HomeMy WebLinkAboutBuilding Permit 04-0981
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
q. ~f;. 04--
White
Pink
Yellow
File
City
Applic8nt
I PERMIT NO. 04 ,0 '18 /
(Please tvDe or 'Print and silal at bottom)
ADDRESS
/ L. 3 ~S
u/'cto/'t'ev ~
ZONING (office use)
r<<St)
LEGAL DESCRIPTION (office use only)
LOT (, BLOCK t(ADDITION
OWNER
(Name)
Gearc- {J <V- f:leCL""i-
~a:.e Rl ~ ~IW<5-'9:35'- t/3S-(,J
tJ (h\ cl
(Phone)
(Address)
BUILDER tf\A, . ~ ,\ rd
(COmpanYName)~"~ ~_iill ~.
(ContaClName) \<:'~-'^ W,\tu:.lN\c..
(Address) (' ~ c/!"... ; rI\ ~
(Phone) qSl. - Lj 'ii - (')03A
(Phone) it").. d-4D --ljo5<1'
TYPE OF WORK 0 New Construction DDeck DPorch ORe.Roofing ORe.Siding ~wer Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection D Misc.
CODE: Mr.R.C. DI.B.c. PROJECTCOST/VALUE $
Typeof&;'~on: r IT nr IV V A B (excluding land)
Occupancy Group: A B E F H r M R S U
Division: 1 2 3 4 5
Signature
application which is to the best of my knowledge true and correct. I also certifY that I am the owner Of authOrized agent for the
ill conform to all existing state and local laws and will proceed in accordance with submitted plans_ I am aware that the building
ore, I hereby agree that the city official or a designee may enter upon the property to perform necded Inspcctions.
,2D.~7A ~ te; q- ;)B~oif
Contractor's License No. Date ,
x
I Permit Valuation 1/tJCIO. 6'C> I Park Support Fee # $ I
I Permit Fee $ A? zS- I SAC # $ I
I Plan Check Fee $ I Water Meter Size 5/8"; 1 "; $ I
I State Surcharge $ ".,1'.-'" I Pressure Reducer $ I
I Penalty $ I Sewer/Water Connection Fee # $ I
I Plumbing Permit Fee IJ 1-1-0.- PI.,;! q'tJ r Del I Water Tower Fee # $ I
I Mechanical Permit Fee ' $ I Builder's Deposit $ I
I Sewer & Water Permit Fee $ I Other $ I
I Gas Fireplace Permit Fee No $ I TOTAL DUE ~ q.O%.o4"" $ /2-9. 25 I
- , . _ . F
This Application Becomes Your Building Pennit When Approved Paid 1j4'-/A) . I ReceiPt No, l-/rILfX'f
#~~ ~4~fi,.~ Date . -=?/I~(?LI By d
f
Buildinl! Otlicifll , Date
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 signcd by the City Planner constitutcs a temporary Certificate of Zoning compliance and allows construction to commencc. Before occupancy, a Certificate of Occupancy must be
i.~sued
Planning Director
Date Special Conditions. if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Aveoue Prior Lake, MN 55372
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
/ O. 13. 04-
l. Blue file
2_ Gold City
3_ Yellow Applicant
I PERMITNO'0.f,09~/ I
(Please tvDe or print and swat bottom)
ADDRESS
\Lo?Jl1S \(\~()JWVW-,
ZONING (office use)
PtJ S.f)
LOT
LEGAL DESCRIPTION (office use only)
BLOCK
ADDITION
PID 25.33 ~. 03, 3;, O~
(_-Pl r'.~ rJ" I~
OWNE' - - , I v~
<Name)R\J\V'\. S-\O-\F" \Mtif"/ (Phone) -- L.
(AddreSsrlJ1J!h~A\dt;\t. ~, r ln~~ ,::-~~q
~:;~fP:'\t1N .~?JLi~ (Phone)~D:~I~
, ~. ~D~/j\U;' ' ~~6lJ/
, , ~ . (City) J?kY'l 1 " J II ~de)
Vl (Phone~~1
/ . ~ DATE /AJ //I/IV
APPLICANT SIGNATURE
I Quantity
I
I
I
I! I===C,-t.
I
I
I
I
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (I or 2 compartment sink
Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
Quantity
Type of Fixture
Rough-ins
Water Heater
I Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Estimated Cost $
~~SD
Residential. New One & Two-Family ~
Residential, Additions & Alterations~
Building Penn it # 04,0,981 B if
$ (~cr.D (./ pAlO ~(L
$ ~ / - .50 lJ I 1,,-0
$ --? t/, 00'<7 B
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Official
~
Date
/(!J . /3. Od-
ReceiptN~
B~
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
REA TING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
10./3.04-
I. Pink
2."","
3. Yellow
~:~ I PERMIT NO. tl-f-: () tJl/
AppliCAnt '
(Please ~ or orint and sUm at bottom)
iY;&G \/ICJtn'U1(0 ('~
I ZONING(officeus,)
prJ&.L)
LEGAL DESCRIPTION (office use only)
. /. .. pm ZoO: 33~ .0$0. C. 7\
,,.,1 (~{........\^.11Ii"~J
g.=e~141l. Stf!ltJV\}l fY,t; _ (PhOn~-~- 2~1
(Address{/~~f11A\rJrVfel. ClqA.nVvA~ S>~I
d1A,~~;\. 3?1/1~. ~ ~bW-~~~~
J ) ~ (City) 8pCode)
'. l i IL (PhonA~ .LlLt 0-2> rfC[
APPLICANT SIGNATURE tJ-J ~ DATE I 0111/ Ifl/
LOT
BLOCK
ADDITION
(Address)
APPLIC
(Name) .
(Contact Person)
APPLICANT PLEASE COMPLETE BF<,LO'Y
DNEW CONSTRUCTION 0 REPLACEMENT rsAL TERA TIONS
FURNACE MAKE MjD MODEL Y'I /,&::1 / FUEL J.---.. / c:::::::-.
J!:!1~ r?. I. RETURN OPENINGS ~ INPUT ry Vl OUTPUT .1:::)/ ~
/- 'I AV~'~ OFSYSTEM HEATING OR PO,\R PLANT
_ \\' {j c,. JW Air Plants 0 Steam PLEASE NOTE:
,~ 1l( 0 ity 0 Hot Water Air Conditioner Units
7' \ I" L' . 0 chanical 0 Radiation Cannot Encroach into
, ~ ./ \ 0 Conditioning 0 Special Devices Required Side Yard
I J:'fJ'~\ ent. System 0 Other Devices Setbacks
\
FEE SCHEDULE
~~:;~L:J.A Residential, Gas Fireplace
Residential, Heating & AlC (New Construction) S99.folll"nlP"q- Residential, Additions & Alterations
Residential. Heating Only (New Construction) $64.50 oP Residential, AC Only
Estimated Cost $ f s1 ' Building Permit #
$39.50
~
~
Building Official
Date
Pai~
-Oate
10 ,Ii> ,6 if-
6~
p~IO 6J2-
6U 11/0
R~
By lId/
I
I
.1
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$,~q/S-V
t . / _ _.5Q
$ L../v, ~-
,
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY/// ~
Date: 9- cJ.?-CJ,/
Building Permit #
Site Address
PID: Zoning:
/t3&s- Vie__far/a.- (lur()~
Legal: L
B
Subdivision:
Emting Structure: YES or NO
CONFORl\tIS TO ZONING
ORDINAi'iCE
YES
NO
Is this an expansion of the existing footprint or
building height?
YES
Refer to Planning
NO
I Is the property located within the flood plain?
I Does the alteration include any additional kitchens?
Does the proposed alteration include any outside
entrances other than patio doors?
Refer to Planning
~
;Va
A0
/10
j!o
Refer to Planning
Refer to Planning
Is the proposed use of the finished space or
alteration for anything other than a normal single
, family home (office, group home, day care, etc.)?
Refer to Planning
THIS CHECKLIST lYlUST BE COMPLETED AND INCLUDED IN THE BUlLDING PERiHlT mE TO
lYW1'ITAIN A RECORD OF THE REVIEW.
r '\Tl",I1'T;, TF\ALTrHCZ.DOC
PRIOR LAKE
INSPECTION RECORD
SITEADDRESS ~ ~~~ t::"*'-:EV~
NATURE OF WORK "f;3 - -. :- -,.,.,
USE OF BUILDING
PERMIT NO. 04-,0 ~ J P.AJE ISSUED .
CONTRACTOR ~"".J... PHONEj'S:&" "J'~-oo)O
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I
I I
UNTIL ABOVE HAS BEEN SIGNED
GH - INS
~ /'-
FRAMING
INSULATION
ELECTRICAL
PLUMBING
~~
~
.
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A
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
DING
ELECTRICAL
PLUMBING
HEATING
DO NOT
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~k- j.J-//t/)o/
~Z- /?/It.,lltItIf
OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted neer an electrical service cabinet prior to rough-in inspections
and maintained until all inspections heve 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 T1IIE
CITY OF PRIOR LAKE ~- ~ /L /
INSPECTION NOTICE SCHEDULED /...4lj~~,?
/ / (
/6:..?b.) dC~fi;" aJ/Ve,.
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
D_I!!$ULA TION
,e'FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
':I ~HooKUP
~~~B~NG FINAL
p1IECH FINAL
CW5MENT~ , __ / r
fr~JhC~( ~ ~--"'_
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o EX/GRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~.:,cpJ2:!"R REINSPECTION BEFORE COVERING
InspecIor. ff~ OwnerlContr:
,
CALL "7.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE~
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI