HomeMy WebLinkAboutBuilding Permit 04-0448
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
See Main File
Lj- 30 c)l/
I PERMIT NO'04 .044 B I
I. White
2 Pink
J, Yellow
File
City
Applicant
(Please tvDe or orint and sien at bottom)
ADDRESS
fftJ7
gWrr- ij;;;;I//P ,//llHL-
LEGAL DESCRIPTION (ollice use only)
LOT 2' ZBLOCK.3 ADDITION 'l:J11i3EM ~T ~~ k/ndh
OWNER
(Name)
fJvl..7&- ~/HE.s
Yl5 .d~II/a;r- ~Af
,
S/IIrr /~()/
I!5III1-n .
(Phone) t?S/~ f/Sz. -S-~
I1k
,s,s/2i
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
.s/ImE.
Uim- 95~f4,)
ZONING (office use)
PUfJ
Plrd6 - LjO}, - () g'6~G
(Phone)
(Phone) tjz - ??/-~cf6--
~.
TYPE OF WORK
/"
lH'New Construction
ODeck
ORe. Roofing
OPorch
OAddition
OAlteration
DLower Level Finish
o Fireplace
o Misc.
/.~.c.
PROJECT COST IV ALUE (excluding land) $
9~/0'5
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 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 can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
:teruZo;~rope~:i~ p? -/37/ 5'.hA'/
~ /-Signarure Contractor's License No. / /'bate"
#
#
I Permit Valuation C/~Oa:?, -- I Park Support Fee
I Pennit Fee $ //);::;"/7,5D I SAC
~
I Plan Check Fee $ 1".'/"., "7, 1?? I I WaterMete~ I";
I State Surcharge $ L/K.-I I Pressure Reducer
I Penalty $ I I City SAC and WAC
I Plumbing Permit Fee $ leo.- I I Water Tower Fee
I Mechanical Permit Fee $ /0 ~, - I I Builder's Deposit
I Sewer & Water Permit Fee $ .~5 SO I lather
I Gas Fireplace Permit Fee $ U(), - I I TOTAL DUE
This Application Becomes Your Building Permit When Approved
~
I Paid
I Date
sr (p :l,P r
(,.r.l~
.:fL/.;t P
Sj/CJjoL
Date
Building Official
#
#
$ I
$ 13~O,-1
$ dS<:>. - I
$ t./5.- I
$ /, ,).ct). - I
$ ?OtJ. - I
$ , I
$ I
$5:5"3. M I
~
\ ReceiptlNo.
Bv ./. .
{;
~" I aCP
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
]C: PI~i:i;;em~rnry C~fi;J:~o~~ce and allows constrllseeenXiaiii a FII~CUP~~ must be
Planning Director ~ate 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
.-W!1ifp - R.lilffina
C.Ca'larv - Fnaineeri~
Pink - I'liiiinfng
Th.. Crnlrr of Ih..I..kr Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
. * IC{(i'
'_.J /\..,.~. ,-'
i/H,,:;J
APPLICATION RECEIVED
1-_,/.- ~ "') --'..-''1U.
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/,J ('/) i)/7'.. {I///! /)(' .'"
. I ,.-,,':"<.(_l_.i\w'~. _.-1
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" /.i
IcY
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Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
il~
Date: 5 - /3 -oy
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,"
-'-~~x PR10Ii'(
f... ~
U rrl
See Main File
While - Building
~~-:y - Fnaineering
.' - PlannffiS::>
Th~ (-..nl..r of lh.. I.MI" C-Onnlf)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
-../!
/' -~;
.;(j
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ / // /
/ ;f, /'
Accepted
/
Accepted With Corrections
Denied
Reviewed By:
~
r
'V (L ,/)j..J
Date:
6/to/uy
. ,
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."
/(fPR/oit
~~
See Main File
Th~ C~nlet of chI' l..kl' CounlrJ
c::::)QtJl;t.. - R. .i1flinO)
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
6J~ ~M~
t.../ - ::3 0- Ot..j
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
LJq()~ ~ i.Lz, ChaJ
/ Accepted With Corrections
Accepted
Denied
Reviewed By:
~
r-
~
Date:
S;//a,/> t/
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."
Ma~ 27 04 08:48a
METRO GENERAL SERVICES
763-428-2968
p.3
Glttu. ~ 'l.(
'tIELLOW - ....flLlc.t,..T
GOLD - e'l"
S.ewer and Water
contractors must
be registered
I ", II _ i. . f ..". ',. with ~the; Ci~Y~..
APPLICANTi:~Th]) . Hen})V1l.Yrv~ONE:Jh,j~tnf</Jl.t;~
ADDRESS: [t/7ttJ (Jlilirlf.. 1'Iut- h, DATE:~--=-2t'" .l)q
SIGNATUR,: jJ:; if Ib/Jt.ln. . - BLDG. PERMIT # / .
SITE ADDFESS: /,t~L~ JulfJtt/.1r. PIDII
. .FILL.. N THE BLANKS .
/:;0 feet.
CITY OF PRIOR LAKE
SEWER. AND WATER PERMIT
FAY. CJ5~ 'ir7-l.ll-Vr NOTE:
S.W. No. 0+. fJH-e>
1.
I
Estimated length of water service
. '1
size of water service I
inch(es) .
2.
"--
3. Location of any couplings from structure ~) feet.
4. Type I of sewer pipe. ABS____ PVC~'I Cast Iron____
5. Estinated length of sewer I ine--e .t:{() feet.
6. Clea:1 out (if required), located at feet
stru.:::ture. . ,I~'A .
I 1'1 '.
I ~. .
=====-=~F==================================================~======
This app~ication.becornes your permit when approved.
I
from
I
BY
DATE:
======:')O~jT~=~~~=============================================
FEES: I1ldJ P.e."......1- . . Sewer and water line connection permit.
.. , Surcharge
/Va Fe.e- . TOTAL
* Fee for either sewer or,water individually is $20.00 plus
$ . !iO surcharge. . ..
* sew~r.andwater permits issued for new construction must be
rec)rded on .the buildinc;! permit card at the time of issuance
to Lnsure th .~. pllcate sewer and water permits are
',iSS . @ ~ ~ ~~\~~ ..
~f:::: JUN."I'''~J.. :~~ ~
,';5',:1: 16200 EagJc:::' ::re:~ Av. S.B., :or Lake~ Minnesota 55372/ Ph. ('152) 447-4230 I FA~447-4245
An Boua! opponunity Employer
----
-~-~---____,"m
~
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+IN~ESO"'''''
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
_ (Please'!'ype or print and sign at bottom)
ADDRESS
1.-/ q ~ 3 - OS--07 -0'1
LEGAL DESCRIPTION (ollice use only)
LOT
ADDITION
BLOCK
OWNER
(Name)
.
/I-{Ji~ ~
(Address)
APPLICN'lJ
(Name) Va II-<-<.j PI........... t":j
(Address) Cf5~v O-.....I:JJ<.A/ ft.v~
(Address)
~r
I Blue
2 Geld
3 Yellow
I PERMIT NO. OL/-l/C/Er
ZONIN&ifl)
LjL!1
File
Cily
Applicant
~l?rlL-
PID
(Phone)
(Phone) '7' C:;;;t- '-19,9-51-1-;;" J
"0 o"..olc-.. ~ 5.';l
(City) (Zip Code)
(Contact Person) C-~ /,,~~ MOrr.~,;
APPLICANT SIGNATURE-:d1Yf' -" ,N~2&.
f/
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
(Phone)
~b",,,~
DATE
(;., -;;,9-o<f.
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential. New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit #
$
$ .50
$ . \'r Q;v/
I Paid fy\ fy
I Dat) d
I 1 ,0' -:r ?--C'-1
Receipt No.
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E.. Prior Lake, :\-IN 55372-1714
8- 3-04;11:27AM;
€~~
+'NNES01....
;952 894 0925
# 6/
9
HEATING/AIR CONDlTIONING/FIREPLACE PERMIT
J. PiRk
2.GrceJ\
] Yellow
~:~ I PERMIT NO.1 J {J'I 71 ~ I'....
Apphcant '-' ~ ..
ZONING (olli", ""j
~
.~{!
~~
'5
t'r1case l'O2~ orpnnt and sim at bottom)
ADDRESS
L[ q(J "7 '2-,\ I , C("
\-+~\({~JL
LEGAL DESCRIPTION (ollice use only)
.LOT
BLOCK
ADDITION
PID
, OWNER
(Namel ~A. Q k \--\nIY\E S
(Address) '?)\c,_",-y)+h ~ ~tiL~ :ij.IU(')
APPLICANT
(Nam~'
(Address)
9uFA&-ville ~9atiRg & 4.''''' I I r
12481 Rhode Island Ave. So.
""':i18, MN sa~~sr22
(phone) f O~\ - LlS,2 -<;:::;7 fX)
9o.cyl'.."l, ~. SSI.:U
I
(phone) !l$~-'f;Gl/-COOS
:,,,,,'
~
~
lIJj
~.
(City)
(Zip Code)
(Contact Person)
(phone)
()U1t.:L ,?-rl Qh1 (j nQ.//
;y'::;
,::;;
APPLICANT SIGNATURE
DATE
t-;) -0<./
APPLICANT PLEASE COMPLETE BELOW
~NEW CONSTRucnON 0 REPLACEMENT 0 AL TERA nONS
FURNACEMAKEANDMODEL ~nn)( (.:.C;IMO-dW~-o<-IS- FUEL IYJ..-J- CrOuO
FLUE SIZE RE1URN OPENINGS S' INPUT i./<y ()(Y) OUTPUT l/ t. ClOO
TYPE OF SYSTEM HEATING OR POWER PLANT
~
Il
OWarm Air Plants
OGravity
~ Mechanical
Air Conditioning
Vent System
o Steam .
o Hot Water
o Radiation
D Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
"'!REPLACE MAKE AND MODEL
ndustrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
R.esident~l. Additions &. Alterations
Residential, AC Only
$39.50
$39.50
$39.50
:"esidential, Heating &. Ale (New Construction)
~esidential, Heating Only (New ConslrUction)
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE $\ / 1)~~ e~h
STATE SURCHARGE $ X .500.JJVFv--"-'.
;r::U~::;;:~tion aecomes Your BU::::::=::oved ~~~t. \~ ~N'
~ 1[:\l\l;j~ I I) 9. 7\J\)~ ~ \
\\\ att\ \1 y
Building Offici.1 Date \
./
I
24 hour notice fo. all inspections (952) 447.9 50, fax (952)
16200 Eagle Creek Avenue, Prior L
'*'wmt
BtIIl.c'ING Pt:~1It
PRIOR LAKE
INSPECTION RECORD
SITEADDRESS ~9~ 7 ,'jflul/F HE"18Hlr' .r'A/~
NATURE OF WORK iTibJ OIJN~IIItt:."II~
USE OF BUILDING ..r:.t.'"" A . .
PERMIT NO. JJ4.o44g DATE ISSUED Sl/~{J V
CONTRACTOR fttLTE IfdIH~s PHONE Il-2ZI-f'U
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
'DEPARTMENT OF See Main 11
BUILDING AND INSPECTION
mSPECToR DATE
I FOOTING I /q I dP 7/d~
, FOUNDATION (Prior to Backfill) ./h....'....lr lVu/ ~ I ""'~~.;."
PLACE NO CONCRET~ UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~.
#/4
I.
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING rJ {5. #f# 7' ftlo1
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST.IIt~ J t-/;/ //~ /~ W
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
fl~~
~~
~/F/o~
j'~//'Y.'
?"/ >>/,,~
j>/A-'/oI'
?/..v/-/
5?/~/"?
~ .
~t:.~
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
I .
II}I.,/pY
I I /
//U. //P/;'y
. /Itf/. I~/t#
UNTIL ABOVE HAS BEEN SIGN'ED
NOTICE
ah
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
DATE
tMi
1"f't1,7 LfL. # #-* 77/
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
//k/
TIME
SCHEDULED
CONTR.
PERMIT NO.
~;/~~lj'?
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~CH FINAL
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
.,~ /
.//~/
r!7JS<./ hJ /-
I
~~.-~rer ~;rZ Ai-
~,,{h.,. ~ #X'L -I-- 7"#
. S/f
- /
h ~e ,'t-'n..f
~ / ./
/;:'7-?? I' C,C
~
WORK SATISFACTORY. PROCEED
. 0 CORRECT ACTION AND PROCEED
o CORRECT WO~~"YOR REINSPECTION BEFORE COVERING
Inspector: /~ Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH <l SAFETY/
IN$1lOTl
DATE
I/b#
ISIw PI-" #'/~ 7/ 1
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDREss
ij9tJ 7
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:
//;;,1'7& /n& ~~,.
I
7'r:'\f" f-
..-/
r/htlf /
..
Ofi::
r)
(/.-
TIME
C) '1- ~~y
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE R1
o FIREPLACE FINAL
o GASLINE AIR TST
o
rJk
~.e(/ /ff/C/ /~Sr:.//e:I
I
-.rAer~ ~
80, /d~~y- ~;~/
--f
o WORK SATISFACTORY, PROCEED ~ / C-
~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR EINSPECTION BEFORE COVERING
Inspector:
Owner/Conlr:
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INS/tlOT1
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH.l SAFETYI
.
~--_.._._~--_.-"-~---.. .'-~.
BUHNSV..~~E-._---
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
.~_._..__._'-_.
__~___.____~.. -. .. -T"-.----
Orstat Test Report for Jobl &'51 ~
Address. L(107 OLVff IIL/(,lrfS '1R Citv ~'M LIIYL
Occupant
Date of Install \0 l\. bc!
Type of HT. F/A v HW Space HT Unit HT
Other
Make
Model
Serial
Input
lLI0.....0~
c;,'Slrh(J 2qP" O'i~ .61
59ol/J./ Z2'.N~
L.N. 000 I5TU ..t
Pilot Type HOT SURFACE IGNITOR
Pressure 3'5 ItA..>(.. CO2 (...1
Input CFH L(L/ 02 ID. r 1
Stack Temp \ \ z.. CO q ~O""'"
Date Tested
Company
Technician
\\-~-DU
BURNSVILLE HEATING & AIR CONDITIONING
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