HomeMy WebLinkAboutBuilding Permit 03-0678
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See M'.:a~n FI"lewhi" F;I.
u.J. . Pmk CIty
,Yellow Applicant
(Please tyPe or print and siJm at bottom)
ADDRESS
liP'I,j'l /tMge,< ~['r I/.i-,III:F
LEGAL DESCRIPTION (office use only)
LOT B BLOCK;l ADDITION -r;t"1;j~,L C~ST PA1U-
OWNER
(Name) PVLTP'L I-I-?J""'~~
(Address) B IS- NQ"t.:r.lW€Sr PkL.-LwA-.t
1
BUILDER
(Name)
SA-1"1~ A- S
.4A-.4.n.J
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
k&otlf:
/l1,4-t..1
~ew Construction
DLower Level Finish
ODeck
Date Rec'd
530--3
I PERMIT NO. 03- (, 78 I
ZONING (office use)
PtLt'J
PIDas- 40 J. - 0 to 1-0
(Phone) loS-I-"r;'-.J~()O
Jv,~ It/o I (E'~,.J, /""/,.)
!>rl J-/
(Phone)
(Phone)
OPorch
&S'/ - if 0 - ril-OO
(g1,;J.- 1/90- '1).,)9
ORe-Roofing
DRe~Siding
o Fireplace DAddition DAlteration
PROJECT COST IV ALUE (excluding land) $ ~1." e 8
OUtility Connection
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 y.....y"-HJ 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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon "petty to perform needed inspections. . I I
X C---t'___~~ Be-/37/ S'{a1-9jCJ
Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
,.
71(.'1000,00 I
$ , 77IP, 7s-1
$ 604,81 I
$ 3L/, 50 I
$ I
$ loO,o() I
$ 100,00
$ 35,50
$ </~, do
~
~f-
This Application Becomes Your Building Permit When Approved
<
Building Official
~/(z.Jo ';1
,
Date
I Park Support Fee
I SAC
I Water Meter Size J
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
# $ -
# $ , z.. 7'5. 00
t V2,." $ 3<05,00
$ 1150 ,00
# $ /20a .00
# $ 7tJo, 00
$
$
$ 5;3/1 (,,4-
/)
I Rec~No. #:5l.J'?0
By ,
U
This is to certify that the request in the above application and accompanying documents is in accordance with the City ~g ordinanx~= re~~is document
~:uen ~igned by the City Planner constitu;es a temporary Certificate of Zoning compliance and allows construction to \:) eefor 1 VI IDli cat..r lie must be
~ H. -Ill-- ID //~/tJ7
Planning Director f 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
I Paid
I Date
.53'~/.t,~
'7 ?/ o?
See Main File
White - Building
C-C-anarv - Enaineerlnll ~
Pink - PlannIng
TIt~ ('nl~r or Ih~ t.lr.~ Counl".
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
?'I (X7/',: L<Q.._.;-.,.i
()-
:;l.
~-)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: .
/
L; ","'C: _
-, ) I
,
-7-:,:/ /7,.~:~--t..i .__:rr/Z:2~;"
.,/<l~...,/
Accepted X
Accepted With Corrections
Denied
Reviewed By: ~r~+ J- "-
Comments:
Date:
1/1-1) 0)
. -
"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 violaiion 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."
'~
u~~
See Main File
White . Building
Canary - Engineering
r-J;;nk - PlannnllD
The ('enler of the L.kp ('Oll"U'"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED.
i.
'. \.,
~.
'....'
The Building, Engineering, and Planning Departments have reviewed the building permit
. application for construction activity which is proposed at:
I '-/ () i-
i
Accepted
~
Accepted With Corrections
Denied
~
.
~
Date:
to/1 d()~
Reviewed By:
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
~ile. Building~
-l..d,Tdi'\T' t:ngmeering
Pink . Planning
Th~C-..nll'r of Ih..I.lbCounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
Q~ f.I-m~
APPLICATION RECEIVED
~- 3G.-O<=>
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1& Lf.s-L1 - ~Avu ~+ iJlv
Accepted
/'
Accepted With Corrections
Denied
Reviewed By:
~
':fJ2AC,u
Date:
tb/I'2.-/63
,
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."
Jun 19 03 08:06a
METRO GENERRL SERVICES
763-428-2968
p.2
o~ PR10<?
~/~s
aREEliI ~ fK.!:
TELLO" . APPLICANT
GOLD. crT"
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
CJS)..- t('! 7- illA5"
S,W.No. 3--(070
FA/.
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT:~O Gt=/Jir.R..PL SE-R.V:JkPHONE'7b3-4~-a..'1'38'
ADDRESS: 571~O IAro ~A,vg ~!E DATE: JUN 1 9 2003
'--f./ 0 _ " ~YY\IC.Hf/ll::.L)""""iM1J.:S-53'7b
SIGNATURE: , ' /J'\ I\~ BLDG. PERMIT #
~
SITE ADDRESS: /(,,4d-.9:33r 3.7r 4//!-7; 51. 5S-;.5hID#
T~~~
FILL IN THE BLANKS
1, Estimated length of water service
50
feet.
2. Size of water service I"
inch(es).
3. Location of any couplings from structure (j
feet.
4, Type of sewer pipe. ABS
FVC~ Cast Iron
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:
========)7~'k:!=:;~;4=============================================
FEES:
(] /(/ f I::)~' f. m , 7-
,
No ree.
Sewer and water line connection permit,
Surcharge
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?rdedlr~~~r~n~~I~permit card at the time O,f ~ssuance
to 1nsur'~ a@J [IF '!!!Iuto~ ate sewer and water perm1ts are
1ssued. ~{ ~~
DATE PAID ~ JUL 282003 ':.J AMOUNT PAID 1"D.''1ft~~*,h.
;1 G ,.o~ 'Y
If' ~4t1}'
"y
REC'D BY
RECEIPT #
'-
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (1!>2) 447-4230/ FAX ('15"2) 447-4245
An Equal Opportunity Employer
80' d ltiJ.Ol
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CITY OF" PRiOR U..KI PLl:).(Sr>G PZ;:;:'\lIT
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APrllC""-ST PlEA.SE CO,\.fPLETt BElO\V
T~vp~ lJf fi.trur~ I QIJ:.ll1ttC"'.. !
I e,l~:1 :1../1) ""'leh \:Ir WiC:ll)I':C j:'C"\!~:- I' ...1 j R.111:.:m-ln:i
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I L.Jun...:r:' Tr::_ (i or: ..;::rr:~:..tr:~::::lC ;ilr.:, ,. ; ':;C:WJ.=~ E,t:-:::ur .
I Si,awer 5,::11 I 8;tcl<r1ow'A~s~:ncly
I Sink;; I B::ckrlow Assembly Test
I Bar Stnk I L.:Iwn Sprinkler
I W::eer Closet llollec) lather
T:,pe of Fi.~:uro
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fH ;;CH.EJ){;U
{c:;r..!u;;..:-::.l. C!;r.1ml:":'"::~ J:. '~(LLlti.(.:!r.'lil,: t% of100 C:J~C 'Ni'~::l Sj9.'sO minimu~
Rc:.:sid=:tli:ll. N<:..... One.k "wQ-F~ily S'19.~O
R~;C::=.:u::1l. A...ic.i::cns &: A::~::or..i SJ? :0
E.;;:.ic.:.l.(Cc.!. C\J~~ :$
el;iiC!j~~ P~-~'dt ,;
PLUr-.1BrNG PERi.\UT fEE
SLATE SURCH.~GE
TOT.-u. PE~"'m FEE
"''''IU ',MH
s BUll DING PERMIT
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BL O::tc.. II By
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tom.;; t:JC 0I11~)
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! Tai=- ..'\'ppliC.:Hion Secomu YOl.lr Bq,UdiQ~ Permit Wben App~ved
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;.. 11<1\L(" I1Uci~.: flJr'.1.U in.$pcctian$l':::) +-l7-'}:j'sU. (~.'t ('J~:) .4..&';'-J:..;
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::>1. I O::>~N I Elwrlldi>3llti('\
2c:Sl 200c-pl-~nti
651 633 8884
Fl RES IDE CORNER
#4087 P.001/007
ClTY OF P .
HEATING/AIR CONDITIO
OR LAKE
GIFIREPLACE PERMIT
Date Rec'd
m.... q:pe.o, 10rinT a..d 01... ~ boltom)
ADDRESS
FIRESIDFj~ ~~'a" I PERMIT NO. ::2y~b~
HEARTH6-H OME"
16459 TWBERCREST DRIVE
ZONJNG (office 011<)
LEGAl. DESCRlYTION (omee IJS< only)
LOT
BLOCK
ADDITION
PID
OWNEll
(Name PULTE HOMES
(Phone)
(Address)
APPLICANT
(Name) Ar.L1F.P~W~...EllJ.lA FTRR~IOF. HEARr.~r.
(Phone)
1i~1-1i33-2S61
(Address)
'700 NORTH FAIRVIEW AVENUE
(Address)
(Contact Person)
RRENDA HUSTON
ROSEVlLLE
(Clty)
(Phone) _651-633-2561
55113_
(Zip Code)
APPLICANT SIGNATURE
BRFNDA J..!USTON
DATE
10/8/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FWE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PI.ANT
OWnrm Air Plants
OGr>vil'y
o Mcch:1nieM
OAir Conditioning
DVenT.. Syst.m
::J Ste.m
J Hot Wnter
J Rll.dinlion
o Special Devices
o OrJ,er Device.
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach inlo
Required Side Yard
Setbacks
fIREPLACE MAKE AND MODEL
BEA T N GLO 6000TRl X 2
'ndust.rilll, ~mmercial & Multi.Family
FEE SCHEDULE
J % of job CO,! R<<identi.l. Gas Firep10ce PAID WITH
$39.50 minimum All!' nlNr:: Pf=!=IMIT
$99.50 Residentiel. Addition~"ll~ trttr 6nS" -
$64.50 ResidentiAl. AC Only
$39.50
$39.50
.)~.'lJ'
Re,iden,i.I, Heating & AlC (New Con"!""ion)
Re~identi3J. Helting Only (New Construction)
'<1_) : ~-_l u
Pc
~
Est,imated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Pormit #
$
$
$
c
OCT 0 8 2003
.50
(om" IJ", Only)
8y_-
This Applicfttion Become, Your Building '::FWJ,W,llInlMNl'Mn1/ogrJ~Qnd Receipt No.
.~~, Builder' Divis;t. OJ I Dar.e By (;) ~.
~ BIl/ldl..QlllWllIJ FairvicIV Avenue North Ro~le, MN 55113 I hone 651-633-2561 Fax 651. .33-8884 'f'J.'~
auno... <LUll, 3R50 wc.t HJ~J'W8Y J J J3urnsvillc. MN 553,~7 PhOne '~52.H'IO-0758 Fox 952-890.540H V l"iWF.1l5^,,,,,.~,.m
2:thour nOliee r.r.II Inspections (9~) 447-9850, fa> (952) 4ol7-4:l45 0' ... .... ......
'W~",.nl'tlldtllP.l'q", I'4N C~ntr"~""r r.'~/I.I:" ZQu9\l~11
DEPARTMENT OFSee Main File
BUILDING AND INSPECTION
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS I~I./S"q ~~+~~
NATURE OF WORK ---ftI~ -
USE OF BUILDING -5P 14
PERMIT NO, ~ _ DATE ISSUED .
CONTRACTOR P n I+-- No nt.e.S PHo_B - ~o- y ~t
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING Will" I
I FOUNDATION (Prior to Backfill) W-.;" I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
(\\4.;'
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
0'ee. ft~,...
#c~
GRADING (Prior to SOdding)
BUILDING '\"t1A{J f\ ( %+011
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
/1
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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
QIrrtifiratr of (J1}rrnpanrl!
CITY OF PRIOR LAKE
~tparfmtnf of ~uilMnB J1nsptdion
/00' Final Permitted C Conditional C.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
~TNm,E FAMTTV
Bldg. Permit No. 01. 0'; 7 Q
Occupancy Type
R 'l Type Construction
UN
Fire Zone
1\1.~ Zoning District
PTTn
Legal Description
T.R_ R'7_ 'T'TMHRR r.RF~T PARt{
Owner of Building
Site Address l.6..Q..5Q 'T'TM"'RW'Q rlOll<<::rr T'lQTUl<'
Date:
RORF,RT~1TTr.HTN~
r I}I<\ldiJlllOfficial
q 2?,/ol/
// / '
PlTTTE HOMES ~}.<
/;1#/
",\lnR'T'm.JFc::.'T' PllT..TV
C::TTT'1'P 140
....A~.u.,~
<5121
Contractor's Name & Address
City Planner
nnN 'QVl7
Date:
I
\
*;<<
~d'r' nME
/b~57 $wt, at:; r' Llr
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
..a1'lNAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~
/"
(dse
h~
--
C'l3 -~ ?JY
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
--.......
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./
I'WORKSATISFACTORV, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~, ;~~ "7 REINSPECTION BEFORE COVERING
Inspector: /47 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
ADDRESS
/t4S-Q
DATE TIME
SCHEDULED /L')--(j>
1""1!n-~
CONTR,
PERMIT NO. '3--C:?6"
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o ~SULA TION
)i'"FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
Jf, (()Ilk!-
7i) W'Q~'
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(J)
<:'IJ::V'A ;a
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rfu
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t$q~ -h.K no1- w{);",i..~~
FI,ld' ~~
1--, ....I PI,...rk ...bY-'..-m...-4 I
5 t1d- :t- r ~ ',$ 0,._ ~~IoC>H<1_-+-
JYl..
;2. .. d
o WORK SATISFACTORY, PROCEED
.)!f"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 <l SAFETY!
l/fSNOTl
cm OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
Jr: 4 ~q
OWNER
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
T rrn~--t .....5>-r
CONTR.
PERMIT NO,
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
B1'[UMBING FINAL
o MECH FINAL
f/ ....Y'1MI'dL tf~~--<-:f?S
DATE TIME
/2- Jcrs
7> - (;,7 <J"'
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o WORK SATISFACTORY. PROCEED
__ ~v~RECT ACTION AND PROCEED
o CORRECT WO.RK. C~ FOR REINSPECTION BEFORE COVERING
Inspector: ,/1 ff' Owner/Contr:
- ,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH '" SAFETY!
lNSlIOTl
-5'\? l.-.J:> JP\\~,=,TAN)
BUKN~ .vILLE
Heating & Air Conditioning, L,L.C.
12481 Rhode Island Ave 5, Savage, MN 55378. 9S2~894-0005
Orstat Test Report for Jobl
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Address \C'.\';<\ 'T,..."I',c~'."\_"'"
Sl< v\ ~ }
\')12 Citv \ I.""
t..-t\~, ~
Occupant
Date of Install
Type of HT. FlA 'X
Other
\(~) ~ \ u
(,'~:\
HW
Space HT
UnitHT
Make L ( ~)~}
MOdel q.q" ,'\c\(., ;) "-\::., 0. \
Serial seo~j '1 c('(h
Input '\ I,'" ;() () f'",-, " ;.
Pilot Type
Pressure
Input CFH
S1ackTemp
Date Tested
Company
Technician
HOT SURFACE IGNITOR
'3\ \>) c.. C02 'f (,. '7"
L\,-\ 02 (2.-'1'7~,
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I CO Sf:"""
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BUR~LE H~ATiNG & AIR CONDITIONING
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f"' r't 1..1.
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