: -J- Owner/Contr:
CALL 447:98~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!