HomeMy WebLinkAboutBuilding Permit 04-0733
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT & / :7 S; -0 L(
See Main F~ ~::y 1 PERMIT NO. OiL, 07.'"'231
3 Yellow Applicant ,- ....../
(Please tvoe or onot and sir:n at bottom)
ADDRESS
4666
f3U}PJ=
H<!"~~I9Tf
LEGAL DESCRIPTION (office use only)
LOT47BLOCK , ADDITION
T~MiEJZ
OWNER
(Name)
'PUL..7"F
IIIJMES"
(Address)
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PiPl:r N IV,t: <7
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PID ~5 -'I{)~-{)L/?-4
Sv'J!7'e
!hIJKI,/A'r 1<(0
(Phone) '-t / - 4(;"2- S- It:b
l"AbA,V !I1V S~/21
(Phone)
(Phone)
I Park Support Fee
I SAC ..---=-.
I Water Meter (Size51Ii:lJl";
I Pressure Reducer
I
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
Sewer/Water Connection Fee
Paid
Date
~.7/ J'Y
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BUILDER
(Company Name)
(Contact Name)
(Address)
TYPE OF WORK. ~ew Construction DDeck o Porch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
~~~dition DAlteration o Utility Connection 0 Misc.
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Lvt.T & ASl H,eO
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CODE: J!:.R.C. DI.B.c. PROJECT COST IV ALUE $ 'If",,&cDO
Type of onstIUction: I II III IV V A B (excluding land)
Occupancy Group: A B E F H I M R S U '.
Division: 1 2 3 4 5
I hereby entity 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 authonzed 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
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// Signature Contracto~s License No. Date '
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$ /02..7.<.0
$ b" ,. ~.V
$ '1'?O~
$
$
$
$
$
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
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I"D, a I:)
3-:;: 5"" t3
4~. t9 "
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Pennit When Approved
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$ 13so.oo
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$ 'f~,oo
$ (ZoO. DO
$ 70 0 ; 0 ..
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T. hIS is 10 ct'rtify that tht' request in the above application and accompanying documents is in accordance with r~." itY_?Oning~.' af~n 'and 'ifW proceed as re.9ucslrd_ ThiS document
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- Pl,nning Directo' . ~e . Speci,) Conditions. if illY
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
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See Main File
(White - Building ;)
Canary - Engliieilring
Pink - Planning
Th~ Crnlrr IIf Ihr t.ak. ("ounll"l
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,!",Y)? ;.&J~ fIJz; ~
Accepted With Corrections
~
Accepted
Denied
Reviewed By:
(~
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Date:
f/~A y
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."
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S@e Main File
White . Building
Canary . En ineering
~ . Plan","
Th~ Cfnlfr of lhf L.kt <,'ountry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
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Accepted With Corrections
",
Accepted
Denied
Reviewed By:
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Date:
7/:? ft; C/
Comments:
'-
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"The issuance or granting of a permit or approval of plans, specifications and f
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,"
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See Main File
Whit" . Building.
( C;anarv . En<!.ineerlng-...,
Pink . Planning
Th. C..nln of Ih.. 1..1" Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
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Accepted
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Accepted With Corrections
Denied
Reviewed By:
Comments:
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Date:
7- /5-0,/
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"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."
Jun 24 04 11:51a
METRO GENERAL SERVICES
763-428-2968
p.3
GAElII - filE
YElLOW. APPLlCAIIT
GOlD. CITY
SITE ADD
NOTE: Sewer and Water
contractors must
be registered
with the City.
APPLICANT!: JJ1d~1) ,r;VeJUh:/.l Sl'fVl~ONE :A~~il7i~l4J'Zik
ADDRESS:_ hr;C!t) Ql1i1.rJ{ lIV.f_ hf' DATE:
1)0 j~ tb/lI"R. . .. BLDG. PERMIT #
?ftfttf P,/ Ibr/L~ PID#
FI L,,:IN THE BLANKS
/5n
FA'/..
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
CJS;;.. '1'/ 7-'1-z, II.$'"
S.W-No. ()~., 133
1.
Esti .ated length of water service
,j 'I
Size of water service I
feet.
:2 .
3.
inch(es).
"--
4 .
5 .
Laca ion of any couplings from structure n feet.
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Type af sewer pipe. ABS pvc4 Cast Iron
Esti ated length of sewer line !){J feet.
6. Clean out (if required), located at feet from
stru=ture. , in
Ii;"
=====================~===~======~==========~======~===============
This appLication becomes your permit when approved.
BY
DATE:
.!
===~=== ====T============================~========~===============
P u, h'e..d iJ ''Hr. .
FEES: I1/J,j P'/-M.' 7-. Sewer and water line connection permit.
.. . surcharge
Ala Pee... TOTl\.L
)>;~'5;,:
- " " . , .'.' /l:, ' :,'~;i' C
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* Fee for either sewer or water individually is $20.00 plus
$ . 0 surcharge.
* Sewhrandwater permits issued for new construction must be
r.eC).rded 9.n +)o,^ l.~. ;.J....i.n9" permit card, at the tim eOf. i.ssuance
r..~s~r~~~ ~lS hcate sewer and waterperml.'t s are
CkrE-;iPAr:J.. JUL 292004 .. .. AMOUNT PAID ~._ ,. .. .
. ,-t-\\,,,,, 110" t"\
RECEIPT t REC/DBy?r.r:'':)(ii\'~r:l~'='~~
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16200 EagJ~:' :reek Av. S,B.. Prior Lake, Minnesota 55372/ Ph. ('Is2) 447-4230 / FAX (~s:2) 447-4245
An Boual Opportunity Employer
.-~ '-;'.~ ~.,.;
;952 894 0925
# 4/ 9
Date Rec'd
UTY UJ:f l'.K1UK LAK~
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
f!'lease '!yp'e Of Print and sim at bottom)
I ADDRESS
LI'i?8Z ~\lA~'("' I-\-+--, \{~
:~::. ~:,~ I PERMIT NO^,,- A""Oll
J.,{e!lowApplj~nl ~
ZONING (ollke use)
. LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
?l.A.O k.. -\-\o.~-c:...S
(Address) 'l, Ie, d lv.\hwc'\ + 0(1 I ~ 1k.i j,/
I
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(phone) '- oc:::, I -
f 0.a r., fl. f.-.A ,r)
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: APPLICANT
(Name)
(Address)
Burnsvil/e Heatinc & AIr. I I r.
12481 Rhode Island Ave. So.
Savace. MN fi!i~7'l_11""
(Address)
(phone) C)"") ,3 -\( q L/ -(:cas
(City)
(Zip Code)
(Contact Person)
(I.
APPLICANT SIGNATURE j/ / 1/1 j
(phone)
73.JII2LJ.L70 ..I7(2g,Ll DATE
//-/7-0L./
APPLICANT PLEASE COMPLETE BELOW
(ElNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL '&-rl/?lV (:c:,/ ;L./reJ. JLI13 .. 0<1 S FUEL 1"1CI ..7' CiCk.A-/
FLUE SIZE RElURN OPENINGS "'S INPUT LIS, 000 OUTPUT 'iI LJ{)(J
TYPE OF SYSTEM HEATING OR POWER PLANT
DWann Air Plants D Steam .
DGfl!vity 0 !lot Water
o Mechanical D Radiation
D1IAir Conditioning 0 Special Devices
OVent. System 0 Other Devices
PLE:~S);: N9'l'E::
AirConi\itioner.Units
Cannpt Encroach into
Required Side Yard
Setbacks
I
1\
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
I
Residential, Heating & Ale (New Construction)
Residential, Healing Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Pennit #
~::z
(om.. Us. Only)
Tbis Applicatioil Becom.sYllur.BuildiDgPerani(WberiApl'roved I~?
I Date
Building Official Date
24 hour notic. Cor all inspections (952) 447.9850, Cax (952) 4474245
161.00 Eagle Creek Avenue, Prior Lake, IIfN 55372
.50
I Receipt No.
I By
t:~~ P~RIO..ps.
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please me or 'Print and sim at bottom)
ADDRESS
;~, ~:~ 1 PERMIT NO.AL. ^"'7"Z14iI.
3_ Yellow Applicant u-I"'" "'"".IU
ZONING (office use)
4888 BLUFF HEIGHTS TRAIL
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name PULTE HOMES
(Phone)
(Address)
APPLICANT
(Name) ALT.JED FIRESIDE DRA FIRESIDE HEARTH & HOME
(Address)
?700 NORTH F AIRVIEW AVENUE
(Address)
(Phone)
ROSEVILLE
(City)
651-6~3-2561
S5Jl3
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRFNf)A HUSTON
DATE
12/7/04
APPLICANT PLEASE COMPLETE BELOW
xO NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEAT N GLO SL.550TR-D
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Industrial, Commercial & Multi~Family
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
PAlO WITH
.5tiUILDING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildine Official
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'IJ b'_
i.. Date Ii' By
Date I i[ -QE ~ 3991 Ii>
24 hour notiee for all inspections (952) 44 tlj'a50, fax (952) 447-4245 ,
i I:~ n
Receipt No.
By,_,
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~~S ~I..(,J~F tiE/Sf( TS. 7)u(/~
NATURE OF WORK AJ€ ~ ,~
USE OF BUILDING S'.Fi A. .-
PERMIT NO. _ O~ 073:1 DATE ISSUED 7l1g/tJlf
CONTRACTOR PUCTE H"WI~S PHONE~Il.- l-Z/-nYS
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF See Main Filt
BUILDING AND INSPECTION
INSPECTOR
DATE ,
_1(7,,:~~ I
l
I FOOTING ;;It t
~
, FOUNDATION (Prior to Backfill) v11'P'JJtk'YI/ ~ I 7ff~7
PLACE NO CONCRETE' UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER/WATER/SEPTIC J41i- 7:~t{
FRAMING VVP I ~ ~ - { 7~ut/
INSULATION //#/ /::7/7 /Alii
ELECTRICAL, _ ,
PLUMBING u/;;? //t/ tf/16H /~. /.:z//.57"Y
HEATING (if required) JlV{/ _ / L- n-CAI
FIREPLACE .,/VJ/' / // 17-(//, J
GAS LINE AIR TES~/., dyu / J: 1/ r '7../ ~ ,2A~s--'
./ i -
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
hilt I J/f~ I O,,?5;/~
FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
-...See
.~
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,;;lL/yt/ /Q5-
~~~/os:-
~,21f/oJ-
.2?~S-
BEEN SIGNED
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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
QItrfifitaft of <IDttupauty
CITY OF PRIOR LAKE
, ~tparfmtnf of IJiuilMng Jlnsptdion
~'Final Permitted [J Conditional C.O. Expires
This Certificate issued pursuant to the requirements o/Section 307 o(the Uniform Building Code certifyinll
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:
Use Classification
SINGLE FAMILY
Bldg. Permit No.
(j 4-. {;733
Occupancy Type
R3
Type Construction
VN
Fire Zone
N/A
Zoning District
PiJD
Legal Description
L47, Bl, TIMBER CREST PARK
Owner of Building
S;te Address 4888 BLUFF HEIGHTS TRAIL SE
Contractor's Name & Addres'pULTE HOMES, 815,-NORTm,EST PKWY., SUITE 140, EAGAN 55121
ROBERT D. HUTCHINS /',/;1')'" C;ty Planne. DON RYE
O Bu;ldjl</l-Off,e,L
Date: J -'? L/ / U ~ Date:
~ I' =
~ 2~:/ TIME
SCHEDULED ~~
~rf'r 6~/P $- ?;/
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
CO~j:NTS;' / / /
~~,,-l/I~~I kkq~.
o~-73J
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
~PLACE FINAL
o GASLINE AIR TST
o
~~
.~;~Al/4cc: h~~i ?J~
t-/ c&h.J-e ICY /~h, 'h/d
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X~ORK~~Y~:EED// p
~-;;ORRECT ACTION AND PROCEED
REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
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CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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OA TE TillE
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'If'~~ %Iv./y/~k' 7;1
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~CH FINAL
COMMENTS:
16:::: -!-/ 3LI
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f?eLet(/-e~
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0;(50/ r
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/';- /
r,/ n~ I
/lh'
&/'-
dq~ 7..f ?
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
r-,
'#r-
$/r/,
.---- /
/--"-J/
~'RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR.wffREINSPECTION BEFORE COVERING
Inspector: / /~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH Ie SAFETY/
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BUftNSVILLE
Heating & Air Conditioning, L.L.c.
11481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
Orstat Test Report for Job# In 90;;
Address 4888 6w.11" J/t:.iC,/17 <; Ire. Citv t1z1Of( LA?i
Occupant
Date of Instatt I:::J ;;l;;l - O~
Type of HT. F/A./ HW Space HT Unit HT
Other
Make
Model
Serial
Input
Lt.: /11/010)(
G...nu..i1, "21\(':, -c>'-{S - 0 I
5Q641" 2311<'
"1'-1.060 f3"(/.A.H
Pilot Type HOT SURFACE IGNITOR
Pressure 35 . we. CO2 /.,,0
Input CFH 1-\" 02 10. "3
Stack Temp II~ CO (n pprr.
Date Tested
Company
Technician
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BURNSVILLE HEATING & AIR CONDITIONING
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