HomeMy WebLinkAboutBuilding Permit 03-1232
(Please.rroe or print and sign at bottom)
ADDRESS
_/& Lfj6
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
See Main Fil&,:. ~:;y
3. Yellow Applicant
~~/LJ-3
I PERMIT NO. TJ 3 - I 232j
77~Ep
("eJ;;Sr
LEGAL DESCRIPTION (office use only)
b~
LOT50BLOCK 3 ADDITION 77MffE:];> ~
OWNER
(Name)
(Address)
BUILDER
(Name) ~
(Contact Name) LO'RSI 7'Y ,k.<Cj-j-I.eo
(Address)
TYPE OF WORK
~w ConstrUction
OLower Level Finish
o Misc.
'H4J:J;
I I
ZONING (office use)
p~b
PID ;:)5- 40;;'- ('J)q(,,-C)
(Phone) (P$1- c.r5?2-~
(fo ,1=;1 ~.&JJ. M~l
~0a:F
(Phone)
(Phone) fL:>/2- 2?-1_ Lf1~
ODeck
ORe-Roofing
ORe-Siding
o Fireplace OAddition OAlteration OUtility Connection
PROJECT COST IV ALUE (excluding land) $ 9 t!) I 0'7:!)
OPorch
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 the above-mentioned property and that all construction will confonn to all existing state and local laws and will proceed in accordance with
submitted plans I am are that the buildmg offiCIal can revoke thIS permtt for Just cause Furthermore, I hereby agree that the City OffiClal~r a deSt ee may
enter upon the prop ;;to~sP~ ...//
X ..~ &:-/37/ ff/~CJ.3
r ~ "signature Contractor's Llcense No / Da e
?/
Permit Valuation
PoL.7P ffoJ<AC=:s
$/~ )JoRTII-W'Ear- p~V I
I Permit Fee
Plan Check Fee
State Surcharge
I Penalty
! Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
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35,5D
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This Application Becomes Your Building Permit When Approved
~ 7.edJp
Building Official
9/j'ft,y
Date
I Park Support Fee
I SAC .
I Water Meter SiZ~ I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
Builder's Deposit
Other
I TOTAL DUE
I Paid
I Date
.5$/Q--.Cs, <1
'T//.." (j)
#
#
#
#
$
$
$
$
$
$
$
$
~
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'70d; -
$ Lj 311.-// & y
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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
~i~p;:;atem~~C~ific;/;;;mPlim"mdillow,consttu~OSee' MalnC'FITePan~ mUSlb,
Planning Director . Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
See Main File
White . Building
~l}aN' - t:nolnp.ennu).
Pink" - PlannIng
Th..C..nlnoflh..l.ak.<'"ounlry
BUILDING PERMIT APPLICATION DEPARTMENT ~HECKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
f' /, ,;-r
,0' LinA'A."i
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Ii ., ,~.-
I {.;.,- <-'./"-lCo.--
~j './..(
~,. J, )...-1
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Accepted
X'
Accepted With Corrections
Denied
Reviewed By:
/h4fS
5c <. IY/e.t'""
Date:
7-2-05
Comments:
F,'!(
"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
See Main File
While - Building
Canary - Engineering
~ - ..,annln";>
Th"(...nl..r "rlh..I..k..Counlrl
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
r
[{/( c L~
APPLICATION RECEIVED
. i
~ .
i - (j.,':
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,I t..: (/,,; (.,-
1
J '.A
. ;'''~-
Accepted
/'
Accepted With Corrections
Denied
.
Reviewed By:
~
'i~ t:.J
Date:
9,A/6..?
Comments:
'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,"
~~
See Main File
<... WhitA .. Building::>
Canary - Engineering
Pink - Planning
Thf ("fnlnof lhe I._I... Counl.,..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
(J~
(
~
0- {LJ-tX3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I'L/qc,.- ,,~h.bv ~, ~
Accepted
,/
Accepted With Corrections
Denied
..-;:< ~ . .
Reviewed By: ~
Comments:
I
-;:f~
Date:
9 /3~ 'l
"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."
Sep 03 03 03:06p
METRO GENERAL SERVICES
763-428-2968
p.4
GRn.. n.E
YELLDW - ""..UCAIiIT
GOLD. cn"
CITY OF PRIOR LAKE
SEWER' AND WATER PERMIT
'1~1.J. '/'I7-'/"l- tfr
S.W.No. ')- D-3,)
FA'f...
NOTE:
Sewer and Water
contractors must
be registered
with the city.
'SEP 0 3 2003
APPLICANT: (h t:.iR() (~Ef'.JERF11 SER.VUPHONE: rb3 -4-d-,?5 -a.'13g
ADDRESS: 57Cj 0 r:J uftr/l AVE NE INCDATE: SEP 0 3 2003
...----;-\ ~I\ .~r .--4l\....-. $, rYl I C!../i A, F- L 4'Y) 1\1. .::,S 3 76
SIGNATURE: J2YQ..-+-l ~ ,e.-1V - BLDG. PERMIT #
SITE ADDRESS;-/ /..,Lf-9L, -121,.0.", (l~'1::w. PID#
FILL. IN THE BLANKS
1. Estimated length of water service
Sf)
feet.
2. Size of water service
1'/
inch(es).
3. Location of any couplings from structure
() feet.
4. Type of sewer pipe. ABS
PVC Lj...II Cast Iron
'---
5. Estimated length of sewer line
5n
feet.
6. Clean out (if required),
structure.
located at
NIA-
feet
from
============================================~=========~===========
This application becomes your permit when approved.
BY
DATE:
============f=====================================================
Pwhed w.'H(
FEES: .l1ld: P",f-Myr- . Sewer and water line connection permit.
: ' Surcharge
CAt/! ~e;;) TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
i
L.
Sewer and w~te~-permr.,'ts issued for new construction must be
rec. . ~~~? 1\.b~j I@l;,J:fi1in~ permit card at the time of ~ssuance
to 1\ir$]thaLt 'no\~Wphcate sewer and water permlts are
issu \' SEl' 1 B 2D03 '\2}\ ' eu/AID WITH
DATE ,',EAI " . AMOUNT PAID '-!)!!I!8 o~..,.
_.--:=.:..\ -.....~!T
RECEIPT 8.V-----,.. REC'O BY fl-
, ~
'.,...! I
*
.'.~
16200 Eagle:CreekAv. S.E., Prior Lake, Minnesota 55372/ Ph. ('ls2) 447-4230 I FAX (<1s2) 447-4245
An EauaI Gooortunitv Employer
Sep 18 03 07:46a
========fJ~/l~=~~~=============================================
FEES: E~r Pe~M'~ Sewer and water line connection permit.
~.. .-;=--~._ Surcharge
~ (-~e...) TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* sewer and water permits issued for new construction must be
rec,?rded on the bui1di~l?errnit card at the time of issuance
~o J.nsure r1.,lfc>~);~'a~p,l.ljc;:~te sewer and water permits are
J.ssued 1"llr' I'.. " I' ,'" I. 'i. "',. ""''0
. .IIII..::J "') . ,) - , Qy r-';'/j
iLi\ ,.... : '1lDI....~~.'1.,./J
DATE.:,~AIO '~'I gE:D 2 3 Z003" AMOUNT PAID 'v'_'"", ry
. UJ \..-fr,) 't::f:/~~'1'"
RECEIPT # REC'OBY / { ,~
By_
,. <.
1-
2.
3.
4 .
"-...- 5.
6.
.:.
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'--...-'
l....
METRO GENERAL SERVICES
763-428-2968
p.4
GRE.r.. . "...E.
YE.LLOW - A,.r"'CAIIT
GOl.D . CITY
FA~
CITY OF PRIOR LAKE
SEWER. AND WATER PERMIT
'1;;lJ. 'I'I7-'/~1/r'
3- /,).3J....
S.w. No.
NOTE:
Sewer and Water
contractors must
be registered
with the City.
'SEP (J 3 21103
APPLICANT: fh CIR() (~EiVERAi S~R.VkJ;PHONE: rb3 -4-d.f! -d,'13g
riVe
ADDRESS: 57 Cj 0 r:J. u A IYl All IE.. N E DATE: SEP 0 3 2003
~\"'''f\ .--.L:(' ~SI.J'YlIt'..,-jf~F-L.---"..,IJ. S537i.-...
SIGNATURE: avO.,..+.1 ~ ",,-IV BLDG. PERMIT #
SITE ADDRESS ;--, t'/-V~h I~~.DA' r.ll.R.<Ll- 'b-v. PID#
FILL, IN THE BLANKS
Estimated length of water service
5f'\
feet.
Size of water service
/.,
inch (es) .
Location of any couplings from structure () feet.
Type of sewer pipe. ABS PVC ~(j Cast Iron____
Estimated length of sewer line ='n feet.
Clean out (if required).
structure.
located at
IV/A-
feet
from
=~========~===-=======-;;================~====================~===
This application becomes your permit when approved.
BY
DATE:
16200 Eagl~:Creek Av. S.B., Prior Lake, Minnesota 55372/ Ph. ('%2) 447-4230/ FAX (lffl2) 447-4245
An Eaual ODDortunity Employer
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PLu1.rBlNG PER.\UT FEE
STATe: SURCH."'-RGE
TOTAL PER.;.'HIT fEE
--
.-
I Tili.' ApFlic:toon 8ccom"", YQY,.3uildin~ l'crvlic When Approved
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pl2l/m - d
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J Date
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IN I OJ~N I m,mdA3lll:l()
ES:60 (00~-B0-1JO
12- 5-03; 3: 16PM;
;952 894 0925
# 3/ 4
II
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
i [,~w J!~;~, I PE~T N03- IJ- 3 =4
I
(?lease ~e or Print and Sl2D. at bottom)
ADDjRf.SSU al_
if -( (lp 1/ rn be/" (',esf
Dr,
ZONING Cofficeuse)
'),C
,.,."
,';;~
LOT
BLOCK
ADDITION
PlD
~~i
I
LEGAL DESCRlPTION (ollic. use only)
OWNER
(Name)
(Address) C6\ S
Pvdk ~ S
AfvJ P tJNL-l ' ) SIi\te
140}
ra-q(lfl
1/ (
(phone) f.6 (- L{'7) - '5":200
tv} f'J 5'5 / ;) I
'.'.;e<;
APPLICANT
(Name)
(Phone)
8"
- III '1'-"".lI&^'G "r<
UUI' '';;:'1J ~, _4...,., .... I ~
12481 Rhode Island Ave. So.
oavCl'='~d~ss~:;ara ~.:: 2Z: (City) (Zip Code)
(Contact Person) ~~ V_A.....\' ~ (phone) CfS;) -. '( 9 cf ~ roD 5
. APPLICANT SIGNATURE G'~ ~ ~\JJ ~ DATE \ 2.. 'I '5 I 0 :r
. APPLICANT PLEASE COMPLETE BELOW
. -
. ~NEWCON.STRUCTION 'c o REPLACEMENT , o ALTERATIONS . .
FURNACEMAKEANDMODEL[f'11f10X G.:)lm P-~Lf0- 010 FUEL rJaJ. qttS
5 INPUT 70.000 OUTPUT ?/( LfOO
HEATING OR POWER PLANT
(Address)
I
.~1f;i
'i::.'
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVen!. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
I
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi-Family I % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & NC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
, I 00
Estimated Cost $ '-I, ODD. Building Petmit #
;;,
,
",Co,.
$39.50
i::.."~.: \
$39.50
$39.50
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HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
Ai /IJ - ?d.., \<:>'j \')I.AJ.IL-.r,
.50 .1
PA10W'In
..' ,.. ot::cM'i
, f)\N~t:.F'
-fI.f I Receipt No,
jBY Ur
V
~~c
8 Z003
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Oflitial
Date
24 hour notice for all inspections (952) 447:9850, fax (952) 447-4245
16200 Eagle Creek Avenue. Prior',Lake,MN 55312.. _CC. --.. i
,~----'-
PRIOR LAKE
INSPECTION RECORD
- ~j.>C'~c.st-l&
0CC .J:vJaln ~tt~
DEPARTMENT OF See lVlaln r
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK ~w
USE OF BUILDING ~
PERMIT NO. 03- ~ DATE ISSUED
CONTRACTOR P PHOf\$~' ~s
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING \Mo.1'"
I FOUNDATION (Prior to Backfill) Mi ~ I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
IIW/
4-)4- ~
I SEWER I WATER I SEPTIC
I FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
J '1 ,
j,.-. ~ .
I/I/Y/
1- / >~o L1
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'<
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING (\:e...(J V"r.\ q-(..ot'\
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS
NOTICE
~ee_ ~~
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,.,
Dryvv1
,
h/e. / J
~ 9ftf//091
-:J/rlI7JI/
J v i-Iq-Oq
BEEN SIGNED
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
~~~ TIME
rA./'e,ores/4-
ADDRESS
/6 ~;r6
OWNER
CONTR.
PHONE NO.
PERMIT NO.
as - /2S.2
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~_...--- ~.~
/ -:/ ...---/ )
~/tJS-L ~.
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
msNOO
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
Ir'rqqt
I
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
II FINAL
5 SITE INSPECTION
COMMENTS:
0-FiY ~
$(""~/
CY (J~".1IkIt.e'1+
OA TE TIME
SCHEDULED ~(/
'0 J116.t" (A5:f O.
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
d<{/
,~
~1-
~-I).:s2.
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
r:;
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5: {.Jot I-v.,j /c:.
1-c: 1M I:'
u:lf~!
0f
/ ~/ .
i V-(
c
II WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~ORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ OWner/Contr:
CALL "7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
"""""
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED ~~;. if
T~~
ADDRESS
/ ~ t../o, (p
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:@
(Jr. .- - --
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
(lI PLUMBING FINAL
o MECH FINAL
~ ~~..
I: :fa
03-/2.72-
o EXlGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~~~~.
rv~ /l.J c:2j,.~
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector. ~. _ Owner/Conlr:
CALL 44;::8~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
INSNOn
1-I./-loL
HVRNSVILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
Ors1at Test Report for Job# (;0 '5 C
( . -
Addl'flS,<\ \~J \ \> \" \.
Occupant
Date of Install 1/ Il I ( ,I
Type of liT. FlA V1Iw
Other
Make
Model
Serial
Input
A
PUot Type
Pressure
Input CFH
Stack Temp
:'-.
Date Tested
Company
Technician
11 '
. (" ~.\ \ , Citv \ \. . \
i
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:\ ,j i.....
Space HT
Unit liT
,"",: I u;{ );:<
r>-:, tlll~~ -;' [" to''' C h. - 01
r,' I \ i ~. \,
/ ( ({~)
- ,
HOT SURFACE IGNITOR
. " C02
L\, 02
(~i') CO
SJ /:
1/ i /.
t-/ .N p'
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>Jlltd
BURNsvJLLE HEATING & AIR CONDITIONING
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