HomeMy WebLinkAboutBuilding Permit #12-1366 o � PR� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE `� ���
-. � AND UTILITY CONNECTION PERMIT �
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���'NESO�� I. Whi�e File pERMIT NO . /'
2. Pink City /� / ?j /_ / �
3 Yeliow Appiicam � `J «/ �/
Please or rint and si at bottom
ADDRESS ZONING (o�'ice use)
��tz� o� ht�� �� D,�� N� r�;�� ke �, -� z
LEGAL DESCRIPTION (oflFice use only)
LOT �' BLOCK ADDITION PID
OWNER � �� L F� - a Z- o
(Name) ��� Z (Phone) e � � � � — Z Z I ' 2 23 �i
(Address) J' � � Q wti � �C 1-�`0 C e� 1� /' . � i' � ��V' }'C
I BUII,DER
(Company Name) (Phone)
(Contact Name} (Phone)
(Address)
TYPE OF WORK ❑ New Conswction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding �.ower Level Finish �,Fireplace
❑Addition �Alteration ❑Utility Connection � �S
CODE: ❑I.R.C. ❑I.B.C. [I Misc.
Type of Construction: I II III N V A B pROJECT COST/VALLJE $
Occupancy Group: A B E F H I M R S U (exciuding land)
Division: 1 2 3 4 5
I hereb�+ ccrtify that [ have fumished information cm this application which is to the best of my knowledge h ue and correct. I aiso cerpfy that 1 am the owncr or authonzed agent fur the
above-ment�oned property and tha[ all construction wiil conform tp atl existing state and local laws and wili proceed in accordance with submlttcd pians. I am aware that [hc building '
ut�cial ca» revoke this per for cause. Furthermore, I hereby agree that the city official ur a designee may enter upon the property to perform needed mspectiuns. '
X � l��q'" I Z
Signamre Contractor's License No. Date
Permit Valuation 3 0�� U� Park Support Fee # $
Permit Fee $ s�� s � SAC # $ I
Plan Check Fee $ _� Water Meter Size 5/8"; 1"; $
State Surcharge $ � s� Pressure Reducer � $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ �,� �� Water Tower Fee # $
Mechanical Permit Fee $. Builder's Deposit $'' ,
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ �T , S-� TOTAL DLTE��-��-� �� �¢ � Z $ ���
This Application Becomes Your Building Permit When Approved Paid ReCei t NO.
- Date _ - 1/ B
�
Buildim� Ul�icial �ate
Th�s u to certify that the requcst m the above applicanon and accompanying documents is in accordance with the City Zoning Ordinance and may protted as requcsted. This document
when signrd by the City Planner canshtutes a temporary Crrtificate uf Zonin� campliance and allows construction to commence. Befure cxcupancy, a Cerhticate of Occupancy must be
issuCd.
Planning Director Date Special Conditions, if any
24 hour noticc for ali inspections (9S2) d47-9850, fax (952) 4�i7-4245
4646 Dakota Street Prior Lake, MN 55372
- - _
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o � pRtp� Date Rec'd
,� CITY OF PRIOR LAKE PLUMBING PERMTT
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2. �,d �; PERMIT NO. � � _� ��
3. Yellow ApplicaM
lease or t and s at bottom
ADDRESS ZONING (otr�,��
n
S`y Z o ,�, �I� w�c�� �, ��s.�, ��,'�;r
LEGAL DESCRIPTION (office use onty)
LOT � BLOCK ADDITION PID
OWNER , - °�SZ- �C�j 5�2
(Name) .�e`� � �In "Z (Phone) C' — (c1 Z. �- � Z l - ZZ3�
(Address) O r� b I� � _ � ��
APPLICANT , ' � Z- b3 °cl 5� 2
(Name) ��' � �c � �1nZ (Phone) L - (c ( Z.� Z Z ! - Z Z3 a
(Address) `J � � C% � .;�� w�. � �e 1..� u � � if� � • ,� � , � � � [1 Y� L� ItN S '�-3 � Z
(Address) � (City) (Zip Code)
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(Conta.ct Person) �C� � l-�� Z (Phone) 5�+�� E<, s a b o U� '
APPLICANT SIGNATURE � DATE `�" Cf —/ Z
6i,Sc'rv�c�s�'f" ��"v�►'S�+
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fixtare uanti T e of Fixture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
/ Lavato athroom Sink Stand Pi e ashin Machine
Laun Tra 1 or 2 com artment sink Sewa e E'ector
! Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
f Bar Sink Lawn S rinkler
% Water Closet Toilet Other
FEE SCHEDULE
Industrial, Commercial & Multi-family i% of job cost with a$49.50 minunum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $ Building Permit #
The Minnesota Statutes § 326B.148
"SURCHARGE" has been extended 'LUMBING PERMIT FEE $
unril lune 30 2013 �TATE SURCHARGE $ .50
The minimum surcharge for a 'OTAL PERMIT FEE $ S L� f�_
"fixed fee" permit is $5.00
_�_., .= �,.,�..,...�� �.,... DuIIamg Permit When Approved Paid � j _� Receip No_
f�9�c'
� � � Da � BY
Buildfns Officiai ate �'
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 553T2
�� p Rio�� CITY OF PRIOR LAKE ' Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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�I�'NES��A �. p� F>>e pERMIT NO. 3(O
2. Gteen City ,�,
3. Yellow Applicant
lease e or ' t and si at bottom
ADDRESS ZONING �ot� ��
J� � Z 0 r+.. ��� I�J� c� c� /..J l. Y' ,r" r�,/ �
LEGAL DESCRIPTION (oflFice use only)
LOT � BLOCK ADDITION PID
OWNER � ` q S Z S
(Name) ��-' �t � �cafi "Z (Phone) C — �!Z - Z 2 I - 2 �30
(Addxess) J�� (,} „r� r"�, �J �C c� �r {r tr r fl✓' - e
APPLICANT
(Name) ��-� �'Z (Phone) S Gc�^'L e: C� s�i. �o t✓�
(Address) �� Z!?' �v� b �t' 1.�/ c! Q�+ � �_ �J �.= Y � t�v Ir' �Gi''CC
(Address) (City) (Zip Code)
(Contact Person) 'j(/�1r'�.C. �.S G�, p G U� (Phone) 5�1�'` � s� $ Ot IpU l�ti
APPLICANT SIGNATURE f DATE ��— � ''( �
APPLICANT PLEASE COMPLETE BELOW uSc'r►��n � ►''
❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL {!.� /'1'"f �� j�' FUEL IV • �g �C S'
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation
❑Air Conditioning ❑ Special Devices Fireplaces with Boz Additions or
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
�, �, Require a Building Permit.
FIREPL AND MODEL ��' `�' � 0 !,/ s �'�P Lc�
FEESCHEDULE
Industrial, Commercial & Multi-Faxnily 1% of job cost 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 $ Building Permit #
"SURCHARGE" has been extended
until June 30, 2013, HEATING PERMIT FEE $
The minimum surcharge for a 3TATE SURCHARGE $ .50
"fixed fee" permit is $5.00 COTAL PERMIT FEE $
This Ap lication Becomes Your Building Permit When Approved Paid • Receipt No.
' !� Date By
Buildine Official Date
24 hour notice for all inspecrions (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 553'72
P R I 0 R LA K E BU1� DRNG AND INSPECTION
IN PE TI N RE RD
SITE ADDRESS .� Zd ��'I O�OC� �►,
NATURE OF WORK
USE OF BUILDING /t.•
PERMIT NO. /� DATE ISSUED • •�Z.
CONTRACTOR ��� �'•�F71IL�"' PHONE �
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING 12�
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST `�
COVER NO WORK UNTIL ABOVE HAS BEEN S GNED
FINALS
BUILDING � � '�1 2--� �•�
ELECTRICAL
Pt�UMBING
HEATING �'
DO NOT OCCUPY UNTIL ABO E 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 shali be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850