HomeMy WebLinkAboutBuilding Permit 03-1403
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
9. z, Z.oJ
Main File
1. White File I PERMIT NO
2. p;", Cj<y . 0 '? - /' 1.n.3
3. Yellow Appliflnt J "'"fV_
(Please wee or print and si2l1 at bottom)
ADDRESS
$lXJ'I
Bw.fF J./ fi/~Hr5
1M-II.-
ZONING (office use)
PUO
LEGAL DESCRIPTION (office use only)
LOT ZDaLOCK J ADDITION /f:mEM. !!Iuif .AlJdlrlO/l'\
OWNER.? _ II
(Name)~ HtJ1IES
(Address) fj/5 tdJlT#tV,r:cg ~A'/,.
PIDZ5.4-02. 02-0.0
s~ /41v.
. ,
_ (Phone) p51-'15Z-~
CAMz1 $n ss-J 2./
BUILDER
(Name)
(Contact Name)
(Address)
5A111&-- _
CPizr ,~IA,9;bKA
(Phone)
(Phone) (,IZ- 221- 419~
TYPE OF WORK
Ii( New Construction
DLower Level Finish
oDeck
oPorch
oAddition
oRe.Roofing
oAlteration
ORe-Siding
o Fireplace
DUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
?4 /J9S-
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 r'~r-"J' 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
;teru:;Z;/O?L~ SC- /37/ 9 ~94~
_ ~- r Signature Contractor's License No. '/ ~ate
I P.Y Val . 0 I P kS F # $
enmt ual10n q 0, 0 0 0 _ 0 ar upport ee
I Permit Fee $ (72.3.75' I SAC # $ 1 Z 75.00
I Plan Check Fee $ 600,~ IWaterMeter Size5/S";1"; $ 25V,OO
I State Surcharge $.tJ-5: 0 () I Pressure Reducer $ -Is: ()()
I Penalty $ - I City SAC and WAC # $ /2-0 cJ . 00
I PlumbingPermitFee $ 100,00 I Water Tower Fee # $ 700.00
I Mechanical Permit Fee $ /00, O{) I Builder's Deposit $ / Co o. (){)
I Sewer & Water Permit Fee $ .::35..57) I Other $ .
I Gas Fireplace Permit Fee $ /I-{),()O ITOTALDUE$~,~/4-.('9 I
II.. .'
I Receio;il\[o. 4-r1U J
Bv /1/
C
, This Application Becomes Y~ur Building Permit When Approved
~ ~ -M/b:r
Building Official Date
I Paid I,I /~
I Date /d .l/lrP )
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 .--.-r-....... Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~anni:Jrdf ' 1~/11.~J ~tL1{potOrrftt1Jf~an~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
'~1
Main File
Tllr ('rdltrof 1M 1...tCOunlry
White - Buildi~
O~.narv - t:nalnpert.,g)
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
L
j:1/L. rc:- ,l-fc/'16S
tf. 2 Z 03
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,5()O+ L1t.~ UFP //S/GflrS- T!2-t.----
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
~
Date:
Comments: ~.... RAverse Side for Additional Information!
li1iA ,., f,' I{
ID- 11,-03
See Attllchment~. 1) ('-.rllrlin'! Pl"-n, 2) Erosion C;ontrol Measures
"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."
Main File
White - Building
CanarY - Fngin_ring
~nk - Planning:::::.
Th~ Cfnlrr ", lhr L.h ('ounlry
IruILDING PERMIT Aff).ICATION DEPARTMSNT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1::Vt.- I t;...- HOI'/6S
C/. 2 Z . G3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
500+- Lf(, UFP /-/6/6#0" 77~'-
/
Accepted With Corrections
Accepted
Denied
"
Reviewed By:
~
~?
Date:
lelf1 ~ 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."
~~
Main File
<::::Wbite - ~"g-.
Canary . Eng neering
Pink . Planning
Tht ('tnlnof Ih, I..h<"ounll'}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
PtJt, 76 /-frJ/'16S
tf. Z,Z..03
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
500~ Lf~-(/PP /ff5/6ff73' ~
~
Accepted With Corrections
Accepted
Denied
Reviewed By:
Comments:
;g~ ~I-- Date: Id;1~'J
kL-.P o-U. ,~,
"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 22 03 09:53a
METRO GENERAL SERVICES
763-428-2968
p.2
DM.lM . PIlE
ULLOW . APPUCAIfT
GOLD . CIT.,
CITY OF PRIOR LAKE
SEWER' AND WATER PERMIT
Cj'~.2.,. 'I'I7-if1-- IIr
S.W.No. 3~ /L{o3
FAy..
NOTE:
Sewer and Water
contractors must
be registered
with the City.
APPLICANT: (h t:TRO (:!;ENERAi SER.I/UMONE:.7b3 -If-d-.fl-;;)''13g
ADDRESS: 57Clo r.::J.uArIl AI/Ellie: ::r:7\JCOATE: SEP22Z003
~ ,1\ .--Llr .-Jl\-- S-r. fYl JC!./1 f'lr=L -w)1V. ~5376
SIGNATURE: J. alJO.'+'(=_g>--1V BLDG. PERMIT #
SITE ADDRESS: 50 () t./-ti-l:..(J.. U'h~:J/14...LPID#
'iV-~
FILL IN THE BLANKS
1. Estimated length of water service
Sf)
feet.
2. Size of water service.. I"
inch(es).
3. Location of any couplings from structure
() feet.
4. Type of sewer pipe. ABS PVC ~(I Cast Iron
'--- 5. Estimated length of sewer line 5' () feet.
6. Clean out (if required),
structure.
located at
NIA-
feet
from
====~================~===~===----~====================-==~=~======
This application becomes your permit when approved.
BY
DATE:
========f7=jT~=~~~============================== ~'-~Jf~.f~==.~~:_-
o r ,c' i,_' ,--....
FEES: /J Id,j FJ~e..M' 1- . Sewer and water line conne on p mitt,! ! nil
.... . 1 Surcharge OCT!:I II
~~fl,;:- TOTAL 1 'l 2003 I J /
Fee for either sewer or water individually 'fBY_$20.0.0. Plu::;Pi
$ .50 surcharge. -- , '.
~~.
Sewer and water permits issued for new construction must be
recorded on the building permit card at the.t~me of issuance
to insure that no duplicate sewer andS' w.n!WB ~its are
issued., UILO/NG PERMIT
DATE..,~AIO . AMOUNT PAID
*
*
'REcEtPT 'j
REC'DBY
0-
.,',.;t.:'n.
16200 EaglQ:Creek Av. S.B., Prior Lake, Minnesota 55372/ Ph. (952) 447-4230/ FAX (~) 447-4245
An E<lUal Ouoortunilv Emolover
1-27-Q4;12:Q7PMi
;952 894 0925
# 1/ 3
.
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGfFlREPLACE PERMIT
Date Rec'd
q'1ease!'a!< o:wt md sim at bottom)
ADDRESS 500 4 ~Iu.ff
I-Hs,
Ii.
l: =. ~~ I PERMIT NO.A" IlL'"
J. Yellow Appli-' ~
ZONING (ollice use)
~~~
'"
~
LEGAL DESCRIPTION (office use o.aIy)
LOT BLOCK
ADDmON
PID
, OWNER
(Name)
. (Address)
O[A,\-\e .
<=61S
~s
r0 W pK-uJj
, Sui~ 140,
(phone) ft,5{- 452- 5200
z:a~ f\I1f\J ';;5"/.2./
J
~
if}.
I APPLICANT
(Name)
Bumsville Heating & Ale, LL(;
12481 Rhod~ )sland Ave. So.
SIIVlgl, MMdlNY8-1122 (City) (Zip Code)
(Contact Person) ~ \LA1A:e (phone) q 52 - R9 C{~ 00 0 >
APPLICANT SIGNATURE ~~ n. {~ DATE '(::2..,!e,t..f
'-.J v ,
. APPLICANT PLEASE COMPLETE BELOW
~NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACEMAKEANDMODEL lMIUTK G'SI mP- ,?JoPr O'ln FUEL Mrl, ~
FLUE SIZE RETlJItNOPENINGS.s INPUT {~OM OUTPUTC,'-l/, t../-OO
TYPE OF SYSTEM HEATING OR POWER PLANT
OWonnAirPlants 0 Steam
OGravity . A --.J" 0 Hot Water
o Mechanical L-e,,(J f V'-''' . ,I 0 Radiation
tEtl'tir Conditioning ID A c..L - a;:< "1 0 Special Devices
OVent. System --'-0 N 0 Other Devices
;)..\
(Phone)
(Address)
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
I
",II
I'
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commereial & Multi-Family I % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
Estimated Cost $ :). SOD, 00 Building Penn it #
$39.50
,
f,.:
;,
$3950
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
s
I~~ A L.! l<kr
~?\~ p~?~rPIl!. ~ O~ ,
lfJ;l
(Omce Use Oaly)
This Application Becomes Your Building Permit When Approved
Paid
I Receipt No.
I By
Buildin. omdat
Date
Date JAN 2 9 20m
24 hour notice ror all Inspections (952) 447.9$50, rax (952) 447-4245
16200 Eagle Creek Avenue, Prior LaIt..,MN 55372.
m'"'
. ~~
:%
/
DEPARTMEN; OF Main File
BUILDING AND INSPECTION
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ScaLI ~ ~ ~/~
NATURE OF WORK AlEW ~/.JS'T ~c::r16'"
USE OF BUILDING S' IF: A .
PERMIT NO. 1J3./~3 DATE ISSUED /019Z;
CONTRACTOR ...&.TE /./MtlES PHo"NE -zz~4'1aS"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
,
I FOUNDATION (Prior to Backfill) I v111f1/)IW1 J /-/tJ--OJ //J*ILI~g
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED / .
ROUGH - INS
I FOOTING
\AlI ( ./
L
.
SEWER / 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 I
FINALS
GRADING (Prior to Soddlnfl) /V# /z ~(~ ~~ / I .
BUILDING 1" -tw<' lII\~\ ~ 1/1\ ./%-H / ~~/dY
ELECTRICAL
PLUMBING IvY / L-t ~ if-Uti
HEATING VV/./ <---I-t'r/V}
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.
/'1//
!/vY /
1~/<J-tft1
~ -/{-()i4
A
/V/, '"
//VT./
J. -I t-cJl1
<-/ /J~(}0
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
p7/~ TIME
, ,
:500c/ 8X# ~ 7>/
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CJ S -/9'&.3
[] FOOTING
[] FOUNDATION
[] FRAMING
[] INSULATION
..,..lI1'INAL
[] SITE INSPECTION
[] PI.UMBING RI
[] MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
[] MECH FINAL
[] EXlGRADlFIWNG
[J COMPLAINT
[J FIREPLACE RI
[] FIREPLACE FINAL
[J GASUNE AIR TST
[J
COMMENTS:
~~/
tJ~
~~ ~
/' - ',,",
/ /J/ F r / 1
~ r _/o.>-e- ~ IP /
"-.... ' - .--/'
-
-
~RKSATlSFACTORY.PROCEED
[J CORRECT ACTION AND PROCEED
[] CORRECT WORK, CALI. FOR REINSPECTlON BEFORE COVERING
Inspector. ~ -- OwnerlConlr:
CALL '.&7.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETYI
..."."
BVRNSVILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave 5, Savage, MN 55378.952-894-0005
0rs1at Test Report for JaW { ,,() +n
l/HW
I
...." t.\ t," (\
/n.nrlo/
(' :hi./!1.P - .:l;J~... 0 -:fa - 0 \
5"rv4 f... 4-0,,<; '"1-4
Address '" rtlt./
Occupant
Dale of Inslall
Type of HT. F1A
Other
Make
Model
Serial
Input
PUot Type
Pressure
Input CFH
S1ackTemp
Date Tested
Company
Technician
i~)',~~ ~ "'""\'(r.,"l City \)...;~
SpaceHT,
\.~
UnitHT
Inl. cx:9O
,
HOT SURFACE IGNITOR
:s.~ CO~ /...f:.%
[PIn 02 q.:.%
QX' 0 CO----l1-fp-
,,111101
BUR~sviLLE HEATING & AIR CONDITIONING
::5~oro
llA TE T1Ml!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/2-1-0,/
,
ADDRESS G"o:;'I B/,$ f-/trf4l-J T / t
OWNER CONTR. _P,/lfr.. I:i.~v
PHONE NO. PERMIT NO. 1'). ~ -ll.JaJ
[J 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
o MECH FINAL
'Jj(EX~UING
... d' COMPLAINT
[J FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
hy~k ,("In
;;t"4f~ 2s D ~
r;( WORK SATISFACTORY, PROCEED
. [J ~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InspectOr.d,,~ "'- Owner/Contr.
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HIULTH & SAFETYI
"""'"'
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
@~
DATE TIllE
SCHEDULED
4~'-/
, f)C(J4 {(Irk Iff>
CONTR.
PERMIT NO.
"'$-/V-c::13
o PLUMBING RI
o MECH RI
o WATER HOOKUP
0. ~R HOOKUP
p'pLUMBING FINAL
o MECH FINAL
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
rz,o.f-~7
f
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR CALL EINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HLUTH .. SAFETY!
.-on