HomeMy WebLinkAboutBuilding Permit 04-0455
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
While
Pink
Yellow
File
City
Applicant
(Please type or print and sil[l1 at bottom)
ADDRESS
417'1
G ['C\.: '" lAJoorO
~'f"
LEGAL DESCRIPTION (office use only)
LOT / 5BLOCK
~J2;tI/1v' 11/000 PA Ae,t::-
ADDITION
OWNER ^
(Name) WOr'Y\/\ I
,
(Address) 4J.l "\
S?;-l'7 tr"\Dl\ U'
br-""I,... rJ~Q C_~ r
(Phone) 44: 0 -- 1 WI
BUILDER
(Company Name)
(Contact Name)
(Address)
Co--s ~.
~'I..~OV'--
-::s- 0 h........ f<....
6/~
Date Rec' d
s-: / /. 04-
I PERMIT NO. 04. 0 ~G51
ZONING (office use)
Ie/SD
PID Z. S. 033. 0 ( z. . /
L"-s, 0, n '" 1.."'--
~ qh..b
(Phone)
(Phone)Co/;)'- "(40-, I (ol(l
'TrI.
~ to 74
TYPE OF WORK D New Construction ~eck ~orch ORe-Roofing ORe-Siding DLower Level Finish ~replace
DAddition ~ration DUtility Connection D Misc.
CODE: ~.R.C. OLB.C.
Type o~nstntction:
Occupancy Group: A B
Division:
B
S U
PROJECT COST/VALUE S
(excluding land)
I
E
II
F
I
IIIIVVA
HIM R
2 3 4 5
I hereby certify thai I have filmished information on this application which is to the best of my knowledge true and correct I also certify that 1 am the owner or authorized agent for the
abovt".mcntlOned 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
:T"'f\~~~r: r(r;~ :"rth:'mo", I h",by ,"co thot the o~ om",! 0" d"'qe€~\" upoo the ptoperty to p,,'o,m 0"5n:';T_ 0 'f
\. 'SIgnature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
#JaCJ6J(). ()O
'/q/.56
/~4/, .tit?
,~~O
Water Meter Size 5/8"; I";
Pressure Reducer
Park Support Fee
SAC
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
'fo.oo
TOTAL DUE
This Application Becomes Your Building Pennit When Approved
~n;~ ~~~
3r.a( 1.,9 ,q
- /)-~-LI
Paid
Date
# $
# $
$
$
# $
# $
$
$
$ 3(PO. ~fJ
I ::~<No':ibh')
ThiS IS to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows consti"tlction to commence. Before occupancy, a Cettlflcate of Occupancy must be
'''"cd 0. i~ '_eN- ~".dol( 3f. a:n ~ ~.(. W.
Date - ~~cial Conditions, if ariy
24 hour notice for all inspections (952) 447~9850, fax (952) 447~4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~"
(""While . Building
Canary . 1::" erlng
Pink ' Planning
-
lhe ( ~n'er or lh~ I..k~ Counl",
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
M SA tJ Ov A c."O!J[f)L...
5.11.04-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4-Z1Q
6reAINWOOD CAr<..ub
Accepted
Accepted With Corrections
/'
Denied
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Date: 6ff~t(. .
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Reviewed By:
Comments: .A., - - t'..
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~. J.:7 ~.
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6
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"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 provisions of this code or other
ordinances of the jurisdiction shall not be valid."
t~~
White ,Building
-Canary - Engineering
~ Pint< ' Plannlnv
--
lh~ C~nler of lh.. I.Mk.. Counln'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
/!/\ f
f-'
: )....,
APPLICATION RECEIVED
i I
4--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4 Z77
/"
, ,
,.- \ I I t
_ ii' -lC::--
f i,
,.
,
Accepted
Accepted With Corrections
Denied
Reviewed By: (~~
Comments:
Date:
S- < I C} 'eN
"
v ~ ~ ?:if '=-6- &(1; ~
"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 provisions of this code or other
ordinances of the jurisdiction shall not be valid."
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~ .2=5.04-
(Please!VD~ or orint and sign at bottom)
ADDRESS
i:i:, ~:~ I PERMIT NO. 04- 0 A fir"
3. Yellow Apphcant " '1'"":> ~
42--79
6/M/NWOOD
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
ZONING (office use)
PID;:> \"':" 0.17.0/"l.....<)
~:;~~ANr0~AJci-~ f) ~l"'~ (Phone) -9 ~;}.. Ll4/-"370-.L
(Address) \ 5Od-- \ (Y\u:",,~ P-o PP i(\Q.. l~ 9~'7)-"'"
(Address) (City) (Zip Code)
(Contact Person) m\.~ ~ r-J (Phone) (o\l-%Co-lY~7
APPLICANT SIGNATURE ~~./ DATE (;'--J...-'S;-o'f
XPPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
$39.50
$39.50
64-- 04-~..r IS y
fF\\O
fS ~D (0.
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OWarm Air Plants
OGravity
o Mechanical
~ OAirConditioning
OVent. System
IREPLACE ~ KE AND MODEL
\.., -~
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Industrial, Commercial & Multi-Family
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
----
/
/.50
------
(Office Use Only)
This Application Becomes Your Building Permit When Approved
I~id .-
I Dat~ . 'Z--C 04-
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
:'P)J~
.-
t
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS LIz.. ?=t G~U.~~OaO ci Q.c:..l.€
NATUREOFWORK ~....~a..i. 5eP-\€'o ~ "-~6~ Pb/U.K
USE OF BUILDING ~~ ' _
PERMIT NO. 04.0455 DATE ISSUED SIILtIt)"
CONTRACTOR e/4S"'~IJA. c.o~,... PHONE~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
.E;)EPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR. DATE_
FOOTING l/tal.lF'( J:tJ(2JJf)2.S #?'Y I ~ // ~ /tPY l
I I" I I
UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
/U?,
. #/1
C./;S~c./
~/i'!I"t/
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
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~~
;irt
dip
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y / .t:~'#:.:/ ,
~lMa~/
bJ~y
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
,
ft,ucy
pz#
7P2/W
- I
~~-0y
HEATING
DO NOT
2#ft'
1--'
OCCUpy UNTIL. ABOVE HAS
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.
-
,
BEEN SIGNED
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OA TE TIME
#r,~
ADDRESS
'7277" ~.,';"hJ'cltlbd r7;t--
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
COJll.~NT..s:
N~cr-r. ~~ /
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ECH FINAL
~c/- ~G-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
~IREPLACE FINAL
o GASLlNE AIR TST
o
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WORK SATl~~~ PROCEED
o CORRECT ACTION A...lJ r"V'-'I:.t:1J -
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~p Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl