HomeMy WebLinkAboutBuilding Permit 03-0602
(Please type or "rint and sign at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 5' Gl()-{)3
See ~ain .File.. ,". PERMIT ~
2. Pink City NO. 63- "0
3. Yellow Applicant
Date Rec'd
/'-1230
~U,...rrA ),i:)
uilts
Cr
;U.~.
Z~G (office use)
l'<.'-I
LEGAL DESCRIPTION (office use only)
---
LOT39' BLOCK 2 ADDITION. -OcJ~-r ,A./~ 1-1;[15 Z)..l2}
OWNER \
(Name) W~NSM.,A/J~
(Address) I ge;r- f~'ZA
PIDeP~-310-03~o
/-tDM ~.s
b IL SL"lll eCO
(Phone) ~~/- t/~6- ((t;1JO
d~;4N,. MA) ff'/$J:J
BUILDER Q _
(Name) ~a-
(Contact Name) At J? '7
- Y.J
(Address)
~/~, z..zt..,/&Z~
(Phone)
(Phone)
TYPE OF WORK
WNew Construction
DLower Level Finish
o Deck
o Porch
ORe-Roofing
ORe-Siding
o Fireplace
DAddition
DAlteration
DUtility Connection
o Misc.
PROJECTCOST/VALUE (excludingland) $ /Ol ~ 2.<; 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
;ter U~& ~ needed inspections. /9'))7 S-'-I Z-
~ '/ / Signature "Contractor's License No. Date
--
P,;,uuit Valuation /1lZ/ ~OO. 00 I Park Support Fee # $ 860. 0 0
Permit Fee $ /,()04.QS- SAC Size~ I"; # $/2.,75.00
Plan Check Fee $ , &~..5 . '2J". Water Meter $ , z,6lJ~ (fl)
State Surcharge $ 0/. 00 Pressure Reducer $ db'..CfD
Penalty $ City SAC and WAC # $ /, z,{fV ~ tIV
Plumbing PC~U1it Fee $ IOD.dlJ Water Tower Fee # $ · 7 0lJ rtfU
I Mechanical P.:.uuit Fee $ I cf7) . 60 I Builder's Deposit $
Sewer & Water Pcuuit Fee $ .3 5, 5t/ Other $
Gas Fireplace Permit Fee $ ~() . (J1) TOTAL DUE $ ~ " J 0 4-.' 7
This Application Becomes Your Building Permit When Al'l'&'" led I Paid ~(.j(jf-.;'1 Re?/. ~q-rV
~ (~P t,/14/03 I Date ~_ 1:1,.0;t By
Building Official , Date
This is ~o certify that ~e request in the. above application and .accompanyin~ docume~ts is in accordance w::c City Zonin~~ce and may procee. d ~ requested. This document
z::::~ Piann-1-~-.orary c~~ :/::tiance and all~ oons~e~ IVlmir FiTeOccupancy mu~ be
Planning Director ' Date Special Conditions, if any
24 hour notice for all inspections (952) 447-985(), tax (952) 441-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
v
See Ylain ~lle
The ('enter of the take Country
BUILDING PERMIT APPLICATION DEPARTMENT OHI;CKLISI
NAME OF APPLICANT i/).M44K~ ~
APPLICATION RECEIVED ~ - ~-03
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/L/J-36- l ~ /.I-i!t; {2;::1-
Accepted
v-
Accepted With Corrections
Denied
Reviewed By:
~
9JL-("jJp
Date:
~/ &,[0 ~
f .
Comments:
liThe issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~.
See Main ~ile
WhitP - 8ull~lna
C:-Canarv - En9in_ri~
Pink - ~18nnlng
TN C,.I... of 11M l.all~ COD.I"
SUILDINa.eERftdIIJ\PPUCATlQN DEPARTMENT CHECKLIST
I' } Ii .. )
NAME OF APPLICANT /.: /J:2'lt~<Z</'Jfrt>'J;t'.V ?/(+7)l.!~",<J,./
APPLICATION RECEIVED
c::.. - ;::) .' ',.-/" -:)
<-::1 ..,-,CJ L,..A_J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
t/',"\O .........-'1. --',-- '/'., , /' .17 .,
I .' ~U'- /,- A-"',,' ,'-" ' ,) l .'. /../-r
I .;.-'/ /' 1._/ ;'v'71 l,.{,.."~/!'~~-,; /\:/-t).' 1<':'] ~.___' ,r
Accepted
Denied
^
Accepted With Corrections
Reviewed By:
1J14-[!.
,$(( /J1e,I.~
Date:
~-2-03
Comments:
F,., (
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provision.s of this code or other
ordinances of the jurisdiction shall not be valid."
Date Rec'd
CIl i OF PRIOR LAKE
SEWER AND WATER PERMIT
"
I. Green File PED..... - NO
2. Yellow City A1Tll J. · J
3. Gold AppIicaat . 0" 0 V
(Please type or orint and sian at bottom)
ADDRESS ZONING (oftke use)
/~1,'30
~cJAJ~A)~' I-LIIIs C-r-
LEGAL DESCRIPTION (ofti~ use only)
~;.', r ' .
LOT 3l(BLOCK /-AoomON ~(,IIV~~ 1d:i11< ~
OWNER
(Name) v,/eNSWtA,J~ /::I~~
(Address).-..1.8!I~ p!.,,4 '" A 1> fI-
(AKdress)
,ruJ eI.S-- 3'f(;l-Od5,Q
~A~
(City)
(phone) "','//)" -''1'1'tJ
ss-/~
(Zip Code)
APPLICANT c-_
(Name) ~6-
~
~
(phone)
(Address)
-,./ ~ ~
(Contact Person) ~~J JLAb,4,/ML1
APPLICANT SIGNATURE 1:).. ~~
,;;1"/,
APPLICANT PLEASE COMPLE 1.~ BELOW
Size of water service / inohes.
Location of any couplings' from structure ur- feet.
Type of sewer pipe. ~ ABC 0 PVC 0 Cast Iron
Estimated length of sewer line e;2 Sleet.
Clean out (if required) located at feet from structure.
(City) (Zip Code)
(phone) gl-z.-~Z,I- JJ. Z V
DATE
'-
~
I
,
r'
z..
"-..,-........,.. .
Residential sewer' and water line connection
Sewer connection only
14'EE SCHEDULE
$35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39~50 minimum
$17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND W Al bK PERMIT FEE
STATE SURCHARGE
TOTAL PERl\'uJ. FEE
$
$
$'
.50
au PAID WITH
lLaING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved ~ ..bid.._ _.._<~ Receipt No.
'[\~tJt ~ 0 ~ L2 I, \: By
Dote \ [~~ AOli 1 ZOOJ J
Z4 boar aollce for alllnlpectioal (952) 447. Uso. fax (952) 447-4US
Buildinl Omdal
.~
f-
By_
, (Cnn1RC1 PC,.~Orl) .-. ",,-,
~ APPLICANT SIGNJ.TURE 94?~ ~
~
~
~
~
II
~.
FILE No.389 08/29 '03 11:01
ID:PLYMOUTH PLUMBING
FAX:7635331121
PAGE 1/ 1
Dflte Ree'd
crT'. OF PRlOR LAKE PLlTMBING PERMIT
; ~;~ ~:~t PERMIT NO.::1'""'6o - ~ I
. \ ~II.I.., .l.pplialalll V n
(rle~s~ IVP(: or pnm and sijln :11 bot'\om I ---.......
ADj'Zf d-aCo- d.2&3~-3Y -3eo fi;urrlWtlJr}j;-' ZONrNG,offic,.,,'
LEGAL DESCRlPTION (l~trlC" us!:' only)
LOT' BLOCK
A.DDITJON
PID
OWNER
(Ntme')
Lv.ers ~V\
(phone)
~)
(Address)
APPLlCANT () /).
(NameJ_._..v L-, '~A^-('l L~'\- ~ ~ J:::.Jill1-\.\1\ I t'\ C1
...) , ::/
(AddT{"~S.) (0'1 (,) q \^) t ,,'\ V\ f + ~ ~ A l ~ k.:
(AdGre.s~)
(Phone) ('7l.c,~ ')~) ?7:>--Lt~5! ,.___..
hu)['kl j,/\.j;",,~ r)SL!;).$)
(Cicy} (Zip Code)
(Pl1c1ne)
DAl'fE
8;/dJ'/r
ATJPLl CANT J'LEASE COMPLETE BELOW
Qu~n 1itJ' I ,T~'p~ of Fb.:tu rt:
,-- 8-- .---r B,tlh Tub wi1h or wltho\l1 shower
I I Dishwash~r
I, Floor Drain
~ I L~lvatory (Bathroom SIIII\ j
J LaLlndry Tray ( ) or 2 C(\11l parlmem sink
t Shower Stall
I I Sinks
. - . .
Qu~n thy
I
Typt of ~ixturc
ROllgh-l11s 'I} h~f1-
v..! ater Heater
I Water Sonner
I ! Stand Pipe ('Washing 'Machine)~ ~h. f>{i
I Sewage Ejector
I Backflow"Assemblv
Backtlow Assembly T~st
I
I
y
I A../41/ oJ II II\,
I \V:!ter CIO~l:l (T(\iIc:O
Other
...._ ". . I -....,... ....".....
,"I
I
FEE SCHEDULE
lochlml.l!. Commercial &. Multi-family Ill,;, uf'.Iub l.:USI with 1J $39.50 minimum Rc:sil.1c:nlinl. New ()rll; &. 1\vl\.Fumil~ S9C),5n
Rcgidc::nl;iJl. Addilion:; &. t\llcl~liun:; S:3Y,Su
l2slin\Jtcd CI.)SI $ "75c()/c.e."-
,
Building Permit II
8UII P~/D 'A.
~DltvG rt11J..,
P~Ii""rr
"
PLUrvtBlNG PERM1T FEE
ST.'; TE SURCHARGE
TOT.li..L PERMIT FEE
$
~.
,J\
..50
$
,om\;! li:l~ Olll~')
This A ppliclltlCln H~c()mc:; V (,Ill!' Building P~rmit Vlhen Apprllvc:c1
--~'J~@' ~ ~ ~ i
'""')l1tc:
r SEP 0 5 2003
'l'" - ---..-- .. _._
tcceipl 1'1/0
~y
--cr.
--I
r'uiIUi"~ ()j1i(~11I1 ";11('
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~-4 hC)ur rllllil:c.: IiiI' :Jll ill\PCl:liUII!i (!1~11447. J~=,Il. laJ. (9S:!, 44i...l~~~
11.~II/J r.',~II' ('""d. """" '.,r.,. "rill!' I,", @y\1'\, ",':"~-I"'l~
Clli OF'PRlOR>LAKE
~ATINGI AlRCONDJ.. lONlNG/ .r.LI:\EPLALE PERl\'J.l J.
Date Rec'd
i. Pinle File PEn.... NO 3 to ~
2. Gr-.n city 'n..L'YJ.J. J. .' - 0
3. Yellow AppIiClllt
(PleaSe tvpe,Qrorintand s~ atbouom)
ADDRESS
'c.f;t,..~ ~N.....c:.'N U./~s. 0-,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDiTiON
~~R~~1$~_4L /.L~
:,'(*d~): /,epS #~'.?~~, ,~C-~,--,
, .' " ,...", --
1:t:~/~~~ ~f',.J"'4~'~~<r (Phone)/l.~/- ~:!f.J--L/7.:5".
(A<ldiess) , ~~) ~~~..6~~ ./~- 4~~ ~~-?
(C,ontact, ,person,> ~,i~;~..a!)~~4~. (Phone) L:5/- ~ffd -,?:72~-
APPJ;ICANI'SIGNA~ ...'::'~-:-~ .............. ...D~TE~;!:. .
, ;~~~_qW'~LE~$~::~l?~:J)~:J.:'Ii'B~~qW':,'
~WCONSTRV~110N ,':' ElREP~ACE~' ': t~rAL~1~KATI9NS
FURNACEMAKEANDNlOD~L' '~'" ~~ Im~C:;;~~ 'FUEL~. ~
FLUE SIZE ~.. ~,~ RE'rtJRNOpENtNoS 7 INPliT'l:o,u...~ OlJll'UT S~,"-~ .0
nl"~ OF SYSl~M HEATIN'G: OR POWER PLANT
~arrn Air Plants 'O:Steam:
OOl'avity , O'I.lot \Vater' ,
D Mechanical ,.[J:Jfidiation
DAir qonditioning DSpeCial'Devices
DVent. System o Other Devices
PID
(phone)
,PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
rlKBPLACE MAKE ANDiMODEL'
Industrial, Commercial & Multi-Family
FEESLI'1~DULE
1 %' 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 $
. ~~~~
.50 .o~/;'4t".
P,y] @] ] ill r,~!lPtNO.
Dlt~ By ~
Date. ,.u ~E.E-O r ')nn~__._, ,
L u ~. /
"24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 -1
By
Building P,;,uuit #
HEATING PERMiT t.titi
STATE SURCHARGE
TOTAL PERl\t.u..1 '~J!JJ!i
$
$
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
"-
.
~
PRIOR LAKE ~~rtD~~~~D~~I~ain ~ile
INSPECTION RECORD
SITE ADDRESS /!!a "SO Fo ~~t.4iP tJ J'Us (!-(-
NATURE OF WORK ~~
USE OF BUILDING
PERMIT NO. 2>1~" D~TE ISSUED
CONTRACTOR ~IM~A/ PHON~- ~, · u..~ i'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPAIRATE DOCUMENT
INSPECTOR
DATE
~
FOUNDATION (Prior to Backfill) ~ / 1~l(,/t!tJ
PLACE NO CONCRETE U,NTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
VV\ ~~.
~
'7~
FOOTING
7/3tr!f3
~ t)? /fX3
l;9 ! ].-J J f(J
LD 11-~ /a3
SEWER I WATER I SEPTIC
FRAMING ~
INSULATION /'
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE ~
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
(~
&-~
~~
V
q!~{gJ
(,B t~ t93
FINALS
GRADING (Prior to SOdding) "~\I ~ \ to .. 'i,' B)
BUILDING 11\ J / t!.- $r I ZJf!f9d... ~ ~
ELECTRICAL 1>1(.
PLUMBING VV\~ ~? ~,4~11) t.J
HEATING ~ t!?'<- ~tl1 ~ Vv..j) ~,.~
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
QInfintttfe of d}ttUJltttttll
CIl'Y OF PRIOR LAKE
~1tpatfmtuf lIf ~uilbiug J1uspttfillu
~inal Permitted D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code certifying
that at the time of issuance this structure was in fQmpliance with the various ordinances of the City of Prior
Lake regulating building construction or use. For the following:
Occupancy Type
R3
SINGLE FAMILY
, Type Construction _ VN
Fire Zone
Bldg. Permit No. 03-0602
N / A Zoning District R4
Use Classification
Legal Description
L34, B2, FOUNTAIN HILLS 2ND
Owner of Building ,SiteAddress 14230 FOUNTAIN HILLS CORT NE
Contractor's Name & Address WENSMANN HOMES~l 5 PLAZA DRIVE. SUITE 200. EAGAN. MN 55122
ROBERT D. HUTCHINS I/L _ City Planner DON RYE
Building Official
Date: (,::...iI,- ().../ Date:
\
,~':', ,"",' ,_ . , .' , :' " . ":_ ': ' ,'--: :c ~ .,
DATE
~
~. lA...... ~,:. - LLL-k
~~_.. ,-
CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDULED
ADDRESS
ftj; 'MO
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
rz FINAL
/0 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
, MECH FINAL
TIME
le~
og,-~
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
V~. f' -ae c9 u[,
~/LfCJ'I..
o ,*ORK SATISFACTORY, PROCEED
JlI'" CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
.' HOl -Sf. HEATING TEST RECORD JOB #
ADDRESS t:t'- 3t! ~".F~O"W) . th " ~ (f- AP'; FLOOR Clrth tf\ t~UBURB
OCCUPANT R~ _ ~ OWNER W~IJ$/'tIt,1rIJ
HEAT LOSS DATE HT.~INST. 1 ~I:J-z, fl-- _~, _ . 0 ~ f I .~IJ- .P.
SOLD BY ..ft~tcr~. (/14t\~ ~EDBY ft\ I~ 1~1i\
Electrical Work By Q.. \. \- \ -c..b 9 ~ _..e...,-* '<' '- ~ Gas Line By A:U-.\~ ~\
TYPE OF HEAT GA FAX HW STEAM SPACE HTR. UNIT HTR. OTHER
~f 1..1 k... (AS DESIGN \~ONVERSI9H
MAKE O~~ MAKE OF BURNER /
Model ~.-,_ O^ lA.J~ Model Y,
Serial "1J' '" lilT. If I .,." Max. BTU Rating / )
INPUT I ~ to -ru.. MAKE OF F~RNACE
~ Model
NTROLS o..e
THERMOSTAT. Vent Size ~ \( ~ 'V G :;t f\.r -
Valve _ Heat PI~~ KIND OF LINER ' SIZF ...NO~ ;f
Limit . Kh~ "TD'f~"" DraftHood. 1. _ _f'egulator U~ ~ ~~
Limit Setting ~ 0 D - t:O 0 f' Filters L Size ~ ~}f ;,J..JO ~ulnber
Fan Setting ~. \ ~..}.~ Chimney Location Inside Outside
Pilot Type J.l' ~ ..,.. . -----, Chimney Construction
Pilot Make
Pilot Model
Pilot Timing
L.W. Cut Off
I
Pressure
Input CFH
Stack Temp.
Smoke Bomb Wiring V
'1 f) b€~ RahIR....-- Draft .:f It.Jp~ Test Tag \0 ,,~/ ./
~ I Door pressure, Lighting Inst. V
~ e CO I r ~ent CO2 ~ C;t If) Date Tested I () ~ ~ e ~
1I () Percent O2 '1-f} .. L1L- Company Testing Alli~fJ'~ech~'JW.'~ ~ ,~ ~e~nebec Dr., Eagan, MN 55122
t-e-l 0 ~ Percent CO ~ Name of Tester Yh. ~ ~ ~
j, '1'
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