HomeMy WebLinkAboutBldg Permit 04-0098 &0126
CITY OF PRIOR LAKE Date Rec'd
HEA TING/AIR CONDITIONINGIFIREPLACE PERMIT
I~"e wi 04-. 001fJ
~: ~~ ~:~ PERMIt NO. ()I~-. O/.? /-
3. Yellow Applicant .,- ~ e::;1
(Please type or print and sign at bo'u:um)
ADDRESS 331- / po X 7J't II.- {)!A / L.
LEGAL DESCRIPTION (office use only)
LOT4-BLOCK I ADDITION
w//.;/:)s SrH
OWNER
(Name)
(Address)
APPLICANT ~ // /
(Name) M~ /VI?/' ~ €
, ,. I"
(Address) '/ '/ "7 7% p .' <:!.
, - (Address)
(Contact Person)
72:YA-7
~ . // ./"
)III.....*' .... ......
(Phone)
DATE 3 - ? -e:>i/
APPLICANT SIGNATURE
(Phone)
ZONING (office use)
PID ZS: .$ /0. oO'f- (.
(Phone) /S~ -t).~;) ..../~~
~4~A:>oJi!! ~ t::'5' 5 >t9'
(City) (Zip Code)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D ALThKA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
n.t'~ OF SYSTEM
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
~LA~ANDMODEL
INPUT
HEATINGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OU It'uT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit # 04-., () I Z (,
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PEAA.u.l .. EE
$ 39,50
$ .50
$ ~O. 00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
pa~ I. 1'1...>
D~ ,q,o~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
$39.50
$39.50
$39.50
ReCei~z.tI 0
BY~
(please type or print and sign at bottom)
ADDRESS
-U ((I
(Address)
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAIE OF ZONING COMPLIANCE
AND UTILITY C.ONNECTION PERMIT
Date Rec' d
~- CJ--? --() L/
PERMIT NOe()L/_tjg
I. White File
2. Pink City
3. Yellow Applicant
Fay 2(j / /
'Jr-
LEGAL DESCRIPTION (office use only)
LOT l' BLOCK / ADDITION
OWNER
(Name)
(L/~
$" Ov
PID~5-375- ()OC./-(')
(Phone)
BillLDER
(Name) ~ .4/b7P
(Contact Name) &II'V?
(Addtess) ~~ 7 /4 e.;5
TYPE OF WORK
o Misc.
P,-uuit Valuation
P,-uuit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee (f,oKY
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee /Va
ZONING (office use)
)?/
Can _<\ '/
(phone) :JS)- ;J9;J -I <!8E
(Phone)
Or SAa...kopep
o New Construction
~evel Finish
ODeck
ORe-Roofing
o Fireplace o Addition OA1teration
PROJECT COST IV ALUE (excluding land) $ :J.. 0) cr:t:J..
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 ~ ~ -# c~rs~ZseNO. ~ - ;)'t.re-O ~
o Porch
,t4d()O, () tJ
$ r7, z,.S
$
$
$
$ ,-/0. --
$
$
$
Park Support Fee
SAC
#
#
<:?OO
Water Meter Size 5/8"; I";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
Paid
Date
jdd fj. 6, t
- ~~ J., /)'1
. f _ ., _ "7_
Receipt No. L/lL:> 4V ;;/
. By tj-_
This Application Becomes Your Building Permit When Approved
~ ~ 4.;l-7~</
Building Official Date
ORe-Siding
DUtility Connection
-
$
$
$
$
$
$
$
$
I $ ;ZZI.. ~.
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
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
r
BY: ~ ~ . Pf-J Date: d" ~?~ tf
Building Permit #
Site Address
Legal: L tf
Pill:
B
/
E:dsting Structure: YES or NO
CONFORlVIS TO ZONJNG
o RD IN.A..i'i CE
Is this an expansion of the existing foo~tJJ. ~t or
building height?
Is the property located within the flood plain?
Does the alteration include any additional kitchens'?
Does the proposed alteration include any outside'
entrances othe: than patio doors?
Is the proposed use of the finished space or
alteration for anything other than a nuuual single
family home (office, group horne, day care, etc.)?
Zoning:
33'11
,
Subdivision: ~
"YES
YES
Refer to Planning
Refer to Planning
Refer to Planning
Refer to Plamring
Refer to Planning
~~/;',
~
_ NO
NO
,J8
~o
~O
tJa
~O
THIS 1.11..1!.CKLIST MUST BE COMPLETED A.ND INCLUDED IN THE BU1LDING PERiVIIT FILE TO
l'tWNTA1N A RECORD OF THE REVTE\V.
T .\ I ",,\,fPT .~ TF\ALTC':HC<.DOC
PRIOR LAKE
INSPECTION RECORD
plJK+a.it Tv-
DEPARTMENT OF
BUILDING AND INSPECTION
.. , ...
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING _
PERMIT NO. ~I/- DATE I~SJJED 3 .. 1-0'1
CONTRACTOR ~ 1ft e.. ,. ~~t-- PHONE~. '" Cc:.
NOTE: THIS IS ~OT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPE... . '",R
DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
!lJ;
~J21
/
I
/
I
~
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
I.-
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
II ff/
/h
s-{~-aVJ
J
/
'-.t1
SIGNED
OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical service cabinet prior to rough-In inspections....... ~ '"
and ..l1\ai.ntoined 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
-........
~
/' .. I yJ \
/ / (/)v .,1"1, le, )
\ /
~
~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~1L{(
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o ~NSULA TION / L
~rINAL V\,
o SITE INSPECTION
COMMENTS:
\
'---
DATE TIllE
SCHEDULED
~-Iq~/
.~lwl
CONTR.
PERMIT NO.
~ 3L-( (
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
}Z PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
----
~-
V--L v-
o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND OCEEO
o CORRECT FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9~~O FQ~ T~IE ..F3.x:.T IN,PE<!TlON 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
I1ISNOTJ
~