HomeMy WebLinkAboutBuilding Permit 03-1091
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File
at bottom
e or rint and si
ADDRESS
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LEGAL DESCRIPTION (office use only)
LO BLOCK 3 ADDITION
Date Rec'd
lr3D ---D3
File
City
Applicant
I. White
2 Pink
3. Yellow
PERMIT NO. ([J _I oq /
ZONING (office use)
'f(D
OWNER
(Name)
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(Address)
~/,{'^IA..Y /
(P;~~~~;:-~~
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BUILDER
(Name)
(Contact Name)
(Address)
~E
(' "p-, 'Al.,4Sc- 4- r "
(Phone)
(Phone) (P/2 - '7'2/ - '-19 fJ<>
TYPE OF WORK
ORe-Siding
ew Construction
DDeck
o Misc.
DLower Level Finish
o Fireplace
PROJECT COST/VALUE (excluding land) $
DAddition
DAlteration
DPorch
ORe-Roofing
DUtility Connection
D 0
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 conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware that the building official ca oke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon rope 0 perform ded inspectio
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Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
-
-
355D
-
This Application Becomes Your Building Permit When Approved
~~
Building Official
7/~~!03
Date
_-.Be -1"<'7t
Contractor's License No.
Park Support Pee
SAC
#
#
(p/~~3
$
$
$
$
$
$
$
$
$
-
I
Water Meter Size5/8"j l"j
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
~
/ h'1
~fi- I
TOTAL DUE
~~~~ fll-!-tf3 fa q
I ReceiptNo_
By
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
~~P~~::a:poc~cmmc;/:;~;anceandallowsconsttuctiOSee lV1ain~ilean~mustbe
Planning Director Date Special Conditions, if any
24 hour notice Cor all inspections (952) 447-9850, Cax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
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See Main File
White - Building
r-l,;anarv - Enaineerin1JJ
Pink - Planning
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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:
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Accepted
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Accepted With Corrections
Denied
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Date:
,!-L:t.( 03
Reviewed By:
Comments:
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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."
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See Main FUr
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anary - eering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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fer 3C>-O~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1",31;).- -(~~rJSk-J
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Accepted
v
Accepted With Corrections
Denied
~ 1'~f-' Date: ,7?~~3
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."
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See Main File
White . Building
Canary - Engineering
C:::-Pink - Planmn~J
ThO' ('..nl.., ,,(lh.-I..k.. ('oun"."
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Itc 3<(;)-
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Accepted
/
Accepted With Corrections
Denied
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Date: 7;G2U:;3
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,"
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PLl.J1'.lBlNG PER."UT FEE S
STATESURCK~GE S
TOlAL PER:.'rID FEE S
50. ~~-110
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\ Tn;s ,'\'P?lic'ion B~=Oll1"" 'Your 8uiJdiu:,: P.rmit When Approved
L Bl.lildin( omd.=l Due:
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PRIOR LAKE
INSPECTION RECORD
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DEPARTMENTOFCpp ~A"' F'}
BUILDING AND IN~!CI"ldtf .I. aID 1 f
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO. DATE ISSUED r{iil). J-;-V'"
CONTRACTOR PHO ' ~ · :5"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECfOR
DATE
I FOOTING I
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC -
FRAMING //Y/, (1- 3-03.
INSULATION n1"/ / 1- 6--~
ELECTRICAL
PLUMBING () &. tV t( +"'7 ./1 ".// /1-'3-0 ?
. rt/{'
HEATING (if required) rvy /I-?-~
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
j I I
FINALS
GRADING (Prior to Soddin )
BUILDING -l"" VA\-' \ f51lfl
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
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
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DATE
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/637;2. ~i.er ~S"/ 4-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
TIllE
~3-/o9/
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: g~ - Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSIIOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4< SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
fC"J.q).....
OWNER
CONTR.
PHONE NO.
PERMIT NO.
?-/tJCf I
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
m' FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~RRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ff Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH <I SAFETY/
ual<<>n
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
I~-K" -d".S
ADDRESS
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7'....b~.rc-:, rr
OWNER
CONTR.
s.-/~qr
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CA FOR REINSPECTlON BEFORE COVERING
Owner/Contr:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
INSNOn
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
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SCHEDULED JL.,..~~
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
s-flY11
,
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
; PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
COMMENTS:
f) r c/J.101f-( ,
y~
o W9RK SATISFACTORY. PROCEED
-l!P'CORRECT ACTION AND PROCEED
o CORREC~OR 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!
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12481 Rhode Island A,. S, Savage, MN 55378. 952.g~~
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Ors1at Test Report for Job# 5' "70/0
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Address
Occupant
Date of Install tt:l.? e(
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Type of HT, F/A v- HW
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Make
Model
Serial
Input
Pilot Type
Pressure
Input CFH
Stack Temp
Date Tested
Company
Technician
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BURNS~/~.E~EATING & AIR CONDITIONING
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