HomeMy WebLinkAboutBuilding Permit 13. 0282 O ...1
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o v R10 CITY OF PRIOR LAKE Date Rec'd
a. <;: HEATINGIAIR CONDITIONING/FIREPLACE PERMIT `4/ /3/ ,
NfyE50 1. P nk Fife
�, �A PERMIT .
2. Yellow NO
J 1��
Yellmr AppV�tuA
(Please type or print and sign at bottom)
•
ADDRESS r ZONING (office use)
1 k -/ - 1 V \Ae-J CA' W
LEGAL DESCRIPTION (office use only) PAID WITH
LOT BLOC)( ADDITION BUILDIV PERMIT
(Name) `O Cc,' ! 1Z. �nci S� b • • (Phone)
(Address) t " PiGC1? -c0e- C 0 1 r( tf1 1 alt-e. 1 r\t,1'\— '- n--
i APPLICANT !y l7
(Name) 1 � 0 C` /C--� __. (Phone) ( ND -, lwv
(Address) l'`'4 ) 4 1 L. '
� — ( '"'r\f t t 12, 1 1,�, S��
d' •ss (City)) -� (Zip Code)
(Contact Person) e . .• $ _ •J • • hone) C - -t (9 . 1S
APPLICANT SIGNA ' , .. —_ sQ. y� L-NA— r t 1 DATE k 13
APPLICANT PLEASE COMPLETE BELOW _
NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AN MODEL NAM g lti3'‘Sc -- ) ".- \ ` fZlp ;\ FUEL ��
FLUE SIZE RETURN OPENINGS ( INPUT b DP OUTPUT 13 '3 to 0
TYPE OF SYSTEM HEATING OR POWER PLANT
Watvi Air Plans ❑Steam PLEASE NOTE: Mr Conditioner
Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water into Required Side Yard Setbacks.
hanical ❑ Radiation Fire (aces with Box Additions or
I C onditioning ❑ Special Devices p
Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi- Family I% of job cost Residential, Gas Fireplace 549.50
$49.50 minimum
Residential, Healing & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Beating Only (New Construction) 564.50 Residential, AC Only $49.50
Estimated Cost $ 1 4 1 Building Permit II
the Minnesota Statutes § 13611.148
"St •RCf 'ARM:" has been changed Ibr one
HEATING PERMIT FEE $
t year effective
STATE SURCHARGE $ J . i) -J .lul■ 1, 2010, u .tune 30, 2011.
TOTAL PERMIT FEE $ ` 5L-(, S(� T lie minimum km•ch;trp' fora "ti.%cd fcc" permit
(Office Use Only) Lam/ ` is ��, bt .inuin0 1, 2010
This Application Becomes Your Building Permit When Approved Paid . I t
Date DU I L // �',4 PERMI F
Hulldine °akiol Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
o Rtp� Date Rec'd
s, CITY OF PRIOR LAKE PLUMBING PERMIT
r
(r' ii-o16/
1. alv< F�I� PERMIT NO. 5 _Q:
2 Oold Cny
3. Yellow Arelkunt
(Please type or print and sign at bottom)
ADDRESS ZONING (otrice use)
1 1 PDX C �w
LEGAL DESCRIPTION (office use only) PAID WITH
BUILDING PERMIT
LOT BLOCK ADDITION PID
OWNER \
�j( vh \
(Name) "` ``�,k I■IreA ., Lc1'1U (Phone)
(Address) 1 - " J ` 4 t t1 ,-x V , C4. v ui / R i \i Y z ,_ ` ' l ` 33 -);-
APPLICANT
(Name) - a - C (Phone) C I S a• c n��
(Address) 3 A D k 13 Vim ` I k. c) R i\Q � � � J) --
(Ad ss (City) (Zip Code)
r > {{qd
(Con tact Petson)1 �(1 �- k� a \A (Phone) a , h o - ` l 0
APPLICANT SIGNATURE VA. )I � IB e li,l 1 k, % DATE 5 13
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity _ Type of Fixture _
Q Bath Tub with or without shower Rough -ins
Dishwasher 1 Water Heater
Floor Drain Water Softener
3 Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (I or 2 compartment sink Sewage Ejector
�? Shower Stall Backflow Assembly
l Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
?, Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi- family I% of job cost with a $49.50 minimum Residential, New One & Two - Family $149.50
Residential, Additions & Alterations 549.50
The Minnesota Statutes *32611.148
1st $ (04 90 , Building Permit #
"SURCI1ARGE" has been changed for one
year effective PLUMBING PERMIT FEE $ t tiC S11)
July 1, 2010. anti! June 30, 2011. STATE SURCHARGE $ SeA') --56
Thr minimum surcharge for "fixed fee" permit TOTAL PERMIT FEE $ y - 1
is u , beginning July 1, 2010 l " 4"SA1
Thls Application Becomes Your Building Permit When Approved Paid Receipt No
PAID IDWITH
Date BUIL PERMIT
Building Official Dale
24 hour notice for all inspections (952) 447 - 9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
A �� r.
CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
7 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT /
� `VNE s °�� ' l U � . G /.> /(-e /
I. White File
2. Pink city PERMIT NO --t
. f / 7� Z 2_
3. Yellow Applicant 1 .. r
(Please type or print and sign at bottom)
ADDRESS I L(3---1'2 P b.,421C-S t D G LQ v 4?'t ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT ' BLOCK 1 ADDITION � � 2 S LI Pv' t rJ T PID
OWNER
(Name) ;'1 P. -1-- i P. t -14 0 NI ES (Phone)
(Address) 12a 1 W A S 1-E i t`1 t ir, i-1 A v' E S S 2-cp ( t=.D t t-t -P }--t N SS 43 9
BUILDER
(Company Name) 4-T i/ t - t — i yv t`"' ES (Phone)
(Contact Name) S u t< B.R (Phone)
(Address) 1' t 1 tk S 4 It-4 r.'ttit....i A vE. S S'1_ Z I 1=o t N■ A H t�1 SG 3)
TYPE OF WORK $ New Construction E. beck ['Porch ❑Re- Roofing ❑Re- Siding Lower Level Finish ❑ Fireplace
['Addition ['Alteration ❑Utilit Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F III MR S U PROJECT COST /VALUE $ 1 S 000 -
Division: 1 2 3 4 5 (excluding land)
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 upon the property to perform needed inspections.
x---_--- 22 r c BC- Zc 5386 is 15
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ 6,, 2 Z S - SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ d 0 Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ 4/ S Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 1 17. 75
'/
This Application Becomes Your Building Permit When Approved Paid (( - i) Recylpt No. l k ' '° i S C
Date y-, 14 /3 Bye'
Building Official Date t
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
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
P Rio CITY OF PRIOR LAKE Date Rec'd
01-0---;,4) � HEATING /AIR CONDITIONING/FIREPLACE PERMIT
, r3 , I lig i 3 — ( Co (
4 1, Mnk Fiie PERMIT NO. /3 _ /) Z9 v
2. Csreen Cily
1 3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
1 13 7 Pad 6'2''
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) (' n� (Phone) q 4'.2 -- -42547 — Stee
(Address) 7 1 �,, C�1h.¢ ) �( t d 1 3"C' - 39
APPLICANT HEARTH & HOME TECHNOLO
(Name), e a - r • . _ 3 ne
Lic 662656
(Address) 27(10 FAIRVIEW AVENUE N
(Address) ROSEVILLE, MN 55113 (City) (zip Code)
(Contact Person) tit-- 651.633.2561 (Phone) l o ( ` Z - - 36 7 Z 1 ?1 •
APPLICANT SIGNATTURE, fL 4c'nc,---
DATE 1 7 3
APPLICANT PLEASE COMPLETE BELOW
NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT .
PLEASE NOTE: Air Conditioner
['Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
El Gravity ❑ Hot Water
❑ Mechanical ❑ Radiation into Required Side Yard Setbacks.
❑ Air Conditioning Fireplaces with Box Additions or
g ❑ Special Devices
❑vent. System ❑Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL i 5 L re 7 /Q - 2- . Tw
FEE SCHEDULE
Industrial, Commercial & Multi - Family 1% of job cost Residential, Gas Fireplace $49.50 •
$49.50 minimum
Residential, Heating & A/C (New Construction) $14930 Residential, Additions & Alterations p �>) Wi .50
Residential, Heating Only (New Construction) I $64.50 Residential, AC Only I � 4�I"� .
Estimated Cost $ 11th. oc) Building Permit # BUILDING ��t
The Minnesota Statutes § 326B.148
HEATING PERMIT FEE $ "SURCIIARGI:" has been changed For one
year effective
STATE SURCHARGE $ .50 duly 1, 2010, until June 30, 2011.
TOTAL PERMIT FEE $ The minimum surcharge fora "fixed fee" permit
(Office Use Only) is SS beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Rulldine Official Date •
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372 .