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HomeMy WebLinkAboutBuilding Permit 01-0044(Please t~qoe or print and sign at bottom) ADDRESS CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT White File Pink City Yellm~Applicant Date Rec'd ZONING (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) BUILDER (Name) ~ ,~,..,,v.,~,~; ~ (Address) ~.~'5~'~ ,~_~'.~'t/t~,~l/ ~ .,~.2J~'%~t:9'~~' TYPE OF WORK ~/New Construction [~Deck []Porch [~]Re-Roofing [--]Re-Siding [] Misc. []Lower Level Finish [] Fireplace J~Addition []Alteration []Utility Connection PROJECTCOST/VALUE (excludingland) $ /~9/ I hereby certify that I have furnished information on this application which is to the best of my knowledge traP 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 enter upon the property to perform needed inspections ~' Signature Contractor's License No Date Permit Fee Plan Check Fee State Surcharge Penalty Plumbing Permit Fee Mechanical Permit Fee Sewer & Water Permit Gas Fireplace Permit Fee Park Support Fee # $ Water Meter SO'; 1"; $ Pressure Reducer $ [ ~__~--,, ~ ~_~ Sewer/Water Connection Fee # $ Water Tower Fee # $ Builder's Deposit $ J l~'O0 · ~)C.) Other $ TOTAL DUE /-Z{~"OI $ I T/Iris t~!ic~don Be/omes Your Building Permit When Approved ( I Paid - k ~n~fficial Date I Date.t' gO- 0 1 I By/r/ff~ ~ r st d Th~s document ~is ~ to ce~i~ that the request in the above application and accomp~ying documents ~ in accordance with the City ZonNg Ordinance and may proceed ~ eque, e ' issued~when signed by the Ci~ Pl~n~ constitutes a tempor~ Cmificate of Zoning compliance and allows~cons~ction~to commence ~Bef°re oc~pan~, a Ce~ificate~of Occupancy~~must be · l~nning Director Date 24 hour notice for all inspections (952) 447-9850, fax (952) 4474245 White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST N^UE oF APP,,CANT P----- APPLICATION RECEIVED ! ~ The Building, Engineering, and Planning Depadments have reviewed the building permit application for construction activity which is proposed at: ' I Accepted Accepted With Corrections ~. Reviewed By: Comments: Date: / Z - 7- 2o~,-, "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." The Cenler of Ihe Lake CountrT White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: Accepted Accepted With Corrections Denied Reviewed By: Comments: Date: "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." White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED /1' oo The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: Accepted Denied Reviewed By: Accepted With Corrections 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." SAN. ~,2001 12:41~M GENZ RYAN G51B226147 ' '--H0.~25' " CITY OF PRIOR LAKE PLUMBING'PERMIT Signature: '.1~ auildln; permit # NOTE: Thai pe~rllit'W.t. II not be pm.ceded without complete infoll~atioll, FIXTURE UNITS · Quantity Type of Fixture Quantity Type of Fixture , \ Dlshwuher ~ I Water Heater .t ~. Root D~,in ; ).. ~, Water Softner . . I , ~ Lav~tol7 (bathroom sink). , : ' '1 Stand Pipe: (w~, hang machine) , ; ~ I Laundry Tray (1 or.2 ~ompartmei~t sin?) Bewage Ejoetor. ; ~ t Shower Stall Badd10wA~ambly (RPZ, Double Check, PVB) i Sinl~ B~kflow A~sembly Teat Bar Sink ' Lawn Sprinkler · ./ - ~, Water Closet (toile C~her FEE SCHEDULE lndu~tria/, Commemlal & Mul.tI-F~mlly (1% of job cost, Sag.SO minimum) Residential. New One & Two Family Residential, Addition., & Alterations State Sumharge ' ? $, permit is ~ upop Lbo exp~ss condi~iot~; ~ uid : /~ ~ ~ C~I for ~ ~ioa~ ~ h~ ~ ~c~. 16200 EaGle Creek Ay. $,E., Prior Lake, Mianesota 55372 / Ph. (612) 447-4236 / FAX (612) 44%42.45 . Aa HqutI Opportunity Employer contractors muet with' the city. APPLICANT: - P PHONE ADDP. ESS: ~DAT .E: ot-oo, cw '· FILL IN TEE ~LARKS : ._ 1. Est~ate~ l~ngth of water se~vics~fset." 2. Size of water service I ~ inch(em). 3. LOcatio~ of any couplings from s~.ructure feet. 4. Type of sewer pipe. ABS__ Pvc ,~ Cast Iron _ I 5. Estimated iength of sews= 6. Clean out (lZ' required), located at' . ~eet £rom ~tructure. ' "': This applicati your psz3ait w~n approved. - ~. ~50 Surcharg~ 3~,50 TOTAL : * Fee for e~t~er sewer o~ water ln~ivi~ua~l~ is ·$20.00 plus S .S0 * Sawer and water'permits issue~ fo~ new constructi&n must b'e recorded o~:the building permit card at the time ~f issuance. to insure that, no duplicate sewAr and,-water permits issued. ~ : ' ~C'D B~~ RECEIPT # · 4629 ~ota Si S,E., P~or Lak~ M~ta 55372' ~h. {612) 447,4230 Fa~ (6~2) 447~246 ~ £~UAL OPPOR~JNf~ ~ CITY OF PRIOR LAKE 16200 Eagle Creek Ay. S.E. Pdor Lake, MN 55372 HEATING APPLICATION / PERMIT Heal~gContxactor ALI, lEI) ?'[I[ESTDE dba FIRESIDE CO~N~R 2700 N. FAIRVIE~{, I~OSEVILLE~ I~N 55113 TaJephone # 651-633-2361 F~r~rt~ M-~e & Medel . TYPE OF S¥~l eM Model Sizq Conn. Load Fear_ ~ Supply Openings Return Openings Input ~dr. F~eS~a _ Outpul ~ GIITL AReralion$ Repair HEATING PERMIT FEE $. STATE SURCHARGE ¥OTAL PERMIT FEES Warm Air Plants Gravily Mechanical ,Rjr Co ndil~onlng Veal. System HEATINg OR POWER FI.ANT Steam HoIW~ar R~d~iion Sp~deIDevicam~ Other Devices TYPE OF WORK Re placome nl New Construction EeL Comp. Data / Budding Parmil .50 Receip~ ,m PAID WITH BUILDING PERMIT TYPE OF STRUCTURE Single Family Commercial Two- Famtl~ MultI.FamTl~ Indt~ldal Public Olhe! Fee Schedule Indusldal, Comnmrcial & MaRt-Family ReeidenUal, Heatlog & AC Residenlial, l--h~t~ g Residenllal, Gas Fireplace Residential, Additfo~.s & Ailelalier,,s Residential, AC I% of Job cost (139.$0 minknu~) $99.50 $64.50 $39.50 Remember to add Ihe State Sumha~je on the boUum ol this appr~ca~on, The price o! your heating pen~ ~c~udes one m~jh-in and ~ne ~ Addi~onal l~p~o~ ~ be b~ al $~.~ ~h. ~g ce~[cate ~ ~up~y ~11 be HE~ ~~ w~h numbe~ ut ~ e~ ~eturn ~u,,~ ~t~ mom ~ CFM~ ~ o~n~ N~ ~ or ~ns s~d~ ~n ~ and return [~fi~ shew~ ~ LO~ C~QN~ FA~E~ ~O APPLiCATiONS KIAY BE MAILED ~ THE ~ OF PRIOR ~KE, 162~ ~GLE CR~K A~. ~E. PRIOR ~, MN Ci~ H~I ~ess hours am 8 ~- 4:30 p.~ ALL we RK MU ST a E I~PE~O ~OUG~IN AND ~)- C~L C~ HALL 4~230 I hereby apply for a mechanical systems permit and I acknowledge that the inlo~ation above is complete snd acc~l~ thai Ihe wo~k wlfl be Tn wilh the ordinaaces ~nd ~dos el the cHy ~nd wdh the ~ate ~ddin~eeha~i codes; that this form doe~ not he.me s pe~it until signed by the OFFICIA~at tho wet,will be in aCCOldance with the approved ~[an case o~wofk which~eq~bes ~eview end appro~[ of plus. t -- ~pl[~l~ Signature ' z Date ~u~g Offi~{'m Signature crrY OF PRIOR LAKE 16200 Eagle Creek Ay. S.E. Prior Lake, MN 55372 HEAT1NG APPUCATIO. / PERMIT Furnace Make & M~el ~ ~t COn~. Lo~ Su~ly O~n~gs MC Permit No. (~ [ ' 00'~ TYPE OF SYSTEM Warm Air Planls Mechanical Air Cendifianing Vent. Sy~em J ~O OR P~R P~NT Steam Return Openings Hot Water Relation Input Output Special Devices Edt. Other Devices Alturalions Repair Est. Cost $ HEATING PERMIT FEE $. STATE SURCHARGE TOTAL PERMIT FEES $ i'YPE OF WORK Replacement Est. Comp. Date ~-~. OO auidklg Permit ~ . .50 Receipl # New Construction TYPE OF STRUCTURE Single Family Two-Famiy Multi-Fam~y Commemial. Industria~ Pubic Other Fee Schedule industrial, Commercial & Multi-Family Residential, Heating & AC 1%'of job cosl (~39.50 ~imum) $99.50 PLEASE NOTE: Resi~ Heating Only Reaide~al, G~ ~mpl~ce R~idea~,A~s& ~e~io~ Reside~el, ACOn~ $64.50 Air Condltloner Umts Cannc $39.50 Encroach Into Required Side $39.~c Yard Setbacks. $39.5C Remember to add the State Surcharge on Ihs bottom ci' this application. The price of your heating permit includes one rough-in and one final inspection. AddilionaJ inspections will be bilted al $35.00 each. House Healing Teat Record must be subrr~ffed with buildina Derma number before build- [ng cerlilicale of occupancy will be issued. HEAT ~ J~r,.O.U. JJ~ with number of supply and return openings listed per room with CFM's per opening. New structures or addilicns send floor plan with supply and reflzrn k~cations shown. HEAT LOSS CALCULATIONS, PAYMENT AND APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE CREEK AVE. S.E. PRIOR LAKE, MN 55372. Clly Hell business hours am 8 a.m. - 4:30 p.m. ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL 447-9850 I hereby apply for a mechanical systems permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the city and with the state buitding/mechardoal codes; that this form does not become a permit until signed by the BUILDING OFFICIAL; that the work will be in accordance with the approved plan in the case of all wor~ which requites review and approval o~ plans. B~din; 0~ Si~atum ~ate PRIOR .LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS I~'~/~ V,/il~l~r~e~ "'~.~. NATURE OF WORK USE OF BUILDING PERMIT NO. CONTRACTOR _~3,1"~_ H oH-~r~ DATE ISSUED 1:2- ~ - 200o PHONE /~ /- - NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE I FOOT,NG I ~ I C~/'~7 I I FOUNDATION(PriortoSackfill)~. ]~-. ~/~/Ol I~..~l/3ht I PLACE .O CO.CRETE U.T,L ABOVE .AS BEE. SIG.E. ROUGH - INS SEWER / WATER / SEPTIC FRAMI"G INSULATION ELECTRICAL HEATING (if required) FIREPLACE ~s u.~ ~,.;~s; COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED FINALS 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-sha~l ~e placed near main entrance. Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS (952) 447-9850 ( grtifkat ®mqrann CITY OF PRIOR LAKE ~tpartmtnt ~t ~uiI~ing ~n~ttian ~F~ Pe~ ~ Conditio~ C.O. Expires ~is Ce~ficate issued purs~t to the require~nts of Sec~on 307 of t~ Uni~ Bui~ng C~e ceni~ing t~t ~ the ~ of iss~ce this st~cmre w~ in co~li~e ~th t~ ~o~ o~i~ce* of the Ci~ of P~or ~e regu~ting buiMing co~t~caon or ~e. For the follo~ng: Occupm,~--y Ty~ R3 Typ~ Construction L~gal[~ac~i~on L2, B2, DEERFIELD ConU'actor's Nat~ & Addr~s D.R. HORTON, SINGLE FAMILY Bldg. PermitNo. 01-0044 VN Fire Zone N/A Zon/ng Dis~ct R 1 SitcAdd~a 17240 WILDERNESS TRAIL 3459 WASHINGTON DR., SUITE 204, EAGAN 55101 /, ROBERT D. HUTCHINSr-~'~)'~ ' CityPlan~r DON RYE '~ B~ilciing O~cial POST IN A CONSPICUOUS PLACE OCCUPANT "' HEAT LOSS __DATE HTG. INST. SOLD BY Y?//~'r, ,' Electrical W~ By TYPE OF HEAT GA FA ~HW /:' .', ~ GASDESIGN HOUSE HEATING TEST RECORD STEAM CONTROLS L/ THERMOSTAT ~ Heat Plug Li~mif "~! (, Limit t~ett ing Fan ~etting Pilot ~pe /. / (/ /t Pilot Make 7~,, Pilot ~d.l L.W. Cut Off Input ~FH Percent O2 S~ck Temp. '~ ~ Percent CO F~m 235 APT. --FLOOR CITY OWNER JOB# INSTALLED BY Gas Line By , SPACE HTR. UNIT HTR. OTHER CONVERSION MAKE OF BURNER Model Max. BTU Rating MAKE OF FURNACE Model __ Vent Size · KIND OF LINER Draft Hood Fi Jters Size Chimney Location SIZE NONE. Regulator / / '?~.~x/.~['/'-/ .Number ~$ide Outside Chimney Construction (' ~/~/~{~4/~/( Smoke Bomb F" Wiring Draft Test Tag Door Pressure / Lighting I~nst. Date Tested ~ Company Testing F~cksorl Heating & A/C, 3650 KenneJ~ec Dr., Eagan, MN 55122 Hame of Tester CiTY OF PRIOR LAKE INSPECTION NOTICE OWNER PHONE NO. DATE TiME SOHEOULED CONTR. PERM~T.O. /-- ¥ ~/ [] FOOTING [] PLUMBING RI [] FOUNDATION [] MECH RI [] FRAMING [] /~sNiSULATION [~ NAL [] ITE INSPECTION [] FINAL COMMENTS: ~"' 7'"'- [] EX/GRAD/FILLING [] COMPLAINT [] FIREPLACE RI [] FIREPLACE FINAL [] GASLINE AIR TST [] [] CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: ~ Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH & SAFETY/ CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS OWNER PHONE NO. CONTR. PERMIT NO. r-i FOOTING ~3 FOUNDATION r'l FRAMING [3 INSULATION ,~FINAL r-i SITE INSPECTION [] PLUMBING RI [] MECH RI [] WATER HOOKUP [] SEWER HOOKUP [] PLUMBING FINAL [] MECH FINAL TIME [] CO~ffi:~I.~INT [] FIREPLACE RI [] FIREPLACE FINAL [] GASLINE AIR TST [] COMMENTS: E] WORK SATISFACTORY, PROCEED CORRECT ACTION AND PROCEED [] CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ,nspector~'~'~ Owner/Contr: CALL 447-9850 FOR THE NEXT ,NSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSON. AL HEALTH & SAFETY! CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS OWNER PHONE NO. [] FOOTING [] FOUNDATION [] FRAMING [] INSULATION .~3'~FINAL [] SITE INSPECTION DATE TIME SC.EDU'ED CONTR. PERMIT NO. [] PLUMBING RI [3 MECH RI WATER HOOKUP SEWER HOOKUP [] PLUMBING FINAL .--:~"~ECH FINAL [] EX/GRAD/FILLING [] COMPLAINT [] FIREPLACE RI FIREPLACE FINAL GASLINE AIR TST [] COMMENTS: r-i WORK SATISFACTORY, PROCEED [] CORRECT ACTION AND PROCEED /~ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING inspector: 14~ ' Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH & SA FETY! CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED DATE TIME b.f.ot Ii :o'7 ADDRESS OWNER PHONE NO. CONTR. PERMiTNO. ~)l' OOz~r"'~'- [] FOOTING [] FOUNDATION [] FRAMING [] INSULATION [] FINAL [] SITE INSPEC~ COM M ENT~'.' [] PLUMBING RI [:]EX/GRAD/FILLING [] MEC. RI [:]COMPLAINT [] WATER HOOKUP [] FIREPLACE RI ~) D~[] SEWER HOOKUP [] F,REPLACE ,,NAL PLUMBING FINAL [] GASLINE AIR TST MECH FINAL [] [] WORK SATISFACTORY, PROCEED ~ CORRECT ACTION AND PROCEED r-l CORRECT WOR~ CALLFOR RE INSPECTiON BEFORE COVERING Inspector: "{~' ,~ ~ Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH & SAFETY! GITY OF'PRIOR LAKE INSPECTION NOTICE ADDRESS OWNER PHONE NO. [] FOOTING [~ FOUNDATION r-i FRAMING SCHEDULED CONTR. DATE TIME [] PLUMBING RI [3 MECH RI E] WATER )-lOOKUP [] INSULATION [] SEWER HOOKUP ,***~ FINAL ~**~ [3 PLUMBING FINAL COMMENTS: [] EX/GRAD/FILLING [3 COMPLAINT [] FIREPLACE RI FIREPLACE FINAL GASUNE AIR TST ~1/WORK SATISFACTORY, PROCEED [] CORRECT ACTION AND PROCEED [] CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: ~'~i O~ner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSON.4L HEAL TH & SAFETY!