HomeMy WebLinkAboutBuilding Permit 01-0004
QAT. R.r..,,/.n CITY OF PRIOR LAKE
/2-2..Q-0 0 BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. S;i~~SLex, tJ "To rJ CoJa-
1. DATE
/ t-/t..e/fJ()
e./Sj)
BUILDI INFORMATION
11. SIZE OF STRUCTURE
(Ho;l/1l) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT J3 BLOCK
ADDITION WIL-OeJW8~
12. NO. OF STORIES
'3
PON D!.
PID ZS-3/A-G+O-O
13. TYPE OF CONSTRUCTION
. HtJ~~T ~f1.t!&
14. FL'jflR AREA APPORTIONMENT USE
IPS7.-
14. J:(~\t"ramo) (Addrass) (Tal. No.)
15. ARCHITECT (Namo) (Address) (Tal. No.)
6. BUILDER (Name) (Address) (Tel. No.)
~IU.E
l4<\1..LAff +bHEb/"'l-, 'tbl~~4t(ll'E~ 151-18~-Llnr
7. TtPE OF WORK Fireplac"",, Septic LI Oeck-LJ Re-roofing LJ Porch LI
New Construction C'J Alterations CJ Addition LJ Finish Attic [J Re-siding LJ Finish Basement~
Chimney LJ Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DA-FE:.
Sq. Ft. Width Depth Yes No ~ - 2iJ -o(
I hereby cenlly that I have furnished intannatlon 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
b offlciarcan e rmlt for just ca e. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed I...............,.d.
X "U>1P>"'~011~-Z.~-O~
lJcens& No. Date
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
FOR ADMINISTRATIVE USE
SETBACKS: Requlrad
Actual
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY DATA LI
Side
Side
Fronl
Be'"
OFF STREET PARKING PILING LOGS LI PERCOLATION TESTS LI
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN ~~5 SURVEY LI COPIES
PERMIT VALUATION .~OOO. lL> PLOT PLAN LI
BUILDING DEPARTMENT VALUATION
laE.s Aft<...
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division t 2 3 4
Permit Fee ................................... $
PtanCheckFee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Pluntllng Permit Fee ....................... $
Mechanical Permit Fee ..................... $
AmountBroughtForward .................. S-
Park Support Fee ........................... to
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
City:
S U
..,,, .'C;
I.C::;O
~
Pressure Reducer .......................... <t
MeterHom................................... <t
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ /5(,. Z5"
-
Paid /">16. Z") Recaill. ..3
Dala 1- Pl, OJ By tJ
This is to certify that the request in the above application and accompanying documents Is in accordance with the City Zoning Ordinance and may p s requested. This document when
signed by the CIty Planner constitutes a temporary Certificate of Zoning COl1l'llance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be Issued.
Ao
AD -
............ $
Your IIdlng Pannll wh,rl/jll40O''t
Date~
GesFI
This
By
Issued
Dale
Special Conditions If any
City Planner
24 hour notic&for all inspections 447-9850
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CITY OF PRIOR LAKE Me
tl2DO b,le Crl.kAv.s.E. Pelm1lNo. 0 {- 0004-
'rlar ulll, MN &5372
HEATING APPLICATION' PERMIT
DBII /- /c'-r'>/ PIl, z6<3/'fro4.3-Q
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TVPE 01' IVSTEM
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H!IIMO Oft POWEll PLANr
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Hal Wal.
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TYPE OF WORK
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HEATING PERMIT F.EE S
STATE SUACHMGE .
10TAl p~ F""R I
.50
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me OF STRUCTU8E
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c-lldaI bIuIlt...
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1nduIl!"~ CInImt.a.l1 Mlal-FMlIy
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A..'....'. Hullllg Only
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RIIldInkt. A1IdIllonl & AI",lIonl
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I'" Dllob CD" 1.3IMill.......
$81.50
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'39.&0
131.60
".SO
RlIlI8I1Ib" 10 ,Ud the lltIII Surcharg, an II, ballam 01 ... IJlPIIcaUun.
Till plc, aI yoUl hllUnt ptrmllnal1ldu OM rough.1n IIId DIl' IIrlll 1 ,.,
AtIdIIIInIllnlpaclcmI wi be blllld 111'3&.00 Hell.
HIM' Bu'lng Tnl RK9nIIIIUtII bII.lMnhl8d wlIh IBIIIdlI:II UDDI ~...........
Ing _tile", 01 IlCJlIlINIftlr wtI be 11IUId.
I:IEAI CAI C1I/.ATJONS AEDUIRED wlVllUl1blf ., 'UIlPI1I1111 "'... '.' ,. IIIItfIJllr
,oom wIUl CFM"I pII . , .l' N_,~ or 1IIdII_1IlId /100, ,........,.,
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. OAEEKAVE;&E. PAIOR-lME;MH &&31a.
eM, HtU butlMH houlI III . a.1I\. . 4:30 p.1lI.
ALL WORK MUST BE INSPECTEO tAOUCltHN AND FINAL)- CALL C.....IAII.
441.-aD
I heroby IIlP" kif a meahlnlc" .,...m. p.nnlt and I aOMDWIedII.aI..
1nlollllllllDllllboft 1118l11Pt,l, and IIIlDu,II.: 'hI\ the wIIlIl will bl In ,
whll lbl ordln,ncI' and cvd.. oIlhl 1111, IIIld wIIh Ih. .1.'1 bulldlllllhH-.II
001"': \hilI lbltlolm dll8l not blcoma I p.nnI\ unlll "gnld by ..11I.I....0
OFFldIAL: lb.\ \he "'0'" w"b.ln _onlanal wllh lhe IIppl1lV...........
II'" 11111. "01 h which IIIqulr.. revl.w end approy" 01 pfen..
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9-01 03:13 PM FROM FGTN PLG HTG
TO 6124474245
POI
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CITY OF PRIOR LAKE
PLUMBING PERMIT "
=::~: ~'t';~;re~,~r~lt~.__Phone:-_.,...
SignaIU~~.b~._. .____ ....
Legal Description: Lot Slock . .Sub.. ..
SlteAddrvss:'c:l'J.S ~(c,;<100~ C...+
Building Permit II _._ ~ .. . . PID II
NOTE: This permit will not be processed without complete information,
FIXTURE UNITS
f Rill,.. FUr
2. Ciuld r:iry
). Yellow Appll..'aftt
OI-ooM-
fl.. IUI"ftf............'....lIlIl"I
I Quantity
r
,
I
I 1
1
Type DI Fixture
Bath Tub with or wlthDut shower
Dishwasher
Floor Dillin
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
Quantity
Type 01 Fixture
\
Flaugh-Ins
Watar Heater
Water SDftner
Stand Pipe (washing machine)
Sewage Ejector
Baclcllow Asllembly (APZ. Double Check, PVB)
Backllow Assambly Test
Lawn Sprtnkler
Other
\t"',-:.I-, ~19 fer h.C)u.l("r level 3/4
FEE SCHEDULE
~~h...
Industrial, Commercia' & MUlti-Famll\l
(1% of job cost. $39.50 minimum)
Residential, New One & Two Family
Aesidantial, Additions & Allerations
State Surcharge
$99.50
$39.50
GAAND TOTAL
,.
s ,l~~.."
[ PAID WITH -..,. ~
llUILDING PERMIT
l1tjli ~rllli, il' .nlUl~ \lplN\ UII: c:aIJfl:lili l,,:umJlIlun ,hat SlltJ
~unlr~ltn. Jhltlll.:umpl)' in .11 rC~~l.:t. with the urdinanccl
of lhe Slllte Plumbin,c C CI ..01.1 UlCIlImenLlmonlllhereof.
ltEC . _1.:oZJrQLDATE
ArresT
Call for all ins lions 24 hours in advance,
16200 Eagle Creek Av. S.F.., Prior Lake. Minnesota 55372/ Ph. (612) 447-4230 I FAX (612) 447-4245
An Equal Opportunity Employer
PRIOR LAKE DEPARTMENT OF
. BUILDING AND INSPECTION
,
INSPECTION RECORD
SITE ADDRESS t:;z. ~C; L.,f=:>c' t-..J(o 7"V N C-r:
NATURE OF WORK L~~ HNI<;M
USE OF BUILDING /<..B, I"'t /~ I .
PERMIT NO. ()/ - 0004-. DATE ISSUED II a/oJ
CONTRACTOR -J<ATZ.' A-&,t;. ~~ />.)<.., PHONE q c:; 2 -"f~'::' - 4175
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT .
1N..:II..o:o.......A
DATE
I
I I
PLACE NO CONl.ncTE UNTIL ABOVE HAS BEEN SIGNED
ROUGH. INS
FRAMING 6'or~. ~/(,/~ I
INSULATION j!7"h I
ELECTRICAL
,. CH~/?/
PLUMBING f8;r..
HEATING (if required) itA- "p./ '/D 1
FIREPLACE
GAS LINE AIR TEST (I. ~ .!)/(,~I
I I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
A
~.
6t'
3/;)3/01
Q ,.. :; I/v'
JjC/ '-1 <J!
BEEN SIGNED
OCCUpy UNTIL ABOVE HAS
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.
Call between 8:00 and 9:00 A:M. for all inspections
FOR ALL INSPECTIONS (952) 447.9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHE;OULED
J.Z3.01
/:3D
ADDRESS
f'5 7_~5 / ~Gi( I N~77)JJ e"T
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0(- OOO~
COMME~~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FIN
o MECH FINA
EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING c@
o INSULATION
'liCFINAL L-. t.-
O SITE INSPECTI N
~
J
.~
~~'
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~I
Inspector.
Owner/Conlr:
I
CALL "'7.9860 FOR THE NEXT INSPECTION :u HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl