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HomeMy WebLinkAboutBuilding Permit 12. 1425 + 13. 0374 ' ,, ,, , g� ; t f �,_u. ,, VIdcn � /,,„i._; __,', , :. ,_ ..; ,. .. _ , r _ . � ,,Y, , ,,„',, , ,, , „:„,.' rig i i_�V M1�ar. i_nVV.n.zrliV l ilsr�i. ii ._i..n_.�ir� ii _i r:i Vr h::u (rr of ®ttup nitg CITY OF PRIOR LAKE e arf rilf of u 1 t %pItfiuu ❑ Final Permitted ❑ Conditional C.O. Expires 3 T his Certificate issued pursuant to the requirements of Section 110 of the ❑ Residential / ❑ International 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: �+ 1 (; I F F A' T I Y B ldg. Permit No. Use Classification a 1 R3 VN PUT) ITS Occupancy Type Type Construction g District ! 1 ill. c JEFFFRS WATERFRONT '� r Legal Description L2 , 14384 PARKSTP? COURT NW ;, Owner of Building Site Address Contractor's Name & Address .. AM 1-41M, s _ RORERT f, H"TO!INS City Planner f :uildin.Official �� ��, Date: . ' i i tL / Date: w P OST IN CONSPICUOUS PLACE �{ ; , I , 11 o , ., •. iu i oil 1 fIU X79 y u II i I R ',',1',,,,::;",:'',',:',;:' i . m I , i . l , i i 1N oZu. 0 w vw ggg o 0a.aa I z z 114:1 O ( iu t77 8 . it- 6 w fA Q $ 00000 a z 0 0 G �� a.a Z o Z W J � Yom? z U a. X =i N 0 ��� 0 a m=wamx o o z r o (1) 0 W W w W Lt. a z ` 000000 a a LL I- 311 0 -� a i\ 1 0 = 0 o V O IN �0 ` z p a f- o tz D z r to tn a ; W Q a Z H 0 0 -i W a � N Z ? o?g = W g g c ° Q c r m r zSe p t5 0 V wV w W w 0 t ° W V V a. 0 o t o L u.u zLL N 0 �, v z a 0 a 000000 V C 0 � /4: LU t §u §4 0 ui { 5 5 5 z K � a2 0 > �§ �� a © ( 0 < \ o ,� Suu.�0 2 z OOOOOC a- L ® r o / w x o / w . d ^ Y X Z x co \ k/ M E 4 F § o k 8 2; 4 '� j 0 I w k z } § w 03 33 §I ( w c & § k ■ U a x x u s x '� A ■ § IX w r z cOOO % B u a a " 1 o 2 § z / j \ w o m § R ( o o o ; % ■ © o re p o < 2 k & 2 )) < i � o g U « 0 a 000O 0 X0 0 ti Z CITY" OF PRIOR LAKE BLILDLrG PERMIT, Date Rec �N, ; TEIPORARY CERTIFICATE OF ZONLr G COI�IPLI_r CE AND UTILITY CONNECTION PER , , _` , . r l'iiiii `. . � 0 N .V E S I. White Fite Pik 2. Pink City PERMIT NO / ,425 3. Yellow Applicant e (Please type or print and sign at bottom) ADDRESS 1g °d L( 1 �t--4,Q -t 1 o ( r f.) tj ZONING (office use) LEGAL DESCRIPTION (office use only) `^ / LOT 2, BLOCK 1 ADDITION ie- PPsa -s " " �' -R � /2-0 "l -- t PID 2 - G41 Bo 2 90 OWNER (Name) 1'1 A T 1 A. M 44 U M e-S (Phone) (Address) 12..c.1 IN A S 14 t t l b r za +,t A v E S S"Ta 20 , a O t t l-N 1-1 tl S S LL 3 9 BUILDER (Company Name) Mg1/4-' t 'ARMY -1- frl ES (Phone) (Contact Name) S u 1=12-a (Phone) (Address) 12) t 1n.14 S14 ti-,l (1 O .J Pt VS S 5 2.0) t -O t N! A h 14 SSA 7 I TYPE OF WORK %New Construction EI.Deck ❑Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ❑Addition ['Alteration ❑Utility Connection CODE: II.R.C. ❑I.B.C. ❑ Misc: Type of Construction: I II III IV V A B 2V Occupancy Group: A B E F HI M R S U PROJECT COST /VALUE $ i 0 00 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(r...,*---,T Q4_, BL 2 3"1 S38b \, k`1 >o \ 12— Signature Contractor's License No. Date Permit Valuation t i , OOP- -- Park Support Fee # $ Permit Fee $ IZoa[ . 50 SAC # $ 2 S, Plan Check Fee $ - Z g''o . 16 Water Meter Size 5/8 "; 1 "; $ 'cep , State Surcharge $ CO3 , / Pressure Reducer $ LID- — Penalty $ Sewer /Water Connection Fee # $ t Soo. Plumbing Permit Fee $ t 5-4-, 7 Water Tower Fee # $ I C 0• Mechanical Permit Fee $ S S° Builder's Deposit $ k. S Qc Sewer & Water Permit Fee $ , Other 12E St rri2g551 O•1\1 $ S •So Gas Fireplace Permit Fee $ 5''. < TOTAL DUE 5 /, This Ap - 'ca k A on ; e o . Your Building Permit W roved Paid � f '.. U Receipt )2E / I l � Date / 2e 1/2//2.--- By i .. /_ z r z ( y rj Buildin • Offi tr ate This is to c:4 that the re. est in the above application and accompanying docu is is ' accordance with the City Zoning Ordinance and may proceed as requested. This document when signe�.y the City ' • . constitutes a temporary Certificate of Zoning com Hance d allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. i i1 ' I Z IL annin Dire—--.... Date Special Conditions, if any notice for all inspections (952) 447-9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 el 1 o� r �`�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec' � 9 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 457, /5 - (3 1i c.Tt J/ ( -Z5 lNN E S �: 1. White File 2. Pink City PERMIT NO / 3 3-* 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS (, t-k--3 8 `E PAN p le . l D- CT nl V•/ ZONING (office use) LEGAL DESCRIPTION (office use only) LOT i BLOCK t ADDITION CI I Z S VJ - & r.! PID OWNER (Name) i'I p1/4-1-1 P. M `t -44 0 ' as (Phone) (Address) - I ?c5t WA 5l -E►tJ b — ► to A vE S S1 20 entr.,l4\ H N SS439 BUILDER (Company Name) MS 1 '` 1 " Y - 1 - 1 - e..) r"' ES (Phone) (Contact Name) S u SCR (Phone) (Address) 124..) l 1.,..1k S I411-4 PTO —J Ov VI= $ STS 2_O l 1 -O t iv *, t-t t4 SSA 3 TYPE OF WORK J' New Construction tg Deck ❑Porch ❑Re- Roofing ❑Re- Siding )wer Level Finish ❑ Fireplace DAddition ❑Alteration ❑Utility Connection a terns- CODE: ❑LR.C. ❑I.B.C. ❑ Misc: '' ' P. 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 $ IS 000 . 6 6 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 confoiur 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. xc -' e , Be., 1 S 2).6 Signature Contractor's License No. Date Permit Valuation -Z 0 0 p U 0 Park Support Fee # $ Permit Fee $ 60 2 2 C SAC # $ Plan Check Fee $ __— Water Meter Size 5/8 "; 1 "; $ State Surcharge $ / 0) Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ 5L/ v Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE $ / / f 1r This Application Becomes Your Building Permit When Approved Paid i / / 7 r � -C--' Receipt No. b f07)- ' / / Date BY .., [ Ji 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 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 MODFI SI IPFRVISION 1 OSS Al ARM OPERATE VAI VF RFI EASE OPFRATF Fl FASF YES NO YES NO MIN SEC HYDROSTATIC: Hydrostatic test shall be made at not less than 200 psi (13.6 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 PSI FOR _HRS IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED OYES NO 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? ®YES NO DRAIN READING OF GAGE LOCATED / WA WATER RESIDUAL PRESSURE WITH,\44 VE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION (PSI CONNECTION OPEN WIDE `f 1 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 ®YES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING - YES ONO 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? !EYES 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 YES 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? ■ YES 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 ❑N NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: ea -21 — j3 NAME OF SPRINKLER CONTRACTOR: FIRE SUPPRESSION SERVICES, LLC. TEST WITNESSED BY FO ERTY OWNER (SIGNED) TITLE /OATS SIGNATURES ( eke / 4,g 6 - i3 F• RI • T A E N) � TITLE DA E F R � N R GTOR (151G ED) ADDITIONAL EXPLANATION AND NOTES 9 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 49-27 —/3 PROPERTY ADDRESS: 14384 PARKSIDE COURT ACCEPTED BY APPROVING AUTHORITIES: CITY OF WOODBURY ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS YES ONO EQUIPMENT USED IS APPROVED BYES ONO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS OYES ❑NO 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 OYES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS YES ONO 3. NFPA 25 EVES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2012 1/2 10 155 SPRINKLERS RELIABLE RES 44HSW 2012 1/2 13 155 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 0 4y 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 07-03-' 13 15:17 FROM- T-003 P0001/0004 F-003 DAD I slitioA CITY OF PRIOR LAKE Date Reed ' ; A? I ECEATING/AIR CONDMONING/FIREPLAOI PERMIT 1 v•i, ..,0 IL4C / • ;: o rt t 1 PERMIT NO. i 3— 4,3 'ill 4 44assfic * s. Vighw Andrew MOW tin of Wit mad aims* blittsist ADD1 44 P - 98 e ri 4,LA CT frior lake 1 ink' zotoNotash,vo . . LEGAL DESCRIPTION Wan use saki • PID —I ovnentA s • : (Nam) (Phone) • -144614110 . . ANT rirt Side, ged V+hiint (Phone) & 1-1033- . A # (Address) _ 00 ,... ' . ' A k '' 4, ' i 1 . Li L 51) (Mims) Onkt giS eat) (antid t Palm) L efg PI (.....) F , ... - 17 #r 1 • ATV, NAV i 0111:40.0- 40' .1. ' ir: APPLICANT SIGNATURE 4'0 1,14 Aklifile ' DATE - .., , . , 4- Avow APPLICANT PLEASE COMPLETE BELOW EAst cceirrituerm 0 REPLACEMENT 0 ALTERATKE4S • FURNACE MAKE AND MODEL PURL PIM SZE RETURN OPENINOS INPUT OUTPUT • ibis OP SYSTEM HEATING OR POWER. PLANT PLEASE Mitt Air Conedomor OViene Air Mos pit Ikeda Uldts end Eirepleeet Outset inerseeh Er= into *squired Side 'Yard &Wein. Redwine DM,' Conditioning fl ad 11....01.110m... Vest. .01.1.W.M.......... Etropban aid' Ben Additions or CalitaMert is the Onestdo of Boldings ° System *squire a Sadist Perak, . putaputa MAKE AND MODEL rtz ECM= Indeonid. Commovoisl & fly I% °flab seat Rasidentlat Om People:. $49.50 minimum PAID wife Residadal, Beatles St A/C (14ew CsailiSction) $149.30 Raslicatial. Mathes & Alk ettifLD 1 NG PartlIT Reddsatial Eating Oniy Olow COnlersolico) $64.50 Residential, AC Ody Estimated Cod $ Building Permit f - The Mienesma Symms i 32611. RS "SURCHARGE" tais bete sisinged lot eat MATING PERMIT PEE $ year effective STATE SURCHARGE $ .11) July I. MO. sue Jitot A /Si I. TOTAL PERMIT EU $ U. elehataa Mier .* Mr a "Axel tie pima Mee Vas Ody) is IS Mine* 4aly t. 2014 This Appicatioat Becomes Year Bnildhog 1Pernott When Approved 61111111111111 LhaiaIIIIIIII Date lisANKOSAMI tufo .• , . 24 kw nodes tor MI kitsectioas .52)447,4454, f (PO 4474145 4644 News Berta La, Prior Lake, hileaseeta 53572 or. .......•••••• ■••■66••••••••••■■•••••••■••••••••••••••••••••••■••.••••■•••■••••* emomers.o.••••... • •• eo.••■••••••• ••••••••■•.......W ••••••■ M• •••• • •••• •••••••••• •••••••■•••.••••••• •••••• •••• 07 -03 -' 13 15:18 FROM- T -003 P0002/0004 F-0030 A, v�tt� CITY OP` PRIOR LANE Date Recd cit HEATING /AIR CONDI'T'IONING/FIREPLACE PERMIT 0 • t ,so 1 10. she» er,�. or.a�ac 1�litl2S)�1 . "7/30/7 R 1 r ( grtslde Cr Prior 1. 4:7 Ai ,m • LEGAL DESCRIPTION wiles ore a LOY KOCK A MOM PID . owtax Age \ . a ill 4Ib}1r1G S i ; APrr.tcAra , 1_ • - - /IWZP74,1111 - , / - ) Air -. (am) 2700 a i v Vi - • ' (Leo Ile 0 MAl 53/13 . (Coated Penew) 1-ea ri — , — 2 — - APPLICANT SIcNAT B �.p ra ' "A ir • DATE . l,,i; , fr , Armor it APPLI , s ,ii T er. ,� ;r _ e 'qy Lyl SW commix-mu JCttO�i ■ REP'LAcEM NT . • ALT*RATION$ FURNACE MAKE AND MODEL FUEL . lime mu I ' A - • - INPUT OUTPUT TYPE OF SYSTEM BEA ' S G OR POWU PLANT PLEASE r • A& Coadilleate • • . anti Air N M a Units and Camelot inpreaeh III • FS Hat Wier lade Begidrai Side Yard Setbacks, RI M/aMai t • Wigton Fireplaces with !slot Addilteai or � $ • tt 4r Devine CaL eVers to Outside of III ' ' '7aleat II Other Device* ns Require • Pervlt. P'IRBPLACE MAKE AM) MODEL. L File BCEEDULE induddit. Deem dot A Mul i r * eeet die dies& S40.50 • Residential, Ot4y New Coartrvvotioa) x6450 R tided d � & �r $.50 a,tia lied Qeet $ Sodding Permit $ The Minnesola Sums 1 3268.14S HEATING P [rY' 'SURCHARGE' Mee been diw ed rot Mt year effective STATE SURCEABOB $ 30 .iuir t. Mio. mat J i0, wit. TOTAL PERMIT nil $ rue minimal Nst W r fie Nina 00' permit Oise Vie O1 it s, MIanwlt Jody kW. 'fide Application' Seeman Year Budding Pee nde When Apprw►ed Reid apt No. Date BY Whim NMI Aloe . • 24 tear aides Err all ialpSS*ae 195l) 4474451, tsx psi 40.445 4646 DaloN.lteraetLL PwUr IAA Pdb esole f *fl ♦...... ♦rw ••f.- ..... .w♦I.M- M.I. .w♦..••••••••• ■■••••••• ,....��� /....NW. Mw .....A.. w.w.. w..w... •......V.M...., ♦ ...... a........ ..y...ry.............................. .... v RIO CITY OF PRIOR LAKE Date Recd °y „' HEATING /AIR CONDITIONING /FIREPLACE PERMIT �. w �W 3 �' ttvhiEsoer I. Pink File 7. Oxon aer PERMIT NO. IA, ivig 5/ 3 Yellow Appiaana (Please type or print and sign at bottom) ADDRESS , (office use) 14 - $ r Pat' Y L6. e. Ccxt, k y -yy UV .vs,ii LEGAL DESCRIPTION (office use only) LO 0 BLOCK / ADDITIO•Te4S l .641ei r/'' o,ij A j, Pm 45%. 1 7 1/ 75' — ON Q OWNER , i .p ' I .r., p n (Name) _ _ L A W ( )Y 1 U C 1 (Phone) - (Address) J tpf ■ (Name) AN Vt ” 1 W t. U T ( U e !V + (Phone) Q S ) (0 ) -` �, J / a 'y 1 ✓ " (Address) C/�co U ' u 1 3 l�i�f /�l lfie �5,33 (Addr s) (City) (Zip Code 9- a (Contact Person) I ' �1 ®' L�/ ®r (Phone) ` . 7 4 APPLICANT SIGNATURE , ,' t . 414 / DATE b 4 / 3 APPLICANT PLEASE COMPLETE BELOW !%1a -W CO TRUCTION ��❑ REPLACEMENT / r ❑ ALTERATIONS n ' �, •� FURNACE MAKE AND MODEL &\) `� i F l P q U l? `6° 31 FUEL ! v (mil A FLUE SIZE RETU OPENINGS -6 INPUT _ ' i Ca) OUTPUT 5 f TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner ❑ Steam Units and Fireplaces Cannot Encroach Gravity n Air Plants 0 flot Water into Required Side Yard Setbacks. 12. hanical El Radiation '° onditioning ❑ Special Devices Fireplaces with Box Additions or Il Vent. System 0 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 cast Residential, Gas Fireplace $49.50 $49.50 minimum Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50 Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50 � ` the Minnesota Statutes § 326B.148 :ost $ f CU t 9 0 Building Permit # "SURCHARGE" has been extended until June 30, 2013, HEATING PERMIT FEE $ I q 9 .so The minimum surcharge for a STATE SURCHARGE $ 7 UCH "fixed fee" permit is 55.00 TOTAL PERMIT FEE $ 1 SL 5{ j This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By PAID WITH Building Official Dite I J 111 rNG P 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 E RMIT 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 ,--- — ---- _ L-21, `1 if r [1 ■17 i ,) ..:\ CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'c 1 11 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE11 APR 1 1 2013 , AND UTILITY CONNECTION PERMIT 4. Pf V NO 7 I :RNII,Iti:;y 1 • !Please tyjic or print an4 sign at botuinit .., — —,--- _ ADDRESS ZONING ,....se, s.,.- 'Rs' pc c:r Niw 1/A5i76N . ' ...., ,, LEGAL DESCRIPTION office use oinlyy " LOT BLOCK ADDITION PIP , OWNER rit.' lormaKi 001-4.06 , f - Phone) qS -2.1 / - 2c , (Name) t"A (Address) /20 k uip,still.. P‘Qc . evi),IA , NI 5S ' -114.4190ER C.,` (Company Natne) FiZC i,./T'FrE .i 014 Sr—g-kJ ke...E.- t 1-1-1--.. (Phone) / (..... 4 -2:77 — 8'1' {00 (Contact Name) Mo.e.q Kaweiz . (phonr) I , i, Address) HI i 0 1 4. -"rz I cs,a..., avecLe Ni t.....1 SA TE, 1-1 C RivcE, 4 k1 ,t 55S3b , TYPE OF WORK Ii5New Constmvitan EiDecit DP' 0Re-RooEng 0Re Sidinf pl- Level Fcrnsh 0 Ftteplace i Addition 0Altetaiton 0 l:tilit Connecnon 1 CODE: XLILC. 01.B.C. 0 Nils: Type of Construction: 1 11 III IV V A B i 1 Occupancy Group: A B E F H 1 M t4 5 U PROTECT COST/VALUE $ 3 75° CX) 1, Division: 1 2 , (I) 4 5 (excluding land.) 1 , _ 1 t hellthV CM thr 1 ..'«ave furrushed information on this aptsti;:vion white 3 to :hi hen ot ins isiossledge ti've and sonisio " .1.1..0 zerlify that I am the nw-ner or authortzed agent for the 1 I. aboretnentoted property and that am cor,stioctim will corforre to all eisiting sire and loca' :aiss 41 W 7r :r: accordame w:th 5uHl1rted plans .I arn aware tha: the hi„,uhting ! ofriza: c rrozisi tins pennit CM NIC CAUte Ftarthterrntre 1 !ttt'llth ligref thAt t't cry offIclai 0.7 a „It. t Cr 't7 "4: e tirore-v ,,, per'onn, fleed td. n1Specv _____ i ? ''' 13 I, signature Conrra,zio: s l_ice-nie Nr,, Date i Permit Vaivation F Park Support Fee 4 4 1 Permit Fee $ SAC l i Plan Check Fee $ i Water Meter Stze 5;'S' . ! `, ! $ € i._----- State Surcharge $ . Piessure Reducer $ Penalty $ i SeWtr; Water Coe, Fee d i S -- 1 Plumbing Permit Fee S ' Water Tower ?et # ! $ Mechanical Permit Fee $ Bulider Deposit i $ Sewer & 'Water Permit Fee S Other I : $ . i r 1 Gas Fireplace Permit Fee $ TOTAL DUE ?NW N i l , p rr c l4 tgrAl 1. , — This licati Bee* s Your Building Permit When Approved This Patti Date 1i) AO , •,--- f3 Q, 1 to ...; Zi Bonding Official ills a ro om that the request an the above appLicanon and acrornpanyrng m$ IS in accertiance sv:th the C.Irs Zoning Or:dr:same and may mimed as roestert That d *hrli trttned by the C:ty PIA:Lief COTatitURS a trillpora. Certticsie of 7,onins compitioter and allows ,-01 !,,, .,,,,,,,m‘v Be 0,:o r 5, cy 5 Cmft o f 0,,,,focy raus tv issued , i Planning Director Date , Spccrar Cund“,ora, d an . 24 hour notice for all inspections (952). 44 fax C952) 441-4245 4646 Dakota Street S..E, Prtor Lake, Minnesota 5;31'2 14 ' °• t. 41 4 0.1 1 p Rip Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT r2'kEse '. Gold Cit P ERMIT NO . /� 2. Y City J „[ , / / � � - I. Yellow Applicmt S�� "t l (Please type or print and sign at bottom) ADDRESS ZONING (office use) 1 L I Pa) ILL(te. cour)-uw 4 ?as6 LEGAL DESCRIPTION (office use only) LCY0 q BLOCK / ADDITION ■✓t 1 1.24 - 4, 4 60x-1- A bi J f PID c 5- 9 `Jf " Don-O OWNER `Q (Name) 1 J U J (CY 3 ) \ ) dri al (Phone) - (Address) A � ROJ / ktXjVl Phone) q s ^1(-i �.�. 9 (Address) a-aD� Li • 1 Wv 1 ] 3 n at it l le 5S 3 3 ) (Address) (City) (Zip Code) (Contact Person) 1 U 1tV (Ctt e , P)U c ):1(k d (Phone) A.S -7 2(; . ? ? 1 559 APPLICANT SIGNATURE iA 0 .' ,►. ! L 41 1 ,' jl DATE APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture ,Q Bath Tub with or without shower ' Rough -ins 1 Dishwasher [ Water Heater 1 _ Floor Drain Water Softener _3 Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly 1 Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler 3 Water Closet (Toilet) , Other FEE SCHEDULE Industrial, Commercial & Multi- family 1% of job cost with a 549.50 minimum Residential, New One & Two - Family 5149.50 Residential, Additions & Alterations 549.50 The Minnesota Statutes § 326B.148 'st s Building Permit # "SURCHARGE" has been extended PLUMBING PERMIT FEE $ i `i 10 J� until June 30, 2013, The minimum surcharge for a STATE'SURCHARGE $ cep "fixed fee" permit is $5.00 TOTAL PERMIT FEE 5 1 " , 'SD This Application Becomes Your Building Permit When Approved Paid Receipt No. _ Date By Building omdal Date P AD WITH 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 B1 ILD;N PERMIT 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 Builders Deposit „ 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: ',6 o C NJ w PERMIT # REFUND TO BE MAILED TO: t-1 ES — 120.1 1"1 t GTON , ✓F S SU rrE Zo I t1`1t� f 2-itl SS439 AUTHO ATION TO RELEASE PLEASE REMEMBER ( ( 500 _,ynda S Allen, Building Services. Amount 1. KEEP STREETS CLEAN DURING CONSTRUCTION (Q •7- (3 Acct. 801.20204 2. KEEP EROSION CONTROL IN PLACE Date 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 DC 6 -- 1 9/ ' 12 PAY TO THE G+ of � o>2 I $ ORDER OF J l i �1 6► }T ' [x I U S-P ∎JD 1=oV� 4 N -UniD T, t WO CD a 0 - — DOLLARS o Seemly �� � Wells Fargo MEMO H3$0- ttk391) �a�l�S+o� 0 C_s _ 1 6 _ 000 18 7611' 1:0 5 3000 2 L91:200004 2 3 L L0 2 ?” C:lDocuments and SettingslsbarelLocal Settings\Temporary Internet Files\Content.Outlook1BD80XI9A \BUILDERS DEPOSIT FORM.DOC PRIOR LAKE BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS I¢ %.' 0 NATURE OF WORK A _ i 7rif USE OF BUILDING PERMIT NO. /2. Z - DATE ISSUED CONTRACTOR W . ILA! it! MI ..- PHONE "r1l1111MWi 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 FOOTING 1 1 FOUNDATION (Prior to Backfill) PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED Radon system under concrete slab _ �H INS SEWER/WATER/SEPTIC FRAMING u' C ,�. Q / INSULATION P °kt 4/6 ELECTRICAL PLUMBING L C 7t, (1/9/ I°• 13. ¢ / // 3 HEATING (if required) I'- " 4 /3© % 3 FIREPLACE GAS LINE AIR TEST Zadon pipi COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED ;ystem. Housewrap • 1 1 Fire Sprinkler T `- `FINALS " GRADING (Prior to Sodding) BUILDING Ai),/ 1-3 -0 ELECTRICAL PLUMBING F--,1c. 1 . Z HEATING 1 3 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 • • • • • 'Y