HomeMy WebLinkAboutBuilding Permit 00-0761
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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
th~ a.bOV. e. ~entioned P;fl"o/ and t~. at a." construction will conform to all existing state an~ lo~1 !aws and ~II proceed in accordance with submitted plans. J am aware that the
bUilding ?~~ ca~vo thiS permit f~lft cause. Furthermore, I hereby agree that the city official or a deSIQn.ee may enter upon the property to perform needed inspections.
X L. 0<tf _ . ZOO '';7, S"""{ f5 -ZS--OO
,. Signature ...\~ Atz..t-JtE\lI","- license No. Date
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee .... .... ................... ~
SAC ......................................... <t
Collective Street Fee .... ............ ....... <t
Sewer Tap ................................... <t
Pressure Reducer .......................... ~
Meter Horn ... ....... ...... .... .... .... ....... <t
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ..... .... ................................ $
Total Due .............................. LI (,,4 ; ciS--
Paid I ("ct ~S Receipt No. "?'-.9( &53
. ,
Dale 'i$" / blsl e5D By c JJJ
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance an"d may proceed 4. rJuested. This cbcumenl when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate -o~pancy must be issued.
8~~
QATF RFr.FIVIOll CITY OF PRIOR LAKE
) " I BUILDING PERMIT,
~ ~$j (JO TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEfORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS
~-z:.~ ; \ 1 ~I ~eJA n..h \i'rII \
3. LEGAL DESCRI;TION 6110 I _ _
LOT N \ l\C\ rS.- S. BLOCK I rl1 ~.1- b::
W' -
I? J <... 3?
1. DATE
~/~g-/(JD
PID ~- I()C-.-() I((-()
ADDITION
I{:;R~\)
15. ARCHITECT
6. BUILDER
(Name)
~\5l),A...,T2-
(Name)
(Address)
~*\~ UJIUDlt-- T3iPC1-\ 'Tf(,
(Address)
(j~':P)l./57()
(Tel. No.)
(Name)
(Address)
(Tei No.)
~tuUl'teLI16- :/Jr{,-I
Re-roofing 0 Porch 0
Re-siding Ll Finish sasemen9\.
LAv.flJ/OC.'Jil t::O,v')\({vq I ().N
\L.-Z'O f'l.\n C-i,
7. TYPE OF WORK
New Construction Ll
SeptlcLl
Addition Ll
DeckLl
finish Attic Ll
Fireplace Ll
Alterations Ll
r
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
40D0 -
USE OF BUILDING
~A1~
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
'0'1 . as-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ..... ............. ........ ......... .... $
Plumbing Permit Fee ....................... $
~. 00
i/Q.oO
Mechanical Permit Fee ..................... $
This A
By
.:~...":::::;:::::::::: L/n.OO
~~ i1ding Permit When Approved.
Date
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions W any
24 hour notice for all inspections (952) 447.9850
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. CY' - ('\'"1"- I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTR
SEATR
16. PROJECT COSTNALUE
17. COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS (J
PLANS & SPECS Ll
SURVEY 0
PLOT PLAN Ll
SETS
COPIES
$
CITY OF PRIOR LAKE MC 110 ' O""1~ /
.. 16200 Eagll. Creltk Av. S.E. P.rmU~o. U {'
Prior Lab, MN 55372
TYPE OF STRUCTURE
I ....
to.-
:1. Vet...
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CD
::J
flk 0+
~y lD
eo..':=:
Single Family
CommelCial.
Two-FamDy
Induslrlal,
HEATING APPLICATION (PERMIT
Dale
q-l..- OD
JW" LJLflAJ ISu..ct /i'Ad
Fee Schedule
PID .
sn. Add.ess
Lot _ Block Addnion
Dwnor"sName (~P~.
Induslrial, Commen:ial & Multi.Family
Residenlial, Healing I!o. AC
Residentlal, Healing Only
Residential, Gas Firoplace
Rssidenlial, Addilions &. Alleralions
Residenllal. AC Only
Address
Healir>g Conlraclor ALLIED FIRESIDE dba FIRESI DE CORKER
Address. 2700 N. FAlRVIEW. ROSEVILLE, MN 55113
TeI.phone' ~51-6J3-2561
FIREPLACE 1/.
Ilw1If.!I Make & Model lHP' JJ {; c.,
Sf.. 7S1f1.
Mutti.femly
"
H
;n
m
'"
H
o
m
(')
a
;n
z
m
;n
Pubic
other
.-1"" oljob cost ($39.50 minimum)
J;iiI_ -"-
. .~.. ~r:;. f2 n '\. ..,
.' 1--.,,;'9 15 U u "
j. 4.5u ---=--__<...
1/: \1~9.%:r. - 5.
, I \sb9.!lP"
U
L-
R..member 10 add Ihe Stete SUrclla'lle on lhe bottllffi oIlhis application. - .
'"
'"
'"
Addilionat Inspections wJl be b4t1ed al 135.00 each. g:
<II
...
House Heating Test Reconl must be submitled with I!l!iIdiog IlIIIlII mmIzllL belo.e buiI-'
ing cerllic:allt of occupancy will bit issued,
.!!EAI CALCUlATIONS REQUIRED w"h number of aupply and ,et..n openlngo l!sled I
room willi CFM's per opening. N... IlIrvclUree or addilione -.:IlIoor plan willi a\lflllly
and retum :. ...;...J shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAV BE MAILED m THE CITY OF PRIOR LAKE. 18200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55312.
Model Siz~
TYPE OF SYSTEM
Warm Air P lanls
G,avily
Mecilanlcal
/iJr Condlioning
Vent. 5ystom
'"
111
~
The price 01 you, heating permit Includes ona rough-in and one flnol Inspecllon.
Conn. Load
Fuel ffi
Flue Slzo
Supply Op8llings .
Aetum Openings
HEAliNG OR POWER PLANT
Steam
Hol Walltr
Radialion
Special Dams
Cily HaD business hours are B Lm. - 4:30 p.m.
Input
Ed"
. OIllpui ..J.3 0:0
'"
CD
'tl
'"
a
a
OIlier Daviees
,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FI'fAq- CAU c:rrv HALL
447-4230
~
~
I hereby apply lot a mechanical systams permil and j acknowledqlt thaI the
informalion above is complele and accurale; Ihallhe work wi" be in conlortnanc,
with 'he ordinances and codes of Ihe city Bnd will> the slale buildlng/mechanlCI
codes; Ihat lhis lorm does nol become a permit until sillnad by Ihe BUILDINt
OFFICIAL; thallhe work will be in accordanclt with Ihe approved ptan in the
case 01 oil work which rltquite5 review and approval 01 plans. Jj
<0
tuJJ- UW4... - /! 'H-
, Awl1J1J)fJ n.
Clm.
TYPE OF WORK
AII.mlions
. Replacemsnl
Est. Comp. Dale
IICXto::> Building Perm~'
Ie
New Consl.vction
Repair
() O. 07..uJ.
PAlO WITH
BUlU)ING PERMIT
,
Est. CosI S
HEATING PERMIT FEE S
STATE SURCHARGE S
TOTAL PERMIT FEES $
.50
Recelpl'
BUild1iirniclTS SlgnallJrs
<II
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,0)
_ale
o/./s-. ad
0aIIt
.-.------------------
------------------
----------------- -
10,'1)1,'99 FRI 09:12 FAX 6124.Ji.\2.\5
on OF PRIOR UKE
i4J 003
CITY OF PRIOR LAKE
I Blul;
2, GOld
), Yollo.....
FlI.
City
Appliul'lt
PLUMBING PERMIT
Applicant: ~54; i/TU-nu./,0 f~
Address: ~_,1 C, . ~"i1.iAJ /t-.. ~
. Signature: H~ {#.pfJ'
Legal Descrlpkl",I: Lot Block _ Sub .
Site Address: ~3 c.P-l~ {fit tl~ 1;J.L[#a1 7iZ JeL
Building Permit #. 00 - o7.f2L_ PID # 25 -lOJrJ'::_O/ B:O
NOTE: This permit will not be processed without complete Information.
/CPRIOIr~
(&~~ "-...
,0 .... t,
'~
',-
TIH (~l'Ijrr nllll~ La'll, C()unl.,..
FIXTURE UNITS
Quantity Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
/ Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
I Shower Stall
Sinks
I Bar Sink
/ Water Closet (toilet)
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
GRAND TOTAL
PPNo.
00. 07fol
Phone:_
Type of Fixture
Rough-Ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector 1
Backflow Assembly (RPZ, Double Check, PVB) 1
Backflow Assembly Test 1
Lawn Sprinkler 1
Other 1
$
$
$
$ .50
",,0 YJ~\1'
$~
This permit is granted vpon the express condition Ihat said
contractor, shall comply in all respects with the ordinances
of the State Plumbing the amendments lhen;of,
R DAn,
ATT'EST
Call for all ins eel ions 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850 / FAX (612) 447-4245
An Equal Opportunity Employer .
PRIOR LAKE
INSPECTION RECORD
DI:PARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ?) 4--~ c..J I~ ~k T 1<-
NATURE OF WORK ~l"_"o;; i+ L, L- .
USE OF BUILDING ~ ~/L
PERMIT NO. co~(tO ( DATE ISSUED .$hs/Cb
CONTRACTOR LAtk-<'voQ() INs.. .4'1.1- - s<'(i$<f-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
,~ I
, f-\;tuMliTI~u, .lJ'"Backfill) I I j
~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~""'~'lV~TER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
oJf~
~/~
f; PI
..
1', 9/ltl#/J
:9J'JM.dI
,. .
~ .
')I?/~
Jtj/ h/~
..~, l} Jt/ P6
0, qJ/2/t'6
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~p~ I I j
FINALS
anAOIN3 (~ l~ UL~
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE
NOTICE
This card must be posted near an electrical servir cabinet prior to rough-in inspections
and maintained until all inspections have been: proved. On buildings and additions
where no service cabinet is available, card shall be ced near main entrance.
.11 J J
IZhl J/ I_
) J
r21{11 JI /! ~
12/it- IIIJ i
HAS BEEN SIGNED
Call between 8:00 and 9:00 A. . lur all inspections
FOR ALL INSPECTI('i\lS (612) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
;?;t.;qC:,
/J) ,'!lo~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING fJ
o INSULATION I
J( FINAL '- i--
o SITE INSPECTIO
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
t...L- F(~
Ceo SI$.... Fr L.&
TIME
//_ ;-0 tj,' of)
Br-C<..d / r
DATE
n -7(0 /
o EXlGRADIFILLlNG
.... 0 COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
P-"t">se5
./
~RK SATISF~ORY' PROCEED
o CORRECT A N ND PROCEED
o ro"'::: ~tL<"", ""~~O"~,, ""'."
Inspector: h I J . Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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