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HomeMy WebLinkAboutBuilding Permit 12. 1424 X, � 4 f t d Nf 1„ :: rr rrV r _ „,; IY , -m r . ru „ ..„ . r o r lr rr; "" ••n ` v O Wa ti M,k a ✓' - u t _. ri .Vin n V �u rl. Vh i � t �: A H uurM`� � � nY�� I�� uVVI �? I c. Vr r; r YY -. . u ._ ic.`rl .a� � rG i _. ``. � ' -: it . . ' LLrftffratr 1 f ®rru nnw CITY OF PRIOR LAKE prilarfntettf of PuUU zn c1n rrftut Final Permitted El Conditional C.O. Expires This Certificate issued pursuant to the requirements of Section 110 of the ❑ Residential / ❑ Inte r � Building Code certifying that at the time of issuance this structure was in compliance with the various ;err ordinances of the City of Prior Lake regulating building construction or use. For the following: Use Classification T � rti Bldg- Permit No (� 7 _ `) [ ` i C Occupancy Type Type Construction / Zoning District P' ID Legal Description 9 q L7 rt.! Owner of Building /� O q ?� c�+ r n p Site Address �`�'� pQ`)I �C.'!.�f`,T �;� Contractor's Name &Address M 9 11 N :i ROPERT D. 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CO c O g C S 2 0 O_ VI O 0 V 4. v , 0 w z�z z �i -� U ~ W j N 0 0 2 =w a 0 O WQ j pV N a0 a �3v) a� ww ww w x k 000000 z ^ 1 a a u 0 . _ l " p J ~ cc z Y ^ O Q V 0 U. w v ` U O v O z a. r. H z _ z W `, y a 0 J O tt w in a w F- g m O4w 2 � Y i u L ' i q IX 0 et t$ V C z P. • • j - ic I- ,, : w p Z 0 � ' O O O V ca 0 u.u 0 3 v v �' �? a 0 a 0 000000 0 1 0 " _ (...)--1? {\ CITY OF PRIOR LAKE BUILDLNG PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT n r `v1Y E S O Se e I. Pink File City 2. PERMIT N O. 2 Pink 3. Yellow Applicant • (Please type or print and sign at bottom) ADDRESS 1t-1.3 2— 1- -Y-'-S ► h C____ $-\/ ZONI G (office use) LEGAL DESCRIPTION (office use only) I ^ LOT BLOCK 1 ADDITION i E F 2-5 `� " '�''- R-.12- PID 2-S 4 S 0Z$ 0 OWNER (Name) t'1 P T T P. M `t' 44 U M S (Phone) ( Address) '12a 1 W 14 t 6 tl A lie S S'Tl =. 20 t e.o t t.,1 H N SS 435 BUILDER (Company Name) M k-—A4-1 v 4+0 i"' ES (Phone) (Contact Name) S u E 8 > (Phone) (Address) 12) t , k S 1 li - rv.--) P IS S ST 2_0 t >=A t t ■J 4 P-11...1 SSq 39 TYPE OF WORK % New Construction (Deck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ['Addition ['Alteration ['Utility Connection CODE: ELR.C. DLB.C. ❑ Misc: Type of Construction: I II III IV V A B Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ 1 3° , 0°0 Division: 1 2 3 4 5 (excluding land) I hereby certify that I have furnished information on this application which Ls 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:: , z_ BL ' Saab 111%.12- Signature Contractor's License No. Date Permit Valuation 13 to t p p ®. _ Park Support Fee # $ Permit Fee $ l7-9.(a . 5 O SAC # $ Z 365. - Plan Check Fee $ g S 1$ Water Meter Size 568 "; 1 "; $ q go , - State Surcharge $ 6 $ • Pressure Reducer $ 1 Z. o. - Penalty $ Sewer /Water Connection Fee # $ (5 00 • Plumbing Permit Fee $ 15 So Water Tower Fee # $ I c on.. - Mechanical Permit Fee $ 1 S 4 So Builder's Deposit $ (Soo. Sewer & Water Permit Fee $ 56.50 Other C- (P.6 SC vva&Skr $ k5 So Gas Fireplace Permit Fee $ 5 TOTAL DUE $ 91 Z q 8 This Applic on B o Your Building Permit When Approved Paid r �� Recei • t N. / �� Date / pa i 2— By f. vow 1 2 (2/2.- / Building Official Date This is to certify .j. t the request in the rove application and accompanying documen is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signed by of City • . er onsti � s a temporary Certificate of Zoning mp ' ce and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. t2. I L 12 Pl.. niaglAirector 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 �� ►." \4 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. (n� PROPERTY NAME: JEFFERS POND 1 `f'.,.ks: e DATE 6- 3 PROPERTY ADDRESS: 14382 PARKSIDE COURT ACCEPTED BY APPROVING AUTHORITIES: CITY OF WOODBURY ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS OYES ONO EQUIPMENT USED IS APPROVED ■ YES ONO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED 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 THE PREMISES: OYES ONO 1. SYSTEM COMPONENTS INSTRUCTIONS EYES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS OYES ONO 3. NFPA 25 '= YES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2012 1/2 11 155 SPRINKLERS RELIABLE RES 44HSW 2012 1/2 16 155 RELIABLE F3QR 2012 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. MAKE 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 (PSI) OUTLET (PSI) INLET (PSI) OUTLET (PSI) FLOW (GPM) VALVE TEST N/A OPERATION: ❑PNEUMATIC ❑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 ONO N/A DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO MAKF MODFL SI IPFRVISION I ()SS Al ARM OPFRATF VAI VF RFI FASF 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 (8.4 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 PSI FOR _g_HRS IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED OYES ONO EQUIPMENT OPERATES PROPERLY YES 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? BYES NO DRAIN READING OF GAGE LOCATED N R WATER RESIDUAL PRESSURE WITH ALVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION L 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 OYES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING YES ONO IF POWDER DRIVEN FASTENERS ARE USED IN BYES 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 VIPS DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR-3? EVES ONO WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3 EVES 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 PIPING ARE NOT PENETRATED? EVES ONO CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS (DISCS) ARE RETRIEVED? YES ONO HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA YES ONO NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: 6-5 — i3 NAME • SPRINKLER CONTRACTOR: FIRE SUPPRESSION SERVICES. LLC. TEST WITNESSED BY F ' ' • ' ! - (SIGNED) TITLE DATE / SIGNATURES • R SP - 1 i RACTOR (SIGNED) TITLE DA E amb,I.1K ►� vr,. —13 ADDITIONAL ADDITIONAL EXPLANATION AND NOTES 70(9 06-20-'13 14:09 FROM- T-383 P008110001 F-590,10 7R1°4 cr1y OF PRIOR LAKS Date Reed A. 1 HEATING/AIR CONDMONING/PIREPLACE PERMIT 1., tolz,€) ((j: 0 PILRYI 1. Whew Anima , t EIWS ‘ t 1 t EL il 0 • _ . • . ,...AL N i ' A 0 ..- ....,: i : LEGAL insatirrioN omo, use on110 Lar_ilLA jVBLoac ADDrnoi4 3,e. CYS toot 4 Pm 075 7e- DV- 0 7 tvlativeng Nolint (Phone) : • • (Address) '*7 a . 111 1.t's 1444DVile • 'Oho* OW =1213:b7/2/ , -, (Addres) 1 •-•- 0 — Y 1 s -- :ilk l' k Olk, ih. 1 t . deer 1 3 _pp (Aide* Oh (*We) • (Comet Person) 4 ‘ . , ) (9 13 1- (037 I Z- • • APPLiemr skaNATuRB . 4441 ,90" DATE APPLICANT PLFASE COMPLETR BELOW ' • a‘V COtISTItliON REPLACIWENT ALTERATIMS • FURNACE MAKE ANO MODEL FUEL FLUE SIZE RETURN Ceet4D13S INPUT ourpor . Ilya OF SYSTEM IMMO OR POWER PLANT — PLEASE NOM Air Coma:donor • MU Alt Phew theere Mike and Pkoplasee Cone Encroach into Required Side Yard Setbaeb. loaximaled Itadbilloa • ir Coadltiesial 0 Special Devices Fireplaces with Box Addition, or • eat System 0 Other Device: Cantilever, to the Oatdde of EAU. Reap*** Indldlog Poragt. • FIREPLACE MAKS AND MODEL 1-..S5C) ...somar- FRS SCHEDULE baffle!, CoGetaatelai k Meki4nagiy Mogen oust Resideatlea, Oat Pitiplees • $49.S. • $41.30 =barmen Rasdeatiat, Heads* & A/C 04CW ODailttiefiell0 $149,S0 • IteMentiet. Addithee & Aherefieas SOSO Reakkonal, Haft Ceti (blew awahhesicia) $6410 Methods& AC Only S4930 Estimated Cost $ Mans Pena& # • The Minnesota Sown f TM. MS litIRCHAR08" bee bees ehespel lb/ este HEAritio PERMIT WE $ you ofthetive MATE SURCHARGE $ a AO I. IMO. *MR Jane X NI I. TOTAL rnivor fl $ Tie arkdisee =Oar. kir 1 ikod OW povill Offlos LW OW k fd. begieniag Ady LUIS Tide AppHcallon Ensues Your Bing Permit Whoa Approved Faki PAID Dm F3UILDMMPERAMT lkilkilkalbentist lkite : 34 hoar notice tor al Inspections (012) 447-0611, fax OS* 4414114d 4046 Dakota Street *Z, Prior Lake, minoesata UM .................___________________ ____...............................•...........•• • •••• •••••• ■•••• .11.0 •••••••••• .... •••••••••••• ••• ••••••■••••••• .• • •••• •• • ••• r 1 --,-, --- ,:::,- , , E., p ,-, r-p ----, LL,' CITY OF PRIOR LAKE BUILDING PERMIT. ' r 'Lj / "-" ' ' tot' a tt itec d n < 1r ..R.. .-- , il I) '1 'I'EMPORARY CERTIFICATE OF ZONING COMPLIANCE , - il 1 APR 1 1 2013 J1 AND UTILITY Y CONNECTION PERMIT 1,,Illiegirres' ,, PERMIT NO 2 • 4 A Pleasc.W.2.,_par Tint and si, • at bottom ZONLNG ADDRESS .. k 3S2 Rs' a-r ii.t.) , , , , I LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PIE) ..._....._ , OWNER 1 MATTek t` t'AORES (Name) (Phone) q5 2 - 2-1 / - 210C I --- Addles) — 720 k 0.)PiSti itsk.,-TON1 1\ ‘ C ,..„ ,. -411646PER. exAare,A4... ,,.. , , (Company Name) Ft Pe +.1r-PCPArt,../k SCAZA) Le...e..5 1 L,L-C— . (Phone) 1(c. - Z, 7 -8c (G O (Contact Name) hi b.:— . .". ,A., (Phone) ' (Address) 11 11D TioVv,,,s11 t csi— C.PZ/...1.6 NI W, SAir..._ 1-1 .E . *gi ' PtN 5-5 • 1 TYPE OF WORK New Construction °t) 0Potch 012.e-Ronfmg DRe lro.drr4 pLowor Level Ftrush 0 Fueplace ! Addition 0Alteration Cr-7olay Connect Kin CODE: XI.R.C. OI.B.C. 0 M c '., Type of Construction: I 13 111 IV V A B. . „.....„.„. ' 'i Occupancy Group: A B E F 14 1 1+4 lik) S U PROJECT COST/VALUE S 3;Z Division: 1 2 el) 4 5 (excluding land) i i heiehy cery.ly this : nave fuentshed information on thts applizatror. which .4 tv the hot of my knerabedgc true anci c. 1 a;-,,c‘ ;CA !ha I an. the oweite *7 zuthonzed agent for th above proper and that all construction 'tati 'conform c„.• ail 'g matt and tocal :}A'A and A..1. T :r. ec.scryr,rancr WIT? ccubemtord ittana 1 ant. aware that the hurt:tulle . oil',..7icat c revoke hi , r‘rrrat or ;nut-oust F urthermore 1 heteryy ar.et 'PA; t:te ATrA Off:CiAt Or k deognee - YAA'A , A,741 , 'ht 7, tit Pctf'orm nCed mriv tt1 : I J•lirrl a ''''' 1+5 'A S X ...IC . Signorine Contractor's License No Date , - PeernIt Valuarlon , Park Su;nport Fee # S r ----- - Permit Fee S SAC # i S i Plan Check Fee $ 1 - IN ore! Mete: S.1ze 1 State Surcharge $ : 1 ---- , Pressure Reducer $ , , Penalcy s 1 Sewer/Water Connect:Pet Fce # S .... l i i „ i Numbing Permit Fee $ 1 ',-Vater Tower Fee # . $ i Mechanical Pen Fee $ - r Builder's Deposit— 1 s t... 1 Sewer ea Water Pe Other rmit fee 5 i $ Gas Fireplace Permit Fee $ TOTAL DU , 1 E ?ND : c l a thk - c n g4(5. P This : ra: ,n, i __ :- cons Your Building P it When Approved r / y A/ Date Otereipt No, 1 BY 1 ,„,,ku_ tat Darr / 4 , . _ Thu. o to minty Inas tire request in Ulf above aripircation arid areorr,ranytna oyxurnents la In or ,roreance W101 thr C Zritur4 Orilinarict arid may potted as reverted Ths tixurneett I 'Atte) lapaet try the Ca" fisaanar AVAIrtittlAtl d temporary (.`ertfry:ate of Zitning ccittht,centr AAVi ai:orar coniir..iio.cr i', cnirohcsecit licfioe oceopah“ 4 CMCCoef , ,F 0C ;',.?.,ur he , usued 1 , — — — - — 1 Planning Darctot Date Spec lat Canclittont, ..f shy 24 hour notice for all inspections (952) 44 fax (952i 44/-4245 4646 Dakota Street SI_ Prior Take, Minnesota 55372 • 4 ••• :1" • • Date Rec'd ° , " per CITY OF PRIOR LAKE PLUMBING PERMIT ity,/ / ii:: 0 1 '11A��N. S 5�4P I Blue Fite O Z Gold City / PERMIT N _ / (� z J ]. Yellow Applicant I (PIease type or print and sign at bottom) ADDRESS ZONING (office use) I43 Pal tLL& C ,Y -km ?U ,5b LEGAL DESCRIPTION (office use only) �-1� /+� / /+ LCf' BLOCK) ADDITION �.l G+fr�..%, 61/.4-4,4144-1 4 obA) PID A - L/ %- Ooze -© O WNE R `� /� C 'n (Name) i lJ� ,�, � (� (�� �1Y .1 (Phone) . (Address) ( Nam e e) ._ � ! - A (Phone) s _1 / F j (Nam) �`] � ) �: L ;.11.. il � ■ "MI I ( [ C ,i..9 " (Address) d - A Vim- U....) ` �MJy ) 3 n 3( i l le 5S 33—) (Address) [ (City) (Zip Code) (Contact Person) ) v 1 r ( Ct( f YU S) 1 CO (Phone) -! J d - 70 7- 1 15.S - APPLICANT SIGNATURE M I 0 . LLB _ ■ I ti, 411 . DATE APPLICANT, PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Q Bath Tub with or without shower 3 Rough -ins 1 Dishwasher I Water Heater 1 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 I Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler 3 Water Closet (Toilet) Other FEE SCHEDULE Industrial, Commercial & Multi - family I% of job cost with a 549.50 minimum Residential, New One & Two - Family $149.50 r ��jjr� Residential, Additions & Alterations 549.50 The Minnesota Statutes § 326B.148 1st s l4( Buildin Permit # "SURCHARGE" has been extended until dune 30, 2013, PLUMBING PERMIT FEE $ it-1°1,5D The minimum surcharge for a STATE SURCHARGE S ,' (:)O "Fixed fee" perrnit is $5.00 TOTAL PERMIT FEE S 1 1 , ) This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By H4 PArD WF�ITFH natne om�lai Hate p � RI�e 24 hour notice for ail inspections (952) 447 -9850, fax (952) 447 -4245 BUILDING � 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 CITY OF PRIOR LAKE Date Rec'd O r C HEATING /AIR CONDITIONING/FIREPLACE PERMIT U� 'tf'NivESO ** ' P`nk File PERMIT NO. 2. Cue= city / J� -/ y 3 Yellow Andmat 7 /� (Please type or print and sign at bottom) I ADDRESS ZONING (office use) I L 6 P GV at (1)C,4 LLK) Pas® LEGAL DESCRIPTION (office use only) L0 1 BLOCK / ADDITIONJe eS /1,44 422) 6 4N Ai Proa 5-$ i9 -a, ( Name) 1v �- �� C C)! l V �J f ( " ` (Phone) (Address) . (Name) ANT G-- � Vq- alt.? ? u J k'a)11 o ) (Phone) 9 a (� f ) &fiiiz , i/2e (Address) V �� (J\ - H. WI / 3 �,�� _ (Addr s) (City) (Zip Code --IF --IF (Contact Person) A a �i $ s (Si a I (Phone) 7 Q ) 6' / � I APPLICANT SIGNATURE L! . t 1 . ® DATE b 4/ / 3 � . APPLICANT PLEASE COMPLETE BELOW (i CONSTRUCTION REPLACEMENT f 0 ALTERATIONS FURNACE MAKE AND MODEL T' CAi � y q) r g.3 I n J gv lcU J 1 FUEL N FLUE SIZE RETURN OPENINGS S INPUT (.4 66 I UCH OUTPUT J3 )' TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner Air Plants ❑ Stearn Units and Fireplaces Cannot Encroach ['Gravity ❑ Hot Water into Required Side Yard Setbacks. !.0 apical ❑ Radiation -. .nditioning ❑ Special Devices Fireplaces with Box Additions or ■ Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL FEE SCHEDULE Industrial, Commercial & Multi - Family 1% of job cost Residential, Gas Fireplace $49.50 $49.50 minimum Residential, Heating & A/C (New Construction) 5149.50 Residential, Additions & Alterations 549.50 Residential, Heating Only (New Construction) 564.50 Residential, AC Only 549.50 1f � / �C , ) fhe Minnesota Statutes § 326B.148 :ost $ C D4 r "IV Building Permit # "SURCHARGE" has been extended until June 30, 2013, H EATING.PERMIT FEE $ ', C . The minimum surcharge for a STATE SURCHARGE $ `j i (-) (j "fixed fee" permit is 55.00 TOTAL PERMIT FEE $ ( . SD This Application Becomes Your Building Permit When Approved Paid Receipt No. Date BPAID WITH Battles Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447.4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 o � PRio Builders Deposit t eVNEs0 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: SITE ADDRESS: ` _ 2 Roa. -s' o = C3 k1 J PERMIT # ' ( L REFUND TO BE MAILED TO: 2't - MY -N-o t—t ES 12-o1 t 6'ror.r •1ti/ S SV Zot t t� ti-t hl SS 43 9 AUTHORIZATION TO RELEASE PLEASE REMEMBER 4 1 , 500 .06 .y>,ida . Allen, Building Services Amount 1. KEEP STREETS CLEAN DURING CONSTRUCTION /0 Date '3 Acct. 801.20204 2. KEEP EROSION CONTROL IN PLACE 3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR $500.00 WILL BE FORFEITED THE FACE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON WHITE PAPER AND ORIGINAL DOCUMENT SECURITY SCREEN ON BACK WITH PADLOCK SECURITY ICON. • Mattamy Minneapolis Partnership 1 876 7201 Washington Ave S., Ste 201 Edina, MN 55439 DATE Ds c- 19, 'Lp 12 - PAY TO THE C1 OF Pw of?-- u� O - ^ RDEROF � � SBt- Ip2 1 i i" �t 1 4 "T�1 US.AND F-pU12 -- }k Ur )O�D TW � 0 • Zarb— b— DOLLARS n �,�,�,„ Wells Fargo MEMO l' -l3$0- IL B91) Pay-le-St DG- - FD-D6 !V' 1 L8 7611' ':0 5 3000 2 L9 1 LO 2 7 C:\Documents and SettingslsbarelLocal Settings\Temporary Internet Files\ Content .Outlook1BD80X19AABUILDERS DEPOSIT FORM.DOC PRIOR LAK DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS Meier/ e~ NATURE OF WORK M. , 1 _ 1; 171JhZ I/„ Ar' 1' -�/ USE OF BUILDING mit PERMIT NO. /Z . 1 DATE ISSUED CONTRACTOR A/ , 1.1A1 1 „t! rt PHONE :.11:11M 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 & times. DATE I FOOTING I I 1 FOUNDATION (Prior to Backfill) 1 ei6 f { S PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED Radon sy under concrete slab ROUGH - INS SEWER/WATER/SEPTIC FRAMING CA A 1 INSULATION PP) (1 3 0 1 ELECTRICAL PLUMBING IA OC , e)9)`7 `/ f4 / ,' HEATING (if required) ( P,Q1C17 FIREPLACE GAS LINE AIR TEST /Vj �/j 1 7 ladon piping C O V ER NO WORK UNTIL ABOVE HAS BEEN SIGNED ;Ystem. I Housewrap 1 1 Fire Sprinkler FIN ALS ,Pb / 33 GRADING (Prior to Sodding) BUILDING ELECTRICAL PLUMBING ?p HEATING 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