HomeMy WebLinkAboutBuilding Permit 04-0091
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
2,1,(:04--'
(Please type or print and sign at bottom)
ADDRESS
/f rI ~oJe...
{,58Z,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(N ame)
(Address)
I. White File
2. Pink City
3. Yellow Applicant
t> E:J1t'At
(Phone)
BUILDER -t-tJ.. / L
(Name) ~i(pt1W~tI
(Contact Name) ~Th 'f:
(Address)
~Au;r it R(?,~I. dl(JJ''i
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(Phone)
(Phone)
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I MN
PERMIT NO. ()q-91
ZONING (office use)
Je./~O
PID vs-., z.t.3. () 0 7. 0
% )- ~9J - 7903
~ .~ ./----
~ ~- ~ -' .~
OLower Level Finish
o Misc. \, la,c" ~;
ODeck o Porch ORe-Roofing
o Fireplace o Addition ~teration
PROJECT COST/VALUE (excluding land) $
ORe-Siding
OUtility Connection
TYPE OF WORK
o New Construction
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~perty to perform needed inspections.
X . 1 ~/J ~- -' 5-tyo ~- )-~5 -0'1
" Sig{rature Contractor's License No. Date'
Permit Valuation ~OOO, ()f)
Permit Fee $ q I, ZS
Plan Check Fee $ 2--", '8,
State Surcharge $ , $""0
Penalty $
Plumbing Permit Fee ()-:reL $ ~tJ,(J()
Mechanical Permit Fee $
Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
;Z~licatiOn~aWng;;;;;~;d
~cial I Date t
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
~~
TOTAL DUE
Paid ! c3cj 'jk..-- ,
Date r)_ - &;,-L/
c:?f /
# $
# $
$
$
# $
# $
$
$ I_ 0 ()
$ Joq,sb
Receipt No. t! t;~ 9 b
By ?-
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, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRl[OR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. Pink File PERMIT NO Cj
2. Green City '"/'"1"1 _ 'I
3. Yellow Applicant (/v
(Please type or print and sign at bottom)
ADDRESS
1r/~7R'f
~&~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
/}
OWNER ( .'/
(N ame) ~:/).L.o.,
/
(Address)
ADDITION
PID
I
~
(
~A){l.v<./
/I
(Phone)
APPLICAU /
(Name) , ~
,
(Address)/5/ / ~
;f,r- J: <-
A-/LJ/he-C r-
, (Address)
(Contact Person) . ....~ I ~
7~
(Phone) rS-Z -~f-7'1.72-....
,&r ~~ v. ;t ~ /J1;c/ 553 () ~
<' (City)
(Zip Code)
i
~
APPLICANT SIGNATURE/?--~ ~
, , :Zf
APPLICANT PLEASE, COMPLETE BELOW
(i DNEW CONSTRUCTION 0 REPLACEMENT IXAL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(Phone) CfS2 - ~L/ - /Cf77_
DATE 3 -/0 .~ 0 '(
!
\
\
\
\
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Steam
Oi Hot Water
Oi Radiation
01 Special Devices
I nl Other Devifes I - i-
t) ~+.'" v't:#' + oJ VI~.""
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
J Setbacks
T' "J ., """" .-
,...~ +-t-r..-..
DWarm Air Plants
DGravity
o Mechanical
I DAir Conditioning
(' DVent. System
IV" fI " ~
. FIREPLACE MAKE AND MODEL
F'......<.- J
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERlVlll FEE
$
$
$
Building Official
.50 .)
./1 \Cr
paiV ~
Date J I
Date ~ -- { 0 - 0 VJ
. - ,
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
Receipt No.
(Office Use Only)
This Application Becomes Your Building Permit When Approved
By
12--
(]
PRIOR LAKE
\
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS (0562 f!AK,t30,e 86,4C!H
NATURE OF WORK /1 L, I 6/GA 77 OAfS
USE OF BUILDING /Z6S !9/1C
PERMIT NO. ()4-~ DOC; I DATE ISSUED L 25.01
CONTRACTOR 0 (j (;'5 ffDnf5 e6P/t1 rc PHONE tjS2... 2,1 Z. 79()..3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
(YI?
{11/./
J - /S--Oc
"2 -r- > -(ft/
/
I'VJt?
M'
1 ,-( ~oC(
.~... (S-...gv/
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
DING
ELECTRICAL
PLUMBING
HEATING
DO NOT. OCCUpy
~
M?
~
UNTIL ABOVE HAS
N01"ICE
1..(-J..7-rJ'f
L{ ~ j, 77)t-1
'-< ,.. k 7 -()~I
BEEN SIGNED
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
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
:SCHEOULEO
~_L?~I
OWNER
(; 5<0- !~ /fL.I;J'- h~~ I. 0
CONTR.
ADDRESS
PHONE NO.
PERMIT NO.
t:-(-a;>q /
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
.----- -~
/ r ~
/ / / q r / '''''-
I / j r.)s;c !-'{ ~ )
\ ~ /
" ~
---- ---
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W.O"K:lt>9'R REINSPECTION BEFORE COVERING
Inspector: r JI r Owner/Contr:
. .
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTl