HomeMy WebLinkAboutBuilding Permit 03-1268
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File", FiI,
2. Pink City
3_ Yellow Applicant
Date Rec'd
ff/t/03
I PERMIT NO'O.3-/Z&f?I I
(Please ~e or orint and si2l1 at bottom)
ADDRESS
/&'.J 02 /
7//"1IJ~L ~Jr IJ"- ftlE
ZfJl11t'use)
LEGAL DESCRIPTION (office use only)
LOT /;J BLOCK :;z ADDITION -ri 1VI1J(5~- WeST
PIDd5- Lf();).- 005-0
OWNER f]
(Name) rIlL r€ 1Io"",e:.J
(Address) !fIr- NCJ/t.TrlAJiEJr PAI2.rt "'f<./ .).'/TE"" It/a
I
(Phone) 6.)// 'f.r,J -5.,.,)00
cA-G-A-.../ I AN s.r 102/
BUILDER
(Name)
(Contact Name)
(Address)
if S/f.""uc AS
A-A/lo,.}
A-BoII€ ,.
MA't--f
(Phone) hr/-- tf.F"l-.Y,JoO
(Phone) tOt,) -If<jo -- if";~ 8
TYPE OF WORK
~New Construction
DLower Level Finish
DDeck
DPorch
ORe.Roofing
ORe-Siding
o Fireplace
DAddition
DAlteration
OUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) S 6t/. f,.5l3
,
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 aware that the building official can revoke this permit for just cause. Furthennore, I hereby agree that the city official or a designee may
~teru~to~~s:ections &_ /37' 9/,103
Signature Contractor's License No. ~ bate
I Pennit Valuation {",') J)/JO, - I Park Support Fee # $ I
I Permit Fee $ r;t./<;?,75 I SAC # $ lif'l5.- I
I Plan Check Fee $ L/<t&" (..q I \.Vater Meter SizeS/8"; I"; $ ~ I
I State Surcharge $ 8"J...5V I Pressure Reducer $ I
I Penalty $ I City SAC and WAC # $ 1 d-<;9O. -- I
I Plumbing Permit Fee $ I D ('J i-'" I ~Water Tower Fee # $ "/00 - I
I Mechanical Permit Fee $ IOI?,--" Builder's Deposit $ I
I Sewer & Water Permit Fee $ Other $ I
I Gas Fireplace Permit Fee $ '-M ;--- I TOTAL DUE $ <-/~ Cl;;' ~ '1'-1 I
This Application Becomes Your Building Pennit When Approved I Paid <!Fb,r 1 . fa.. I ReCei1Jt~. ~r('/-I
~ ?~}.J Jf;S-~3 I Date t/i~Ol Bv tI"-----
()
Building Official Date
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 constitvtes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~ningZ~P Fj;sj~ ~ File
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
5~~
See Main File
-
rh..c-..nl..r"flh..('.k"('OUnl~'
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White - Building
Canary - Engineering
..-Ph n( - !:,.ann,mr-------.,
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
-~
APPLICATION RECEIVED
/..
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
II Q ;2 / - !~. j ) . l"
Accepted
~
Accepted With Corrections
Denied
< ~ ? /? -"0,:.;
Date:
P/~3
Reviewed By:
Comments:
.:'1 I \.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."
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See Main File
Th..C..nl..rnflh"I.8h('ounlrJ
<=-WIlite - t.1I110ma '">
Canary ~ngineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
a&~
R- /-0-3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
If" C; CJ.-- / - --r;.,,~~ ~T J ~ .
Accepted
/
Accepted With Corrections
Denied
Reviewed By:
~
~ "1~P
Date: Y';~3
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
White - Building
Canary - Engineering
Pink - Planning
Tht {'t'nlpr <If ''It' L.lit' ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I I' _ '-~"':':I 1___
I f n cc_:_ :.C'- f
,-( ,'f;"C. L.2:_:~-I......,.. __~
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Accepted X.
Accepted With Corrections
Denied
Reviewed By:
_AV ~A\^
~~ j \J-
Date:
~h 16)
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 cance.l the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
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T:';,:o .-\pplic:lCior: S"comfC:$ Yo...r BuiIdin;;t P.e-rmit When ApprQved
PLtJ"1\,lBlNG PER."UT FEE s
STATESURCK~GE S
-rOT..u. PERlHlT fiE S
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Yl!llOW - APPUCAMT
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CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
Q5).- I(t( 7- t(-;A.s""
s.w.No./)3-/dbt
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT:~~O Gl:fJ~AL ~PHONE'7k.B-4~~a.41j'.3!S'
ADDRESS: 5~~~ DATE: AUG 13 2003
'!ST. mlC:HIII.L)-rn~. fJ'S 376
SIGNATURE: BLDG. PERMI1 #
SITE ADDRES;- It.LJ'.:1/ -(:;,;,J'u,A 0/1...YA>+~,PID#
FILL IN THE BLANKS
1. Estimated length of water service ~C)
2. Size of water service--1" inch(es).
J. Location of any couplings from structure () feet.
4. Type of sewer pipe. ABS PVC 4-" Cast Iron_
feet.
5. Estimated length of sewer line~
feet.
6.
Clean out
structure.
(if
required), located at
NJA
feet
from
----------------------~--------------------------------------------
------------------------------------------------------------------
This application becomes your permit when approved.
BY
DATE:
========fJ~fTed==~~;4=============================================
FEES: ;] I "... . Sewer and water line connection permit.
(1. . - -. ~. -. Surcharge
ND ree TOTAL
~..._,-".."
*' . er sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID
i" d ~ 2~.{J]
AMOUNT PAID
b
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RECEIPT #
REC/D BY
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~...._..__._.~-~--- _._.---~
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. C1!>2) 447-4230/ FAX (!'ii>2) 447-4245
An Eoual OODortunity EmOloyor
S'd
8962-82v-E91.
S3JI^~3S l~~3~3~ D~13W
e82:01 EO DE daS
11-17-03; 3:34PM;
;952 894 0925
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
# 4/ 8
.
Da.te Rec'd
; ~ ~:~ rl'ERMIT NO. 3- Id-. 6?1 )
J. Yellow .4pplscant
(Please type or print and sif'll at bottom)
I ADDRE/&5)/ ~~W CVe"s;(-
iJr:
ZONING (office use)
LEGAL DESCRIP110N (office u," only)
LOT
BLOCK
ADDITION
PID
OWNER fl.. n 10 iL...
(Name) VU 1C... rrU~'S
(Address) 'KIS rJuJ PM Y
Si"u-k (c(O
(phone) ff5/-L/5;2- 5;;:2W
EMC&7, /v1 N. ~7/;;? /
t/
APPLICANT
(Name)
Bumsville Healing & NC, LLC
l;!'1tll ~noae ISlana AVB_ <>a.
SeVIlle, MN 55378-1122
(Address)
~)VvlA 1... (phone)
APPLICANT SIGNATURE A'&'~ C). \M../\....~ l~DATE II ( 17 ( D<
. "kPLICANT P~EASE COMPLETE BELOW
fi!NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL leflfLr5'X G5i(Y)( --;),t./6 - oL(~ FUEL I\hf C/tlS
INPUT U7" 07JD OUTPUT l{.~ t.J(jf')
(phone)
(Address)
(Contact Person)
(CitY) (Zip Code)
0;"2 - gff t.j - avo c:;
FLUE SIZE
RE1URN OPENINGS
TYPE OF SYSTEM
OWarm Air Plants
OGravily
o Mechanical
OAir Conditioning
OVent, System
HEATING OR POWER PLANT
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
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
l-{ 000 . 00 Building Permit #
$39.50
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Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39~ID WITH
BuILDING
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
Ai~
, ~ I
(Omce Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Pd.
.50 ~\ , 1\. ,..-
t>MICY'-Y
I Receipt No.
NOV 2 6 20031 By ( l-
V
Date
Building Officiltl
Date
24 hour notice for an inspections (952) 441.9850, fax (952) 441.4245
16200 Eagle Creek Avenue, Prior Lake, MN 55312
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS /t,S'~/.. r4#K~~+ O~
NATURE OF WORK --N.J:,W
USE OF BUILDING -.SF 14
PERMIT NO. ()3- i4-c.'it DATE ISSUED
CONTRACTOR 'P u.H'1'- PHON.'~- U'O- 'I~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF See Main Fil,
BUILDING AND INSPECTION
INSPECfOR
DATE
, FOOTING yt-\Di'" I
, FOUNDATION (Prior to Backfill) WCl;~ I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
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I GRADING (Prior to Sodding)
I BUILDING rfev-t?
I ELECTRICAL
PLUMBING
HEATING
DO NOT
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
'- )ee.
tf-f04
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OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
I ~ l-~- Cll-I
1- 1-7-061
,
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
QItdifiraft of Q1}uupanry
CITY OF PRIOR LAKE
~~parfnt~nf of ~uilbing c31nsp~dion
/J!1 Final Permitted D Conditional e.O. Expires _
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code certifying
that at the time of issuance this structure was in compliance with the various ordinances of the City of Prior
Lake regulating building construction or use. For the following:
Use Classification
SINGLE FAMILY
Occupancy Type
R3
Type Construction
VN
Fire Zone
Bldg. Permit No._ 03-1268
N / A _ Zoning District PUD
Legal Description
L12, B2, TIMBER CREST
Owner of Buildinf'
Contractor's Name & Address PUL TE HOMES" 815
ROBERT D. HUTCHINS /$);1
Dare p!%y
Site Address
16521 TIMBER CREST DRIVE
NORTHWEST PKWY., SUITE 140, EAGAN
55121
_ City Planner_
DON RYE
Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/65".2/
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
--crffNAL
o SITE INSPECTION
COMMENTS:
~~
----
/
/ ---- /'
( ///~S-e..
,,-
SCHEDULED
. /
~-.6~...-
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
y~~y' nME
,
0~s/d-
as - /.2 6,r
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
. ..-------..
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T~ / e...._________
~WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~.;A;~7 ~EINSPECTlON BEFORE COVERING
Inspector: /~ Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
".,'W"
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
1-J..Y-eX(
ADDRESS
IC';'J-I tf/il1~/(~~vt'
OWNER
CONTR.
PHONE NO.
5-/)..C~
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
81. PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
(j) r(" i1A{]vt. -rr#-7 JHi?7
o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORRECT WOR~, CA~R REINSPECTION BEFORE COVERING
Inspeelor: y1/'f' Owner/Contr:
CALL .&47-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE_
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH ,{ SAFETY!
/NSlWn
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BUHNSVILLE
Heating & Air Conditioning, L.L.c.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
Orslat Test Report for Jobl L; '/ ;/
Address ) L.r' - ; i
Occupant
Date of Install
Type of HT. F/A v'
Other
Make
Model
Serial
Input
Pilot Type
Pressure
Input CFH
StackTemp
Date Tested
Company
Technician
'1 \.
(0" . \ L, City I ; \ \ \ (
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Space HT Unit HT
U-1In, X
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HOT SURFACE IGNITOR
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BURNSVILLE HEATING & AIR CONDITIONING
"
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
!(;,Ct ( 'if PIt b(rc.~.5 f
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNOATION
o FRAMING
o INSULATION
IiJl'FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENT~:
(II {=t",.,!
(J,) c;,.,d
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to- .'.
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DATE TIME
;2-), -y;K (
"'1~ IUv
o EXIGRAOIFILLlNG
o COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLINE AIR TST
o
~?~
q-(-o<.-(
rORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~RRECT 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!