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HomeMy WebLinkAboutBuilding Permit 12. 1024 12 1324 & rfifirafr of (1�rrttpattr r CITY OF PRIOR LAKE Prilarfluttlf of uUUMtug c 3u s y rxflint . j ❑ Final Permitted ❑ Conditional C.O. Expires � � This Certificate issued pursuant to the requirements of Section 110 of the ❑ Residential / ❑ International s j Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City of Prior Lake regulating building construction or use. For the following: — Use Classification S I Ng F FAMILY Bldg. Permit No. 12-1024 ' Occupancy Type R3 Type Construction Zoning District r `�!� ' Legal Description L45, BI , JEFFERS WATERFRON Owner of Building Site Address 14 367 PARKSIDE COURT - -f" Contractor's Name & Address MATT AMY iY HOMES _ ROTERT D. l�JTCHIS % ' . City Planner . . Buil: ing Official �'. Date: Date: • > POST IN CONSPICUOUS PLACE y 9uti y nt „q u , a , . w i i r , �. a ,, i, a •.i %,N y :„ ,' A t�� ,.. c{ 'E is 1 ti: , i �2 '.. 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QS 0 4c() I d \k M z a k ■ 0 § 2 B B 0 2& �k 2 k ��� � � Xceit § rt re et U w "' ■ § = 0 § / ti 0 § 111 0 �2u2iZ 0-_ 0 a 0 < 0 a 000000 0�: 0 c �4 rKrp CITY OF PRIOR LAKE BUILDING PERiMIT, Date Rec'd ti TEMPORARY CERTIFICATE OF ZONING COMPLI -ONCE 3 I Z t» AND UTILITY CONNECTION PERMIT r r -NES- See M .File I. White File 2. Pink City PERMIT NO. f Z . f b4- 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS l 1 1. > L Pts,-TL>L` ., l O t= C 0 u f ZONING (office use) ( LEGAL DESCRIPTION (office use only) 1 LOT t- (SBLOCK ( ADDITION JE w-F-ea A- v--° ^t T PID 2-54 04SO OWNER (Name) Y't A'F i M `t -14 0 N1 e- S (Phone) (Address) IN A S N- t tJ 6 — i-1 A ye S S 20 l t .Ott .1- H t S S 4 3 9 • BUILDER (Company Name) M' 1 k o t`"t ES (Phone) (Contact Name) S v E- (Phone) (Address) 1'2 t t... P' s 14 ti (.'I-UN va S 5'E- w t 1 -O t t., N. t-, t--.1 SS439 TYPE OF WORK 0 New Construction gpeck ['Porch ❑Re- Roofing DRe-Siding ['Lower Level Finish ❑ Fireplace ❑Addition ['Alteration ['Utility Connection CODE: I.R.C. ❑I.B.C. ❑ Misc: Type of nstruction: I II III IV V A B 140 , p a Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE > 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. g(.1)%.4.` -F: •e ?:)6/ 21 3'1 S3 B 0 - 29 — V2— Signature Contractor's License No. Date Permit Valuation t 55, o O o - Park Support Fee # $ Permit Fee $ t 3 g S S p SAC # $ 2- 3 ',5. - Plan Check Fee $ S Water Meter Size 5�'; 1 "; $ ,4 State Surcharge $ 1 5-0 Pressure Reducer $ (Zp_ - Penalty $ Sewer /Water Connection Fee # $ t S-JU. _ Plumbing Permit Fee $ ( 5 4 ^S7=, Water Tower Fee # $ (OW Mechanical Permit Fee $ (5-4,v Builder's Deposit $ ( cco - Sewer &Water Permit Fee $ SCP -10 Other F. t e 6 c ea ( $ , ( >j 4 •SZ, Gas Fireplace Permit Fee $ 5'4 C, TOTAL DUE $ 9/ 099 7[3 This Applica i 1 n : c• Y • ur : uilding Permit Wh App ved Paid < s q - "I Re pt No. IP -4 / 0 ■ / J Date /D. 8/- (L B i .41A 11 1 . uilding Official ' ate This is to certify 1 t the requ7 t „ the above application and accompanying cum is is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signed b . e C P • t co :tutES a temporary Certificate of Zoning comp ance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. f 7 Ad A- CI ( ( , 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 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd im TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMMIT /i. 3 • I Z +Almicv I / ivt-: -- k✓ /1. /d 2 1. White File PERMIT N Z. City 1 2 . type or print and sign at bottom) ADDRESS 1 6-- A S i O F- LT ZONING (office use) LEGAL DESCRIPTION (office use only) ' - LOT L IS - BLOCK I ADDITION cJ FE a-s VvAw---4 v PID OWNER (Name) i n' T T N- M `t' -1-4- 0 M ES (Phone) (Address) - 12 c5 l IN A S H- t T E1 I-1 A v E S S 7_ i r=.0 t t -N I iU S S 1 l 3 9 BUILDER (Company Name) 1 -T Pr i 4- + 0 tI ES (Phone) (Contact Name) S v t= E, \R (Phone) (Address) 1 l 1,.. A; S 14 li\, c, .1 Ao., 5 STS. 2_U t 1 O t tv e� H Q SSLI , TYPE OF WORK New Construction [ 4Deck ['Porch ❑Re- Roofing ❑Re- Siding Lower Level Finish ❑ Fireplace ['Addition ['Alteration ['Utility Connection CODE: ❑LR.C. ❑I.B.C. ❑ Misr. Type of Construction: I II III lv V AB 2� o 00 r Occupancy Group: A B E F HI M R S U PROJECT COST /VALUE $ 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 . -.�.1 ■_. FCC, 2031 532)b t t •9 I t 2 Signature Contractor's License No. Date Permit Valuation 3 i U O v , U Park Support Fee # $ Permit Fee $ 7'4 75 SAC # $ Plan Check Fee $ Water Meter Size 5/8"; 1 "; $ State Surcharge $ /_ 50 Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ , 4I _s Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE $ /30. 75- This Application Becomes Your Building Permit When Approved Paid / 30 , 7c Re ipt No. , / `6 0 Date /L,, 4p ., L. - By ., Building Official Date 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 Contractor's Material & Test Certificate for Aboveground Piping PROCEDURE Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall be corrected and system left in service before contractor's personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is understood the owner's representative's signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PROPERTY NAME: JEFFERS POND DATE 3- g -/ 3 PROPERTY ADDRESS: 14367 PARKSIDE COURT ACCEPTED BY APPROVING AUTHORITIES: CITY OF PRIOR LAKE ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS OYES ONO EQUIPMENT USED IS APPROVED RYES ONO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN It ISTRUCTED AS OYES ONO TO LOCATION OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? IF NO, EXPLAIN INSTRUCTIONS HAVE COPIES OF THE FOLLOWING BEEN LEFT ON TH REMISES: ` OYES ❑NO 1. SYSTEM COMPONENTS INSTRUCTIONS !°' ■= YES InNO 2. CARE AND MAINTENANCE INSTRUCTIONS YES ONO 3. NFPA 25 YES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2011 1/2 11 155 SPRINKLERS RELIABLE RES 44HSW 2011 1/2 15 155 RELIABLE F3QR 2011 1/2 1 155 PIPE AND Type of Pipe BLAZEMASTER FITTINGS Type of Fitting CPVC MAXIMUM TIME TO OPERATE ALARM DEVICE THROUGH TEST CONNECTION ALARM VALVE OR FLOW INDICATOR TYPE MAKE MODEL MIN SEC FLOW INDICATOR POTTER VSR - F DRY VALVE Q.O.D. P4KE MODEL SERIAL NO. MAKE MODEL SERIAL NO. DRY PIPE TIME TO TRIP TIME WATER ALARM OPERATING TEST THROUGH TEST WATER AIR TRIP POINT REACHED OPERATED CONNNECTION" PRESSURE PRESSURE AIR PRESSURE TEST OUTLET` PROPERLY MIN SEC PSI PSI PSI MIN SEC YES NO W/O Q.O.D. WITH Q.O.D. IF NO, EXPLAIN LOCATION MAKE & SETTING STATIC PRESSURE RESIDUAL PRESSURE FLOW RATE & FLOOR MODEL (FLOWING) PRESSURE REDUCING INLET (PS» OUTLET (PSI) INLET (PSI) OUTLET (PSI) FLOW (GPM) VALVE TEST N/A • OPERATION: ❑PNEUMATIC El ELECTRIC ❑HYDRAULIC PIPING SUPERVISED OYES ONO DETACHING MEDIA SUPERVISED OYES ONO DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE OYES ONO CONTROL STATIONS DELUGE & IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT IF NO, EXPLAIN PREACTION FOR TESTING VALVES OYES ❑N N/A DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO MAKF MOfFI SLIPFRVLSION I O.SS Al ARM OPFRATF VAI VF RFI FASE OPFRATF Fl FASF YES NO YES NO MIN SEC HYDROSTATIC: Hydrostatic test shall be made at not less than 200 psi (13.8 bars) for two hours of 50 psi (3.4 bars) above static pressure in excess of 150 psi (10.2 bars) for two hours. Differential dry-pipe valve clappers shall be left open during test to prevent damage. All Aboveground piping leakage shall be stopped. TEST DESCRIPTION PNEUMATIC; Establish 40 psi (2.7 bars) air pressure and measure drop, which shall not exceed 1 -1/2 psi (0.1 bars) In 24 hours. Test pressure tanks at normal water level and air pressure and measure air pressure drop, which shall not exceed 1 -1/2 psi (0.1 bars) in 24 hours. ALL PIPING HYDROSTATICALLY TESTED AT 200 PSI FOR 2 HRS IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED OYES ®NO EQUIPMENT OPERATES PROPERLY OYES ONO N/A DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OF SODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? OYES 1 DNO DRAIN READING OF GAGE LOCATED„(1EAR WATER RESIDUAL PRESSURE WITH VALVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION 1 PSI CONNECTION OPEN WIDE PSI UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THE U FORM NO. 85B ELVES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING EVE S ❑NO IF POWDER DRIVEN FASTENERS ARE USED IN ■■ YES ONO IF NO, EXPLAIN CONCRETE, HAS REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS 0 WELDED PIPING OYES ONO IF VFS DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR-3? RYES ONO WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN COMPLIANCE WIT — HE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR-3 EVE ONO DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISC ARE RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF PIPINP� ARENT PpNI<TRATED ?- OYES' - ONO CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS (DISCS) ARE RETRIEVED? YES CI NO HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA [EYES ONO NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: 3 -1?-13 NAME OF SPRINKLER CONTRACTOR: FIRE SUPPRESSION SERVICES, LLC. TEST WITNESSED BY ' R • NE' IGNED) TITLE DATE 74 SIGNATURES / �` ` ttc �/r8/j • - • ' IN •J• (SIGNED) TITLE DATE 3 - re-r3 ADDITIONAL EXPLANATION AND NOTES /9 -- CITY OF PRIOR LAKE BUILDING PERMIT. Date Rec' d . \ TEMPORARY CERTIFICATE OF ZONING COMPLIANCE _.... y ...., AND UTILITY CONNECTION PERMIT - , '\,,,,„,LL.L.__F:i-•.t.„/ --.-/ La (.4), (2 ... l d 2.._,,c--__( 1 PERMIT NO_ ADDRESS I 1 ZONING p , - - : __, P / 0 ,;,- i _ AgA...si 6 .,________,. .....: 7 ..________ LEGAL DESCRIPTION (office use orjy) L OT BLOCK ADDITION PIT) — ........:—.------------- . --- .------------- OWNER L A (Nme) r ‘AATA t•ki `OME,...... (Phone) c At .1 52... - B - _LOC) , Address) - 7 io t L k ) C k S i - k it4t.:".1 - , t \ i P L — ? BlatzaER C,Z,I,YOZroiL, ,'. Company Narne)r_igr,___6;,.„ - , 1%-i '. 1_,L-. . (Phone) 203 - - 7-1-7 - ai Contact Name) 1A._, OA NklEg., ____ ,., ,. ....„ (Ad4ress) II_UP____,SP-AOU' -nu" Li 1_ . - ,friK) — _— ' TYPE OF WORK 16Ncw Constracr,,n .072; 0 i`' : 1 0Re-Roofing 0Re-Slc mg DL'' Level Finish 0 F reriart Addltion 0: CODE: ei OI.B.C. %,!,,,,, .r i„ 0,6- Type of onstruction: I 11 III IV V A B .„---, 7, Occupancy Group: A B E F R 1 M 1 S ti PROJECT COST/ VALUE $ , f- - --: )2 -1 k--: C Division: 1 2 (3> 4 5 (excluding land) 1 ;•••t-.•!':-. :,••..r.: •hvr. 1 st have furrisi :riforri,•; -:./.. "71 arp;',,:v‘ whIch v: %".- trei rt of my kni,IW :4,7 ::-_^ . '..:' . —_', ' 1 1. mut: :hat 1 am the . or 41.1*.hr•p:m. age-nt I-;- Ittf , i-z - - -: !r. .r t.-3 7-17::•7Y and that an ri-,F,!tr;: • r , . ; .,, f,77; - - ,',.. :‘,-17.2 and 1ca1 :as ,- .: , , • : •- • • .... • ,-•...- ,.'•!, y;t-mitted rJars 1 -F.r11 awitFe '44: 7.ht ,s ! 1.'r', ''.■ ..: ", ! 7.<" :.1.5t C'AUIC F .7*H""'. - ' rt".- ,..-,-,.., - :- - ,,, : :- ' , :il' a ‘.ki: r - t '' • - ' :' - ' ' :-.` ." '-'-' : -' - , lecdtd :11.5.21c1:•.7,r,s 1 X , -- 4 ;,. , 14--r,„ 04J-cA/vtiki ____ — s,,,r, Cf':.'.7'..... '' 5 :„.c N-.3 — Fnn! Valuat:s,n Park Support '.7. 5 . :., . ; SAC : Fan Che;:k Fee i 5 ..1!tr Mete: S;ze '3 Fl 1 -, S I , . i ,— -- State SuNharge 5 rt..:,,:t.. :.,..•,::.,:t ' $ Fena:r: i $ — - : ,.,,,. : ".'-' .v:..: ."7.onn11or, Fee ti 5 Plun Perrnit Fee . $ ' 1 .',`-‘r•.-- Tzrss -.7 i'•.:•.: :-.` ' S , Permit Fee 5 , Fi-tnNet'5 'Pero::: i S I , 1 Sewer S4, Wsler Permit Fee ; S Other $ -- Gas Ftrepta:e Permit Fee s — . 1 TOTAL DUE i Thi p re ' .13 . antics Your Building Permit liVit Approved—I PAO At - / i T-Fald i Dale ; _ y - . • ,1,, ,..., A •.T 1/ / e-1 _ *.'PA41.1.• Ult.'7 Oftictai 1 ThiS 3 tc- 3133 thl reV-IC33 In the abttve arplz,73Wn iIrd accmipanFIrg n!...2,7,ZICE3 3 ir 1-"Zitt :!,...ncr„ wtth !r.: i'r.... Z:.,T•xv, u,-1,r,,,,,, ,,,,,t E - 1 ,, nfc ., ; ,, : ,1 .a ,...„ -7,-„, 1 ,,Olza signe-,1 ti z.;.-:: Ctri Flar= o7 a teinp-zraty CeraftcJrse cif Le. i:rturilance a .1.:] , .',' , :' , .'1 , 1M,Ir.;:r 3e0Te o-o_ur•aric 3 Ctr::::, ,.•,•:. ( .., , c.. , .:r•17-1 - •,,,,,, i F3nving Dircoar MItC — St“:,:i 2-4 hour notice Cor an inspections (952)44 ft (952i 447-4245 From:Genz -Ryan 952 767 1900 10/17/2012 15:39 #657 P.008/O „ 4 Plop Date Recd ° ' " � CITY OF PRIOR LAKE PLUMBING PERMIT IliA 4-41 xso"tt' r, arse , i. s. saga err PERMIT NO. :t. Yellow Amlkmx y • Meese type or print awl slgn at bottom) ADDRESS 1 ZONING ware use) 19 3(07 ?rxv 1 ta,.c. (. IA\nl LEGAL DESCRIPTION (office use only LOT BLOCK ADD UON PID OWNER (Name) (Phone) (Address) APPLICANT (Name) GENZ -RYAN (Phone) • (Address) 2200 TGHWAY 13 W , BURNSVILLE, MN 55337 (Address) (City) (Zip Code) (Contact Person) �L.iN lAt - - f , (Phone) 952 - 767 -168 APPLICANT SIGNATURE A A. 14 .I —.t DATEy.© 1 1 71 1 Z- APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity �' Type of Fixture F Bath Tub with or without sb.ower _ Rough -ins t Dishwasher w -_ Water Heater },. Floor Drain ` Water Softener t.•) 41 w Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink _ Sewage Ejector Z. Shower Stall Backflow Assembly i Sinks Baekflow Assembly Test _ `-" Bar Sink Lawn Sprinkler 5 Water Closet (Toilet) Other FEE SCHEDULE. ��L:- A •, F .. ,: �, ,..., Industrial, Commercial & Multi - family I e of job cost with a 549.50 minimum �, v tdcntial Ne�V Sub 8eiiygl? gitly,;�,�. ,i p ;;,a`� s� �� Residential, Additions & Alterations 349,50 The Minnesota Statutes 32613.145 —1st S __.. Building Permit # ,�•�_ PAI WITH "SUURChIARCTG” has been changed for one ��� D%NG PERMIT year effective PLUMBING PERMIT FEE $ ` L July t, 2010. until June 30, 2011. STATE SURCHARGE $ .50 The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ t ne). d o is 3i, beginning July 1, 2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Bonding Official bate 24 hour notice for all inspections (952) 4479850, fax (952) 447.4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 • From:Genz-Ryan 952 767 1900 10117/2012 15:39 #657 P.007/00L ! „I PR04) CITY OF PRIOR LAKE Date Rec'd . HEATING/AIR CONDITIONII1G/FIREPLACE PERMIT 41 40/Esoo I :It. tit PERMIT NO. 3. Yellow Appllemil (Please type or print mad sign at bottom) ADDRESS ZONING orsce use) 1 6\.\1--•.\cle, C. LEGAL DESCRIPTION (orrice use only) LOT BLOCK ADDITION PID ..._ OWNER (Name) (Phone) • (Address) . APPLICANT - (Name) u-lr,YNr_ , QM (Phone) • (Addressf2ZOC) \.1..) r Y)L2y2f . • c\irsa .. ren i (0 ) , _ (Zip Code) r• ---. (Contact Person) 1 OA V , (Pone) 92 76 APPLICANT SIGNATURE ea.AdO ‘A.A ..L..t . .A DATE 10Mill P Zg BW CONSTRUCTION A PLi PLEASE COMPLETE BELOW 0 REPLACEMENT 0 ALTERATIONS ■ • FURNACE MAICE AND MODEL q17.1-171.4..05r1 FUEL FLUE SIZE RE OPENINGS A INPUT BC 0 OUTPUT ..33 i TYPE OF SYSTEM HEATING OR POWER PLANT : PLEASE NOTE: Mr Conditioner OWarrn Air Monts 0 Steam Units and Fireplaces Cannot Encroach , OGravity 0 Hot Water into Required Side Yard Setbacks. F Z1 Mechanical 0 Radiation ls, it Conditioning 1:3 Special Devices Fireplaces with Box Additions or 8 ;,: ent. System 0 Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL FEE SCHEDULE Industrial. Commercial & Multi-Family I% ofjob cost Residential, Gas Fireplace • $49.50 ' kislien Aligarni Residential, Additions & Alterations 349.50 Residential, Heating Only (New Construction) 264.50 Residential. AC Only 249.50 Estimated Cost $ Building Permit N The Minnesota Statutes i 3265.148 . "St JRCHARGE” lass been changed so HEATING PERMIT FEE $ 141, for one rin year efibctire STATE SURCHARGE $ ...50 July 1.2011). until June 30. 2014. TOTAL PERMIT FEE $ i pi), 00 The minimum toweharne Sar a "Med ke" permit (Office ting Only) isl,S bestowing July 1.2011 This Application Becomes Your Building Permit When Approved Paid Rilkitywrmi bate Date BOWING PPRA411 Building Meld 24 hour notice for all inspeedons (952) 447.9850, fax (952)447-4245 4646 Dakota Street &E., Prior Lake, Minnesota 55372 . ...... . _. ........_......._......____........................._ ...... .... .. .... _..... ...._.... _. .....--_ - .............. ........... _ ._..............— .. . . ..... PRI° 4) Builders Deposit 4'IlvvES9`v, City of Prior Lake A $1,500.00 Builders Deposit is included in the Building Permit fee. The Builders Deposit is issued as security to insure compliance for a Final Occupancy Permit. (It is not an escrow account.) All exterior items including but not limited to grading, sodding, landscaping, tree planting, driveways, siding and painting shall be completed 180 days after the date the building permit is issued. If the work is not complete within the 180 day time period, the City shall notify the applicant of the violation and the applicant shall have 10 days to comply or the $1,500.00 builders deposit will be forfeited and the applicant will be billed for clean up or corrective work to rectify the situation. A $500.00 Tree Deposit may also be required and will be refunded if specified trees are preserved for a period of one year. By signing - this I, the undersigned contractor, acknowledge that I am aware of the erosion control requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors handout. DATE: ° _ - _ 12 SITE ADDRESS: \`k u--u -S D E C PERMIT #a REFUND TO BE MAILED TO: 1" - AY - TM F 41 o E 12 o f w A S 1 1.1 6m tv PI V F S Sv 1 Zo l l hl 1s M tai SS 43 9 PLEASE REMEMBER 1. KEEP STREETS CLEAN DURING CONSTRUCTION 2. KEEP EROSION CONTROL IN PLACE I .. - �.__ ►_��.�_.�_s _ - • - � . � ... i � _• - ia■ AUTHORIZATION TO RELEASE SIGNATURE: �`—`— I� COO, OU a S. Allen, Building Services Acct. 801.20204 Date C:\Documents and Settings\sbare \Local SettingslTemporary Internet Files1Content .Outlook\BD80XI9A\BUILDERS DEPOSIT FORM.DOC P R I R LAK DEPARTMENT OF BUILDING AN S bee INSPE RECORD SITE ADDRESS gal / 1 • NATURE OF WORK 1 Jj j /; 10:1 USE OF BUILDIN PERMIT NO. r DATE ISSUED CONTRACTOR S I T . ' V ,LI rl ' PHONE NOTE: THIS IS NOT A PERMI FOR ANY OF THE INSPECTI NS BELOW THE PERMIT IS BY SEPARATE DOCUMENT Install erosion control & maintain clean streets rill times. mum I FOOTING j 1 1 FOUNDATION (Prior to Backfill) 1 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED Radon system under concrete slab mrH - INS SEWER / WATER /SEPTIC FRAMING ( Q� . 71 INSULATION / 3 03 ELECTRICAL PLUMBING �/3f;. HEATING (if required) FIREPLACE (% / GAS LINE AIR TEST / 14 ' ;44 . , Zadon piping COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED system, I Housewrap 1 1 Fire Sprinkler a { G „FINALS,, /' 1 GRADING (Prior to Sodding) BUILDING1., " tt Aid /0/7/3 ELECTRICAL PLUMBING HEATING Q l j 2 - 2if 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