HomeMy WebLinkAboutBldg Permit 04-0261;Plg 04-0308
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
O~ PIl/O+
... ,.
100 ~
~ :0:
U '"
"";IVNESO";~
(Please type or print and siKll at bottom)
ADDRESS
I ~ /77 {N<Ju'/O",,,1<. 1:-",.:,
White
Pink
Yellow
File
City
Applicant
I PERMIT NO.,?)/( - d-0 / I
LEGAL DESCRIPTION (office use only) - d
LOTa~LOCK I ADDITION!fl ~ E3
OWNER
(Name)
DAd
o t t~I=.l1
(Address)
(Address)
nOrJo.... jJ.('/'f)
15t-JAo- -nllJ 401......
t/l{ U, 001, ",-,.I
:z;.~
BUILDER
(Company Name)
(Contact Name)
a-hr'
Date Rec' d
~-/L/-ot/
ZONING (office use)
4A-/)
PIIbt5- 337-03b-C)
(Phone)
C)rl- 1/27- 7J'foJ
p;.. 9"~ , ?"o/
(Phone)
(Phone)
jJJL-J
6Jl- t[pl-&t'ltj
6'2-~1()-1J9)
TYPE OF WORK 0 New Construction DDeck DPorch ORe-Roofing ORe-Siding jd'Lower Level Finish .00 Fireplace
DAddition DAlteration DUtility Connection 0 Misc.
CODE: bm.R.C. DI.B.C.
Type ofGnstruction:
Occupancy Gmup: A B
Division:
II
F
I
mrvvA
HIM R
Z 3 4 5
I
E
B
S U
PROJECT COST/VALUE S 2-", J.N, ,oJ
(excluding land)
I hereby certitY 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 owncr or authorized agent for the
above-mentioned property and that I construction will conform to all existing state and loca1laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can revo s perml or] , cause. Furthermore, I hereby agree that the City oftkial or a designee may enter upon the property to perform needed mspections.
l{- Nul}
x
Signature
I Permit Valuation i~I)J)tJ
I Permit Fee $ - 79,7-S:
I Plan Check Fee $ -
I State Surcharge $ ;. <:""/1.
I Penalty $
I Plumbing Permit Fee $
I Me oI'""""fl';;lW1 FeefjpAlfr $ '-/ (). -
I Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
This Application Becomes ~ur Building Permit When Approved
~'~ 2/j/~f
Buildin.!!. Official , Dale
$
$
$
$
$
$
$
$
4--./C.+- $ //(,.ZS-
I ReceiJJtNo.q~~/l~
Bv 1',1.-..
;
IJ 17
Contractor's License No
Park Support Fee
SAC
#
#
Date
ThiS IS to ccrtify that lhe request in the above applicatIOn and accompanying documents is in accordance with the City Zoning Ordinancc and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Ceniflcate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Water Meter
Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
Water Tower Fee
#
Builder's Deposit
Other
TOTALDUE ~
Paid / f( R ~;-J.;:5
Date . /.1 ~/C; ~Ol-1
. ,
~
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
Special Conditions, if any
Residential Building Permit Checklist
Basemem Finish or Imerior },.ltcrarion io Single Family Eomes
.~~
BY:
Building Permit ;;
Site Address
Fill:
Legal: L
B
E.:cisring struCI'Jre~or NO
CON~ORlyIS TO ZONING
ORDINAJ.~CE
Is this ~"'1 ex:pansion of the existing foo-cpru:.~ or
building height?
I Is me properry locared wirJrin me flood plaiI:'7
I Does ~"e alteration inciude any additional k::cnens?
Does t.'1e pro-posed alterarion include any our.side
e:J.trmces ollie:' man patio doors?
Is the proposed use of \.he fillishe~ space or
al:e:anon for an:fi:.b.i.'l.g oeb.e: m:.m 3. nOTIn::.l singie
f:L.--:J..ily home (oEiee, grouD home, C2.y C2.re, ,~~c.)?
Date: q- /L/---O L(
Zoning:
WCXJd
---
Uuclc / ~
I~ I r; 1
Subdivision:
"t-:E S
NO
YES
NO
Refe: to Pl2.r..ni.,g
Refer to Pl~"1..L--llng
/0
YO
;J{J
Refer co Planning
Refer to Plan.ug
rJu
Refer to Pla:nr=g
Aft)
THIS CREOG..1ST ,~lUST BE COMPLHD .~'fD Ii'!CU'DED Ii'! TRE BUlLDIi'!G PERMIT FILE TO
~L-\..E''lTAli'i A RECORD OF THE REVtEW.
."""-'::7.,pr -'.. -::',...\, T -:~~::r: ~C(:
I. Blue File
2. Gold City
3. Yellow ApplicaDC
PLUMBING PERMIT PPNo 0'1.030[')
APPlica~~~-N-'" 1'\\ ~"""" ~ r-c. C' f\l'.\ 0 Phone:.9S~- q~- ~E:I q
Address: ISr..,\ fYI--tIlll'_-::C~\'~'" _ U _ ~ h""'~\\'(
Signature: ~\ OfN> . C; 0 r~, ~ I
Legal Description: Lot Block Sub
Site Address:..l5\'\'1 \~ ~'lr\J \r":" Q.
Building Permit # FI L-- E / IV 1)4.0 2h LPID # 25. 337. 030. ()
NOTE: This permit will not be processed without complete information.
(Lc~~3)q.h~ ~ Wo.t-~ ,"-l~l/~~~ITS
I Quantity Type of Fixtu}e . , cluantity
I
I
CITY OF PRIOR LAKE
TM emll'r of ",.. Lab Co"nu",
Type of Fixture
Bath Tub with or without shower
Rough-ins
Dishwasher
Water Heater
/
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Back/low Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
J
J
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
$
$
$ ~q.Sn
$ .50
GRAND TOTAL
$~'[)t'l
This pennit is granted upon the ex.press condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
4(p (p &:3 , 4 ;U ()'f' DATE
ATTEST
/
Call for inspections 24 hours in advance.
16200 Eagle Creek Av, S.E.. Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employer
APR-22-2004 10:34 FRoM:KLEVE HVAC
__~/21/02 fRI 08:38 FAl 8124~74245
9529417240 TO: 19524474245
CITY OF PRIOR LAKE
P.l
I4i 001
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONINGIFIREPLACE PERMIT
Dale Rec'd
I. '1M
......
J. Y.u-
~... I PEN'UA l'OOt/- idl' I
.
(P'teu! t'.Ii!. or urint I.ft:Cl slfJ1 at lloaoml
ADDRESS
15111 WooddueJ, trqi I
ZONING (._00<)
U!.GAL DESClUPTlON (ol!II:l; II>C C>lly)
LOT BLOCK
ADDmON
Pro
OWNER --;:2., .
(Name)_ Ur, 'C\Yl
I (Acldr05) LL \J; ~ lD
--rF1 orsokJ. l-tOt11eb (ptlone)
W e..d,lle. IN DcxJne. EOaan M tV ~51 Z...::;
oJ '-J
~;;;.rXIO.Up- Hto- i qlC'.1 (Phone) Q62. - qc/A - q.,ill
(Addre>')~S p,OOm?u. -rra/,I Ed(in Prair~ HIJ 55o~7
CC_'- lJJ~:~d- (r 1, <p>_,'Cl5Z -qJ, ~rl.77
APPLlCANTSICNArok ,~\ ~ DATE I./: -?'2- 'D~
"-- ..
OAPPLIC^~T PLEASE CO~LETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT ~ AL n;R,A TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETUIl.N OPENfNCiS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWumAlrPI",,,
DGr.lvity
o Mcch>ni",,1
t1Alr Conditioning
OVcnL Sy:ttcn
FIREl'LACE MAKE AND MODEl..
gSIUm
HO'WIl.,.
R.adl;ation
o Spedal [kyle",
o Ol/Ior Ocvie"
PLEASE NOTE:
Air Conditioner Un I..
CIllIDOt Encroach Into
Required Side Yard
Setbaclcl
-. '-.- ..
--~~,_.
IIEE SCHEDULE
'ndumial Commen:i.1 ,t Multi-Family 1% oi'job CO$< Residential, Gas Fi..pl=
$39.50 minimum
RcoldonllaJ. Heatin; &; Ale (Now COflSUll<!li In) 599.50 R..idcnUII. Addi,lo", &. A1D:nllio",
R..ldendaJ, H..1InS Only (New C..stroctlol ) 564.50 Rcsld<nrlal, AC Only
$39,'0
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$-
5
$
$39.50
~.9.jO
,',.lnA
. '1~15':]0
'" t, .~'
,'~ "'i.........
""10';'::J
'~-''')''
.'."
-'VII.'
Eatlmaled Cost $ Building Permit #
,50
(om.. IJ.. O"y)
Thil AppUc2t1nn S.eomCll Your Balldlnl: Permit Whea Approved
Buildl., OOldol
Vare
I P..d
.1 ,l.laJ-f)~ Z r LUU4
I Reallpl f'lo.
24 hoer node. r.r 0111"0""0" (952) 4oI7.!1'SO.'" (9S2) 4017..41.5
~Yr
IV
PRIOR LAKE
~1~A~~~~~~~~j~~~ I "
NATURE OF WORK L L
USE OF BUILDING _ :s.c=
PERMIT NO. ()~~ PfTE ISSUED 1./, I~. ~ _ .
CONTRACTOR hl>"'St"~.J ~W'-~~ PHON~/~" 8'/~"..fS"Y'?
NOTE: THIS IS OT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I
I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
-
FRAMING (}//~ )
INSULATION I
ELECTRICAL I I
PLUMBING .1 I
HEATING (if required) 1 I
FIREPLACE .1 I
GAS LINE AIR TEST { P - ~Qr H-lt- -\b
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
4--;),,/
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
/'~
- ,
7/-217/t:; '-/
&/~/~.
,7-6y>~
7/~#
SIGNED
;////-
1 I~/
OCCUpy UNTIL ABOVE HAS BEEN
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/)/77
U/Od/
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
AfFINAL
o SITE INSPECTION
CONTR.
PERMIT NO.
~LUMBINGRI
. I
WATER HOOKUP
o SEWER HOOKUP
..,..l!f-I"LUMBING FINAL
,..,P-MECH FINAL
~<I' TIME
e I
4t--d ~
oc( - ..26(
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
,.-ar1'lREPLACE FINAL
o GASLINE AIR TST
o
COMMENT~: _ _ /1
~r 17 Ie,.., ( 7; l.. / /~~
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/ /'Y6se /-i (e )
<... - -----
X WORK SATISFAo,,;,uK', t'KUo";",,D
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspedor: ~ ~
. OWner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .l SAFETY/
HWW"