HomeMy WebLinkAboutBuilding Permit #03-0194
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ADDRESS
SGC- lAc
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main Fi~_e
t. White File
2. Pink City
3 . Yellow Applicant
//14 /'11/ F/ L L
Date Rec' d
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PERMITNO.03_0/tf4-1
/~3 15 f:rnl3G/L t!lL~r O/l-it/E-
LEGAL DESCRIPTION (office use only)
LOT 4'BLOCK 2- ADDITION {;1J1BG;Z I!/l.~ ~1J/nUL
OWNER
(Name)
-(UL-rk.- JJOWlk-5. ~ c
NOn;rJIw~r
(Address)
x-J5
BUILDER
(N ame)
(Contact Name)
(Address)
YY\V\
Pv..J ,
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5A1vt~
(11 JLr b LAScHUtJ
TYPE OF WORK
j2(New Construction
OLower Level Finish
o Misc.
(Phone)
S/JlriZ
EA-6kfl.
JiIO
ZONING (office use)
PUlJ
PID a5- t/OJ..- 05'7-0
tYlv\
55/ Z I
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(Phone)
(Phone) 6) Z - z-Z/ - 1/9;:-S
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
~~ FZ rt7--
? . Z I " ('7
o Deck
o Porch
ORe-Roofing
~ireplace
DAddition
OAlteration
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
;"'UP~;;Zj?~ f3C- /37/ //b~.~
#./ /A Signature Contractor's License No. / %:tc;
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
PROJECT COST IV ALUE (excluding land) $
$
$
$
$
$
$
$
$
(,5.000,00
/7l./1r. 7 s..
;;elD. ftJ1
32.50
/00.00
I (JO, 00
L{o,o 0
This Application Becomes Your Building Permit When Approved
~ 7~1-- 0(1/dl3'
Building Official
Date
#
#
#
#
$
$ '2..? $"", 00
$
$
$
$
$
$
I 2..0 0, 0 0
700.00
~~f;z-94-
f
, Receipt Nt) ~ J '7 CI C(
BY;J
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
''23.-<''-~i";"t.~j6 01/~d3 ~ 7l1~ :f~
Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
See Main ~i~e
The ('rnltr or Ihe I...., Counlry
White - Building
Canarv - Enqineering
(.!mk _ - Plannlnj)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
f
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ ,.- ..-... .
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Accepted
/
Accepted With Corrections
Denied
,
Reviewed By:
~
-:;~ ~
Date:
01/7" ~ J
f . f
Comments:
See Main ~ile
"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."
See ~ain File
C~it;-:- Building)
Canary - I::.nglrleerlng
Pink - Planning
The ('tnler of the Like ('ountry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
f)~
,
j- 30 -0-3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for constructio; zc;t~~h is ~ ak ~j-- ~ .
Accepted
Accepted With Corrections
/'
Denied
Reviewed By:
~
1~
Date: -2,/ ~ /03
Comments:
See lV~ain Fi~.e
liThe 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."
See ~ain ~i~e
Thf' ('''"'tr of 'h~ 1.8kl' ('ounlry
~ite - Rujkling
. c;an~rY - Enginet;lrinc()
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proP9sed at:
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Accepted
X-.
Accepted With Corrections
Denied
Reviewed By:
Jt14.j3
~ t: iJ1l:4,'V\
Date:
Comments:
Pfk
'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."
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CfTY Of PRiOR LAKE PLL-;'(El;-,"G PER..\rIT
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, T.01:~~J.."PER.)mm ..,:,.,.~~~.S X:w:;:~U~.;,;:...,,';:.,., ,.MAR 0 4 2003
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This "'-.cpilc1Cion B<com~ Your BuiJdil1: Pt:'I"tIlit Wacn Approved .~ P,:~~~,"_... ;...,/Sy _! R~r;=:pc..;~o.~_ ___
a..ildln-: .OlTlc:i:d OUe Dace IV' By
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5- 7-03;12:37PM;
;952 894 0925
# 7/ 8
.
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~n ~il~. I PERMIT NO......< .Jt'1L(
], Yellow Apphclnl J -/ I
(Please tYPe or print and sien at bottom)
ADDRESS ~
/ {; :;15 - Il'r(}~r
Cr~&+
Lf':
ZONING (office use)
"
.~.1
LOT
BLOCK
ADDITION
PID
.:::t
:~~.1
~i
I
LEGAL DESCRL1'" nON (office use only)
OWNER
(Name)
PuAk !ft;-rrliS
~15 NW. P6JJ,'-1. . S'IMTE-
(
ILiD I
(Phone) 6'51- C/52-5;2aJ
E M.Af\J J fY}rJ ;;5/;2/
(Address)
APPUCANT
(Name)
(phone)
~
::':.~~
RllrnsvillA HARting P" AIr.. Int'!
12481 Rhode Island Ave. So.
(Address) ~avage. M~I ,","~7..a-1122
(Contact Person)c;,. \ \JJ.J\ ~ (Address) (Phone) (Cit)'q 5;;) ..- ~crL/ ~zoud5
APPUCANTSIGNATURE Fl}. ~bmIl DATE _'7 -7- 03
. APPLICANT PLEASE COMPLETE BELOW
jJ)(1NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONSA J~~l
FURNACE MAKE AND MODEL t. ell fJ1YX G.:< (p (Q:;2. - 5::) FUEL / Vu.:;r. qtL..3
FLUE SIZE RETURN OPENINGS 5 INPUT 50., C:OD OUTPUT LJ~ 600
TYPE OF SYSTEM HEATING OR POWER PLANT
I
"g
::.:,]
:>:~
f:}~
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OWarm Air Plants
OGravity
o Mechanical
@ir Conditioning
OVent. System
UUlflf,'f-
\D~~\~
S -10-<'
\ \
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1 % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating &. Ale (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
S. f\{){\ 0'0
Estimated Cost S I LA-^-.I, Building Pennit #
$39.50
,_:\~
$39.50
$39.50
I~t
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HEATING PERMIT FEE $ SUII ,.~/() ~
i~~~S~:~R:E ~ / Lfd..50~ bw.\~""(t~\ .~~"fH
(Office Use Only) --1J.f ~ .. -'FIIIrr
Thu AppUca'ioo _om.. Your Building Permit When Approved '\.~ W~ ~ 0 \Ii [E 1" Receipt No.
Building Official Date! J ~A' - 8 2003 JJ By / fi\,
VI/
24 hour notice for all inspections (952) 4 17-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Pri. B~~ ,n".J
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS I to 3 ? S / t vrI be. va yes/- .()t-
NATURE OF WORK ~tAJ j Ifi2 ~ n ~I
USE OF BUILDING 5 F fI ' ~_ ~ :,
PERMIT NO. ,.... 05-- OICf4- DATE ISSUED \ rEB " !j.
CONTRACTOR _~ PrO~:J..- a.d-'-Q9f5
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE I ~~.t:CTtONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF See lV~ain File
BUILDING AND INSPECTION
INSPECTOR
DATE
FOOTING M()yi\ I I
I FOUNDATION (Prior to Backfill) \fIA.b.iil/\ I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC \M~\v\
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
VVP
W
(:; ~ 4-03
6, '-art/)
11/(7
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G' 4--"7
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
-~(l,\,^
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
M/
j/II{/ 7 ~ /8 ~(j)
;1,/f"l 1 r (K - (J)J
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
7.. LI 1J3
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
.
_.-~.
BVftN~ wILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
~/7lc
Orstat Test Report for Jobl
Address 'L.. 31-< ~} I -~, b{' ;- r {p .J... Ci1y '1:>t"'; f\ r- 4~
Occupant .$ l.. "r\.,(' L
Date of 1081311
Type of HT. F/A ~ Space HT Unit HT
Other
Make L-., i .1 () ~
Model ().~~Q;), L;V' iI
Serial ~90"3D)~7..)~
Input $t) L~
Pilot Type
Pressure
Input CFH
S1ack Temp
Date Tested
Company
Technician
HOT SURFACE IGNITOR
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BURNSVILLE HEATING & AIR CONDITIONING
~......
-.)CA ....~,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
1(, 17~\ 1'if1~"LrcJ;J-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
B" FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o yt.UMBING FINAL
.. MECH FINAL
COMMENTS:
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DATE TIME
7~l-1
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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o WORK SATISFACTORY, PROCEED
B""CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: $ 7::..2Ar()) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!