HomeMy WebLinkAboutBuilding Permit 04-0122
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE. .
AND UTILITY c.u.\. la!.crJON PERMIT
Date Rcc'd
3,8.04--
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IADDRESS \'5'b'5b b'\~ \-\o~ V~ \\J1fIJ
; '::' ~ I PERMIT NO. 0'" 0 I z. z.1
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LEGAL DJlSCJlIPTION (oIIIce... only)
LOT BLOCK
A.."iLn... .ION
I ZONING C__) I
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PID
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(Addms) IS :,sl, ~ j \-\OfLn \J(}J)6 N w . ~fl..io (l loJ.{(?
~~Na_)rL1Qeoo,-rnc (Inno\X)Ji\lQ.a~;nuSj.1iItl (phone) gc;2-Y-"\ -3>1 '2.1
(ContactName)::er.-UV.l~~-1...\m.(2.Il,/~/Z.r\S~"'f"IUS\'e(t" '(Phone) 51;;'J-4~\-3.1'2..'l-
(AddIess) \U.'-\~4 'Volt\-\lM'\d AvQ.. :rM.<<A ~lAltn'Svil\e. . Mt\J 5S?,.39-
TYPE OF WORK 0 New c-truction DDcdt DPoodl DJle.RDoIln& DJle.Sidiaa lIOLoftr Level FiDiJh JEfFi........
/ DA_ [JAl1aatinn DutilityC,..,...,... DMiJc:, Z. ~
CODE. llilu..c. []I...c. W PI.OJECT COST/VALUE S' Q.a. + 2:5 . 00
TypeofC_oa: 1 n m IV (0P'....;...1aad) J .
O",,,,,,,Groap: A. E FBI U
DniJloa: 1 Z 3
(Phone) g'52-'2...2b-J53~
MAl Ss?,,+'2-
I bcftby catiIy mat 1 have fDnIiItwd infonutioa OQ Ibis ~ wbk.'b ilco die bat ~ my , .'. ".' . trvr and comcc. 1&110 cenifJ lbat I am me owner d' , " ,... ' ..., IFQf for the
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PermitValuation Z, 000. 0 0
Permit Pee S fI Zo. zs
Plan Cbeck Pee s-
Slate Sun:harse S I. Il 0
I Penalty S
I Plumbing Permit Fee"" ....~ .J.. 4- 0 . 0 0
I Mechanica1 Permit Fee S
Sewer '" Water Permit Fee S
Ou'-'.,\ ..~~~...S -I-O.OCJ
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I Part..L.." .'" Pee
I SAC
I WaterMeter Size 5/8"; I";
I Preaore Reducer
I Sewer/Water Connection Pee
I WaterTowerFee
I Builder'. Deposit
I=ALDUE
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24lMH1r IIOtict for.n I....tt... (951) ...7-91..... fal (9!1) 447..a45
16200 EqIe Cleek Avenue Prior Lako. MN 55372
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Residential Building Permit Cheeklist
Basement Fbrlsh or Interior Altermon to Single Family Homes
~ ~ Date: S!~ '04
Buildfng Permit # 0 LJ ~ /7... "Z. pm: Zoning:
Site Address - "yc, _ 'iAA.. ),. \ . . 1 ~ - \
\ .,,,~ $l'- ~ ~.,s I" ,'-'V,
Lq2l: L B Subdivision:
BY:
EDting Structur@rNO
CONFORJ."\'IS TO ZONING
ORDrnk~CE
I
Is tbi3 an e:tpa:DSion of the aisting fcu't";". or
building height?
I Is the property Iu_.....: within the flood plain? I
I Does the alte:"..tion include my additional kitchens? ,
Does the proposed alte:ation include my outside'
e:ltrmc:s otlle:' than patio doors?
Is the proposed use of the fiDisJle:i spac: or
altention for mything other thm a Il=al single
f'amiiy home (ace:. groti!' ham:. day C3Ie. etc.)'?
('?I
QY/
NO
YES NO
Refer to Plamring
-
Refer to Plamring
"
Refe:o to Plamring ---
Refer to Plamring "
Refer to Plamring
---
Tms cm:CXUST )IUST BE COMl'LETED A,.'ID Ii'lCUiDED Ii'I TBE BtllDC'iG P!R.'tIIT F'l~E TO
)(AlNTAll'l A RECORD OFTdE R.!VLEW.
.
.
.
.
Date Rec:'d
CITY OF PRIOR LAKE PLUMBING PERMIT
3. /fe.Ot/-
(Please ~ or~! and siRD. at bottom'
ADDRESS
f 535[ Bith HI'JrI1 Pose;
J
LEGAL DESCRIPTION (office use only)
I. Blue File I PERMIT NO Ji"lA.. ~
2. Go~ Ci~ ' v-r . () rz;.
1 Yellow AppliCll\t
ZONING (office use)
LOT BLOCK
ADDITION
PIOZS-.1'7r;" t>2-z.-lJ
,
OWNER
(Namp) :):: /f/ ot/Ollv' I/-e
IYT!' lH~d /;,1&,
./
(Phone)
(Address)
APPLICANT . DI 6
(Name)~PUI ~ ,-,1./"'" t'J1c,
./
(Address) /r:;l[~3 AI/Y"n 13/l/cl
(Address)
.---
(Contact Person) J /) WI /)'P/J,17
APPLICANT SIG~ATURE ~~;);--i~
~
(phone)
er io r tel/-:'"
(City) -
(Phone)
~3S72
(Zip Code)
952 -292-753/
DATE 5-/:; -Ol/
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
i Sinks Backflow Assembly Test
1 Bar Sink Lawn Sprinkler
I Water Closet (Toilet) Other
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Residential, New One & Two.Family $99.50
Residential, Additions & Alterations $39,50
Building Permit # () 4--. 0 1'2.- z... {> {
/' fIY,1) V
~ 0 t,.,.P
$
$
$ ~
/"
IPai~
IDat~,'6,~f
. -
RecMpr'No. I1f)j
By /f/):1L--~
/
Estimated Cost $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notiee fnr all in.peelinns (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONINGIFIREPLACE PERMIT
(Please ~ or orint and sion at bottnml
ADDRESS
Date Rec'd
$.1''-04-
i;;:" ~::y I PERMIT NO. 04-" oIl.-" I
3. Yellow Applicant . c-.r
/53570 8/ C; Ho~ ,t?,?/..[f'
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
OWNER
(Name)
(Address)
(Phone)
~;;~~ANT~ c. If. HCi'/5M 1Il-~ f- A-/A .
v
(Address) 7 { 'f S. (2- '3 r- 1) S -I-- r
(Address)
~ C-o <e:r; /
APPLICANT SIGNATURE ~-;.j~
/-
(Contact Person)
ZONING (office use)
PIO z.s-. $7S Oz.z..,()
(Phone) Cf 5" ).. 'I <ilf - 7 l' Z- 0
hi) {l!-- V A-f ( <Ly I'V/~. !> ~I L.. <(
- I (City) / (Zip Code)
(Phone) 9 ~ 2-- '{r!oo 7 ~z..o
3-{'7-D'I
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
RETURN OPENINGS
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
~ OVenl. System
~PLACE.~ AND MODEL
FLUE SIZE
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OUTPUT
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 Cnnstruction)
$39.50
$39.50
$39.50
Estimated Cost $ Building Permit # 04-, () ,Z,1- J$ 'I
HEATING PERMIT FEE $ ./ r If1 D
STATE SURCHARGE $ ./" ,50 tJ I ,0 rz--
TOTAL PERMIT FEE $./ 1;1 V
,
.r-
lice Use Only)
IP~'
LD:} / q. 04--
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hnur notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
'R~
By k--'
U
PRIOR LAKE
INSPECTION RECORD
/535i:J 81 tI H~IC/J J4IIS5
NATURE OF WORK L t)~
USE OF BUILDING ~ "-
PERMIT NO. -b+. D7C7. ATE ISSUED ~ . 8. lJ4-
CONTRACTOR .IN/tI~"~ lAIC-,. PHONE 9~Z.'l:JI. .3/2.2-
NOTE: THIS IS NOT A PERMIT FdR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
_ClllA
DATE
I
I I
UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
t/I/P' 3'J,~.()'( /
INSULATION /lfO I
ELECTRICAL ,
PLUMBING Y'#' I
HEATING (If required) ~ I
FIREPLACE p1/Y/ I
GAS LINE AIR TEST ~."-.Y
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
, , I I j
FINALS
(/";
I
I
I
~
5"-]
ELECTRICAL
PLUMBING
HEATING
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 CIIblnet Is available, card shall be placed near main entrance.
FQR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE ME
SCHEDULED 5-7-OY
ADDRESS I 'S:t~{" '""J:.~ 1-t~1I\. Q,.".
OWNER CONTR.
PHONE NO.
PERMIT NO.
[] FOOTING [] PLUMBING RI
[] FDUNDA TION [] MECH RI
,r--- ~,,"NG [] WATER HOOKUP
. [] jllSULA TION [] SEWER HOOKUP
~NAL [] PLUMBING FINAL
[] SITE INSPECTION J ~ [] MECH FINAL
COMMENTS: IJ"JI.,lt'i. 014,... L"
0</ - 0 /2.,
[] EXlGRADlFILUNG
[] COMPLAINT
[] FIREPLACE RI
[] FIREPLACE FINAL
[] GASLINE AIR TST
[]
A WORK SATISFACTORY, PROCEED
[] CORRECT ACTION ANO PROCEED
CALL FOR REINSPECTION BEFORE COVERING
OWner/Contr:
o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Inspedor.
CAL.
UGNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI