HomeMy WebLinkAboutBuilding Permit 04-0257
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
See Main File
:3 ~L75- L/
I PERMIT NO. d4-,Oz.57
(Please'!vpe or orint and sign at bottom)
ADDRE~~
17<f23~ed Driue. :fE
I. White
2 Pink
3_ Yellow
File
City
Applicant
LEGAL DESCRIPTION (office use only)
LOT z.. BLOCK 1 ADDIT~-~N J JQ. erfi -c...Jd I ~
OWNER
(Name)
(Address)
~~;~r~n~. ~~~Q..
(Contact Name) "'d..-u:.. t-z... ~
(Address)
TYPE OF WORK
~ew Construction
DLower Level Finish
o Misc.
l'~f C,
"/.-6
e-3
ZONING (office u,,)
12'd-
PID;)5- t!o1- ()O;)-6
(Phone)
(Phon'q~ ) 985-7533 _
(PhOne~~("~ h~"'V
../
ODeck
DPorch
ORe-Roofing
o Fireplace
DAddition
DAlteration
113, '327.,
ORe-Siding
DUtility 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 t'wy..nJ 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. Furthermore, I hereby agree that the city official or a designee may
;terulonthey,vY<"Jt~;~;tions drooSC06i '2 }"" Jay
\ Signature Contractor's License No. ~ rJate
I Permit Valuation
I Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
PROJECT COSTlY ALUE (excluding land) $
I
I ~ /~ j, IJ[)O.f)iJ I
$
$
$
$
$
$
$
$
l~n,5o
zr~,/. 68
70,50
/tJ(). &d
IOt),OO
SS-. $"0
i/O,DO
This Application Becomes Your Building Permit When Approved
:& ~~n~ i~ci~ Li l:.,e3,1u <(
I Park Support Fee
I SAC
I
I
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
() 6Jr,,;/
4-. LCtl!---
#
#
~
Water Meter Cize 5/8':;}I";
Pressure Reducer
#
#
/
I~~.
$
$
$
$
$
$
$
$
$ <'0035". / e
~
~
Paid
Date
/35"tJ,oo
'2. 'SO, 00
t/~.O(J
tZCJ6, Oil
700, eJt)
4'U (. ,ye
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
~ PI'"tiJ) ~empmMY cenifica#;~P;ce ~,dallow, CO"'tru'Seeen1vlalii File'UP,"~ mu"be
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
c-White - BuildiiiSi::::>
Canary - Engineering
Pink - Planning
The ('rnln "f the L.kr ('ountr,'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
LY R No-z/ern.J
3 - ;;;zs--o.)
The Building, Engineering, and Planning Departmflnts have reviewed the building permit
",pli~t;oo fOCOOO"/:;;;;::rzt;l:d:o D J- .
/
Accepted
Accepted With Corrections
Denied
Reviewed By:
~~
~~
Date:
4/~/ol/
Comments:
See Main File
"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 .- Plannl'!9>
rhr ('~nl..r Ollh.. I..k.. Counl')
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
/
! '
I :'
, )1
'_./
.-.-
APPLICATION RECEIVED
-' u..j
'-
.....-
1 .
"_ The Building, Engineering, and Planning Departm,ents have reviewed the building permit
application for construction activity which is proposed at:
1//// ), :;.' /./ 'i;-(~' /'
f . _J' J / ,-' .: ;,__._~..
.
Accepted
/
Accepted With Corrections
Denied
Reviewed By: ~ ~~
Date: #~~t(
Comments:
"
See lVlain File
..,
"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,"
s~~
See Main File
Th.. ('r"'I" of th.. L.kt Country
White - Building
cCanal ~'-.:_ ~~l"lneenng......->
. PinK - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
, '
,/ !
/
I
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/
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:::;;;- - ..-::? "~;-:""-C(/
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The Building, Engineering, and Planning Departm.ents have reviewed the building permit
. application for construction activity whichis proposed at: ,.-_
I ""i" ."
,.f..:!. r/ ./ / )).-..
ij ...\J..._
,/ .,'
1;~/}/~/~:;;\,3
/
Accepted
x-
'-
Accepted With Corrections
Denied
Reviewed By:
1J/J4/~
. -
5r'.(,. n1e"h
Date:
L/-~-OY
Comments:
~"/I'
-
.~
....,
"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."
1t'774 '1
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
1. Pirik
u;"',
3. Yellow
/
~:~ I PERMIT NO./ ./_ '"'\ ~",
Apphcant ."., .~
~lease .~..or, orint and sign at bottom).
ADDRESS
/7LIJ3 DI'ex' QplJ
\)r.
ZONING (oo;c" us,)
LEGAL DESCRIPTION (olliCe use only)
LOT
BLOCK
ADDITlON
rID
OWNER "'" """"
(Name) V. I<:, .
1--1-0 r f.nVl
..
(phone)
(Address)
~f;~~ A/h'~vH-- M fc-tl ,~.
(Address) ,'~ 10 .'In . J\..~t1f> he.~ n..
(Address)
(Conta.ctPerson) d!Arot12LA.Ll,/ /
F-~~
/-~ - . ---
E a. Ct ell/!
-'
(phone) ~51- 4(5~-c2115
/1I16\J S 51 ,;z~
(City) (Zip Code)
(phone) (p 51 ~ 4(6::1- 01 "7,/5 )(,;2/,$
qlb/6;1
DATE
APPLICANT SiGNATtJ'RE
/"
APPLICANT PLEASE COMPLETE BELOW
E11':lEW CONS1RUCTION 0 REPLACEMENl' GAL TERA TI<;>NS
FURNACEMAKEANDMODEL~r-Vo.n+ JIOAAVOl/:l.Or;O FUEL A),,+. r;",s
FLUE SIZE ,'ill RETURN OPENINGS INPUT 2'ff, 000 OUTPUT
TYPE OF SYSTEM
OWann Air Plants
OGravity
~o~~~:Oning
OVent System
FIREPLACE MAKE AND MODEL
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o SpecialOevices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Constnlction)
FEE SCHEDULE
1 % of job cost Residential. Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial. Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $ 5500. 00 Building Pennit #
REA TING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
:;)i\n,,",,,
. '.'lIli~~~
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-. lti~vrW' V
(Office Use Only)
This Applicntion Becomes Your Building Permit When Approved
PaId
Receipt No.
,~~
~
IJ
Building Official
Date
[lat~ APR 1 5 2004 By,
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
--~-j
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. Pink
2. Green
3. Yellow
File
City
Applicant
I PERMIT NO. 'I~,.5~
(Please tvoe or orint and silDl at bottom)
ADDRESS
ZONING (office use)
17423 DEERFIELD DRIVE S.E.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name DR HORTON
(Phone)
(Address)
APPLICANT
(Name} ATJJFDFTRFSTHR DRA PTRRSTDR HEARTH & HOMF.
(Phone)
051-013-2501
(Address)
?700 NORTH FAIRVIEW AVENUE
(Address)
1l.0SEVILLE
(City)
<;<;113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
0/14/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
OWarm Air Plants
OGravity
D Mechanical
OAir Conditioning
OVent. System
o Steam
o Hot Water
D Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEATN GLO SL-750TR.D
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Residential, Additions & Alterations
Residential, AC Only
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
$39.50
$39.50
,~~(l. . \\\;'<
~')'\o"~';();f"
~.{f",~~~;
~~..V'
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
(Office Use Only)
Buildine Omcial
--,
m 1]itG \~ 0 W ~ \\' Receipt No.
!, \ I. D~lJN l I) 2004 " By
UlJ --
24 hour notice for all inspections (952) 4479850, fax (952) 447-4245
Bv
This Application Becomes Your Building Permit When Approved
Date
{J
(j
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS J?A./~S Dbt:t2-r;::;cL.D ~,~ S.E.
NATURE OF WORK Nl;~ CINSTIUA.a"'.~
USE OF BUILDING S*~A. .. .
PERMIT NO. 04-.0257 DATE ISSUED ~
CONTRACTOR -1).2.. ~ I i~. PHo"N~ .,-~.,."
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF See Main File
BUILDING AND INSPECTION
INSPECTOR
DATE
, FOOTING
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
. "
SEWER I WATER I SEPTIC I /IVY'
FRAMING ..". Ie. Jl#?~
INSULATION """/C ~
ELECTRICAL
PLUMBING {/, (d, IfI1 (PI/lor /Y~ ~// Y/c:'I
HEATING (if required) $?- ~ /.JZ~6/
FIREPLACE , ;; ~ 6/24. '4
GAS LINE AIR TEST JI/..,}. f /If/; ~ t' ftt(/~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
?t, j.,h(./~I
Jb4/"~
<fr~ r ft~
J
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
c >ee /f~;" /:?/.~ .
4U/ 7~"/~
I ~I' t!'y
/JfJ1 ~/ ~/ CJtf
~ '7#~~t
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
This Certificate issued pursuant to the requirements of Section 110 of the 0 Residential / 0 International
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:
04-0257
QIrrfifitafr of @ttupanql
CITY OF PRIOR LAKE
~tparfmruf of ~uilMug JJusprdiou
~inal Permitted D Conditional c.o. Expire~_
I
Use Classification
STNGLE FAMTT.Y
Bldg. Permit No.
Occupancy Type
R 1 Type Construction VN
L2 Rl DEERFIELD 11TH
Zoning District
Legal Description
R~
Owner of Buildin~
Site Address
174:'3 DEERFTELD DRIVE S. E.
Contractor's Name & Address n.R _ HOR~ KFNi\RTDr..F.
RORFR'T' D. - FU'1'rJ.H Nc./??/ ;L- CIty Planner
9~p;nq"ffiCial
, ,
n()1..1 "RVR
~'1'.. SlTT'1'E 1 nn _ T.AKEVTLLE 55044
Date:
Date:
'\,
DATE
?//k
/7'1.,23 Aer4.// ,tJ~'-
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
COMtJlJiNTS;-. .
/:/~Pt~<<-(
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
rECH FINAL
nilE
o <V - ..2S'?
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
..,.A!f1'iREPLACE FINAL
o GASLINE AIR TST
o
~ /" I
0/lq I cfo~
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/7,.<//<,~<
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/P'{.e C.h .
Inspector:
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of
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
~ Owner/Contr:
-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4< SAFETY!
"'SNOn
CITY OF PRIOR LAKE __ %"L
INSPECTION NOTICE SCHEDULED '9~t19"" TIME
ADDRESS /7</Y.> vee/I)'c/d d-
OWNER CONTR.
PHONE NO.
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
~LUMBING FINAL
o MECH FINAL
COMMENTS: /' /
~""'''''.Al4'"~p- k ~T
~</ - .-1?S7
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
d-
~ /' / ~/ ~, /
(i J /t'..e e d (9-rS~ /l <; ;;b ---/ 1/'
g /y~~rt/ ~rv /~sh//t':d-
(i7 //~bI -Px.~YeS
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(~/.
f~
,
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/;/1<:;/
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F 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/