HomeMy WebLinkAboutBuilding Permit 04-0735
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
t --' ?_r:;v6 L(
Se. e Mf.:)~n Fl.1t:)~i~:' ~:~, I PERMIT NO. 0 A.. 0725]
u.l. ~YeJJDW Apphcan/ ." .;;;.1
(Please tvIH: or Print and si2ll at bottom)
ADDRESS
i/tf9L. $t.HPP J/~~ 1/t.JHL-
ZONING (om" use)
PuO
LEGAL DESCRIPTION (office use only)
LOT 'fSBLOCK I ADDITION
--7':4fJibt ~r- .PA-i2.<.
PlD;):5 - tit) J.; I)L{C;-(j
OWNER
(Name)
Pot..:rE-
ilofflrr::.
(Phone) t?S1- ~~Z - S2.0d
(Address) 'ir/~
,J(J{J.,"ttlI-Jf!{T
.
P.t(l/(WAI/. <tJ:Z71?
/40
.
tA6J.J)
MAl
~:'-~/.2 I
BUILDER
(Company Name) .5A-fl.f';;:
(Contact Name) _tu ~ ';1'; ~.H~
(Address)
(Phone)
(Phone)..-6~Z -Z;v ~tt9Ys-
.,,-
TYPE OF WORK lB'New Construction oDeck oPorch oRe.Roofmg
DAddition DAlteration OUtility ConnectIOn 0 Misc.
CODE: ~C. DI.B.c.
Type of Construction:
Occupancy Group:
Division:
ORe-Siding DLower Level Finish
o Fireplace
A
B
I
E
II
F
I
III IV
H I
2 3
V
M
4
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
J?~~ax:)
I hereby certify that I have hlrnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authom:ed agent for the
aDove.mentlOned . perty and that al1 construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
:fid'l "n;e-;;;''' ~o'W 4'bY ",ee 'h" 'h',,~ off,,',1 0" d'8e":Y ;;;; the pmp'ny co p,,'mm necd:;;:~~ y
'l Signature Contractor's License No. /" ~ate
Permit Valuation .J'q/" MO.OO I I Park Support Fee # $ I
Permit Fee $ r I I SAC # $ I~so.oo I
/11 Z 7. .e:;O
Plan Check Fee $ bfo7. Ffl? I I Water Meter (Si~"; $ ZSO.~O I
State Surcharge $ ~r. D 0 I I Pressure Reducer $ 4-S.00 I
Penalty $ I I Sewer/Water Connection Fee # $ IZCO.<<9C I
Plumbing Permit Fee $ /1Jt:J. t!)~ I I Water Tower Fee # $ 700.00 I
Mechanical Permit Fee $ ~() 0.00 I I Builder's Deposit $ I
Sewer & Water Permit Fee $ 3S: S- CJ I Other $ I
Gas Fireplace Permit Fee $ LftJ, 0 0 I TOTAL DUE $ 5;Sh3. B971
s:rc..:S..TV /I
This Application Becomes Your Building Pennit When Approved I Paid ~~c,to .;-1z,..,f'7
~ ~ ~a!15Y Date 7 ~~i.-
U
BlIildl1l1!.Otlicin1
ThIS IS 10 certify that the requesl in the above applicatIOn and accompanying documents is in accordance with the City Zoning Ordinance and may proc('ed as requested. This document
~s~~;:' JI,nnec j;' ;;m~~ C"tif,,,,, Of;~'O;2" ,nd 'llOW"OSeemNfaiiin'YPileO""p'n~ m<<stb,
Planning Director - I' ., Dati Special Conditions. if any
24 hour notice for all inspections (9S2) 447.9850. fax (9:;2) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~~o~~ PR10"'<'7
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See Main File
White - BuildinL
...-canarv . Engineerl~
Pink - p.lDlnlng
Th.. ("..nerr 'If th.. LIIK.. Counel'}'
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:
I ; r//~ "-i
7 . ,{ ',f ;~:;Z -""
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
/VI48
Date:
7-/7-0Il
Comments:
St: ( 1Y7&11~
hI-<.
"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."
5~'j;
See Main File
White - Building
Canary - En~ineering
(~ink - ....an",n,,--:'
Thf Cfnlfr of Ihf L.\r.t ('ounlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT '. t
APPLICATION RECEIVED
Ii
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,..L...._....t "A t' i' r ~." .. .,-...,
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
f/v! -2 -- ~/_ I.j I
: J .
\::..:;r-" L.
I
~
Accepted With Corrections
''''-A~cePted
<
Denied
"
,
~ 0 -to, '-<-- ~ f:-
Date:
J/ 3.~ ~I
Reviewed By:
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."
~~
See Main File
rlNii!!e . - BuildinQ::>
Canary - Engineering
Pink - Planning
Thr ('rnlr. of fhr I.akr Counll')'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKUST
NAME OF APPLICANT G JJ/C: . ~
(p ~ 015 -otl
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
applicatipn for construction activity which is proposed at:
. . Life; () -- ~ cj,.!{; ~
/
Accepted
Accepted With Corrections
Denied
Reviewed By:
~
"
?-JLdJ/-'
Date:
7/;3~if
. . ,
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."
Jun 24 04 11:50a
METRO GENERAL SERVICES
763-428-2968
p.2
GREEI . fN.E
YELlOW - AHlICANT
QOLD . CITY
NOTE: Sewer and Water
contractors must
be registered
with the city.
APPLICANTI:JM,~ ~.p, ~lIfJ1l)V)/ ~Y:f((~oNE:lh.3.jlJJ:,,;r;'4~
ADDRESS: .l{ry4'J (J/H1.fll.. IIlH~ (JJF DATE:
SIGNATURJ: - . lJn};I 11:v1t.t;J-",-., - .BLDG. PERMIT #
SITE ADDJl!.SS: 4,fO,J $./t A!t1'kr~, PID#
, ' FIL . .IN THE BLANKS
(1)()
CITX OF PRIOR LAKE
SEWER AND WATER PERMIT
c)5~ If" 7-'/"), I/.G'
S.W.NO.~ D7~5
FAY-
1.
Estiliated length of water service
. II
Size of water service /
feet.
2.
inch(es).
.
t
J. Local ~ion of any couplings from structure r} feet.
/1,1
4 . Type I 0 f sewer pipe. ABS PVC Lf Cast Iron
~ 5. Esti~ated length of sewer line ~/) feet.
6. Clea~ out (if required), located at feet from
structure. /llA .
~~=====~=============~========~==========~========================
This apFlication becomes your permit when approved.
.1
BY.
DATE:
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FEES: j] Id" P.e-/I1.:i- Sewer and water line connection permit.
v .. , Surcharge
Afjj Pe.e.... TOTAL
* Fee for either sewer or. water individually is $20.00 plus
$ .!;O surcharge.
* Sew, 'r . and water permIts issued. for new construction must be
r."eC,.,'lrd,e "" ....."'D~'1'ci-m...,.ng permit card, at the time, O,f"i,ssuance
r,,~' i !i1!l!'~~~1 ;" Ir I, 1.'Cdt. ,owor ,nd W,',', or pmi" , are
DATE)J:1A,(\l~ JUL 2 9 2004. . AMOUNT P~D.~~ .-
RECEIP'I# REC'D BY JJ.'..I.i,~Gl='J:~!\r,!
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16200 EaglC;::rreekAv. S.B., Prior Lake, Minnesota 55372/ Ph. (.,,2) 447-4230 / FAX ('112) 447-4245
An EoualOpportunity Employer
;952 894 0925
# 8/ 9
Date Rec'd
CITY UI" l'.lUU.K LAKJ<;
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
; ~~ ~:~ I PERMIT NO. ~- 0'7'~
3. YeJJaw Al'pln:ant ~ . ;:)p
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~lease!Yee or print and siJm. at bottOm)
ADDRESS
L(\?C".d- ?>\u((' I-\--+:--, \{~
ZONING (om", use) I
LEGAL DESCRIPTION (office u,e only)
LOT
BLOCK
ADDITION
PID
I
OWNER
(Name)
(Address)
~l A. O.:*e.... fu "'~S
~\S I\I{X~h\A~i D\ HJ')
o
.:\:I:.1l.IO
(Phone) ( oS I - I.../S7..-S2Q)(J
EOUJ{An M'Y\ <;<;\'2../
APPLICANT
(Name)
Burnsville Heatino & Ale I I r:
12481 Rhode Island Ave. So,
Savaoe. MN 5!i371l-11??
(Addr...)
(phone) 95,)- y:c, L/-C.D0:5
~'B
"t
it
(Address)
(City)
(Zip Code)
I
(Contact Person) (phone)
APPLICANT SIGNATURE (~/.i1l1, K nf2-l1f7o J1C::e./7 DATE
/1- I 7 -()I-I
APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL Ln m/CV !:-Cj//l-/p. ,}.I...{,'3 . Q{/5- FUEL r7Ci I C;Or....Jj
FLUE SIZE RETURN OPENINGS 5 INPUT L/ ') . (JUO OUTPUT 1dL. LJ {)(J
TYPE OF SYSTEM HEATING OR POWER PLANT
OWlU)ll Air Plants 0 Steam
OGravity 0 Hot Water
o Me~hanica1 0 Radilltion
rxtAir Conditioning 0 Special Devices
OVent System 0 Other Devices
Residential. Additions & Alterations
Residential, AC Only
I
~,~
rk
I}B,)
M~
iF'jI', '
n~
. c~
i,iiij!
.I.~.~_,'.l.,..
~!J::; -
PLl!:"~J;) N{)l'E:
Air Cqn4itionerl!ni1.5
CliIlIlotJ;:llcroachinto
RequIred Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
(Office Use Only)
Tbis Application Becomes Your Building Permit Wben Approved
.50
Receipt No.
0'
I
Date
By
Building Official
Dale
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Menu.. Prior L.~., l\{N 55372
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
;~, ~:~ I PERMIT NO.nL ^ ~
J.Ye[]ow Apphcant ~.U'~
(Please tvPc;. or Drint and sim at bottom)
ADDRESS
ZU1'lli ",G (office use)
4892 BLUFF HEIGHTS TRAIL
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name PUL TR HOMES
(Phone)
, (Address)
APPLICANT
(Name) ATJJRD FTRR~TnF DRA FIR ESTDE HEARTH & HOME
(Phone)
65] .633.2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
(Contact Person)
BRENDA HUSTON
pnSEVTr r p
(City)
(Phone) _651.633.2561
55113_
(Zip Code)
APPLICANT SIGNATURE
BRFN/)A HUSTON
DATE
12/7/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERA TlONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
D Radiation
D 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
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additinns & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$-
$
.50 PAID WJn.f
BUILDING PERMIT
(Offiee Use Only)
This Application Becomes Your Building Permit When Approved
P"il
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~ !
Receipt No.
Buildine: Official
Date
I ;Wtf:JEC 8 2004
Lfi_
By
24 hour notice for all inspections (952) 447-' !!f:O, fax (952) 447-4245
. v.--- ......
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 4S9z.. 'BLU~ Hc1J.g, 7I2.A1~
NATURE OF WORK AJE~ ~S7. C1~
USE OF BUILDING ..s:: t:': A .
PERMIT NO. . {J4, 0735 DATE ISSUED :z..Ll3b." .
CONTRACTOR PII~r6 NdAII€'S PH'ONEMZ-JZ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF See Main Fj
BUILDING AND INSPECTION
INSPECTOR .. O~TE J'
I FOOTING I /t"c~ I ;:/~j' ~y
. , ~
I FOUNDATION (Prior to Backfill) ftn.tr~,( Co., /,; I'~;.L. I .fh~:/fy
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
. -
SEWER I WATER I SEPTIC ~-/?-- . ? /.A:1 /1--/
FRAMING j/f/f./j- P /IJ/a(
INSULATION .4'..?:!f ///!5Y~
ELECTRICAL , ,Ph ~/p ~ I
. PLUMBING 0. ti /It!! ~R/;I /111j ).;1.//1/l'i
HEATING (if required) !f;J'f. /..J(Ujt'/
FIREPLACE J14/} z;fljju-f
GAS LINE AIR TES~j..,...?/t"rJ'/"/( rW ~ .$/zAr~
- / - .. .,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
J-a if I;/It# I / ?Pf-ft~
FINALS
,fee ~, ~
~
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
I PLUMBING
I HEATING
DO NOT
/76
;j{,J;
, .
OCCUpy UNTIL ABOVE HAS
NOTICE
A~ /
.zN/a-J-
//~/or
//?r/os-
~/).lo.r
BEEN SIGNED
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
@erfifiraft af @rrupanru
CITY OF PRIOR LAKE
. ~tpztrtmtuf nf ~uilltiug Jlusptdinu
/rQ Final Permitted [] Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code certifying
that at the time of issuance this structure lVQS in compliance with the various ordinances of the City of Prior
Lake regulating building construction or use. For the following:
Use Classification
SINGLE FA!'!ILY
Bldg. Permit No,
04- c 735
Occupancy Type
R3
Type Construction
VN
Fire Zone
N/A
Zoning District
PUD
Legal Description
lAS, BI, TIMBER CREST PARK
Owner of Buildinp"
Site Address
4892 BLUFF HEIGHTS TRAIL SE
Contcactm', Name & Addre'I'UL TE HOMES, 8.1:if~ NORTlfI,EST PKV.'Y.,
ROBERT D. HUTCHINS /('~ City Plannce.
Date :p<(~!!&illficial .
SUITE 140, EAGAN
DON RYE
55121
Date:
H:rE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED oS--
ffJ?~ 6% /Y //A' 7//
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
C~~NT~~ .
~-e.c/-/IJ C~ I
ki~/
~.,y- /,s.s-
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/
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A~"Mm;'=~ h ~
/ ~RRECT ACTION AND PROCEED
/
o CORRECT WORK,. C~~~)E~SPECTION BEFORE COVERING
Inspector: /'" ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOrI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETYI
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
I/f9.-2
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED ~~5~
,e/v.F;L' /h~/
CONTR.
PERMIT NO.
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
"a:HIIECH FINAL
8 Y"?SS-
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
.,..D-el\SLlNE AIR TST
o
COMMENTS:
./1 4 .___ / I )
//~~O,lf<1'~ nr. I~.rr .~
/:j!r~ ~ ~ ~,-'t." A~y't'--=-7 'q /
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/It/lC[ U/c.
/ - /
Je...J7
~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PR CEED
R RElNSPECTlON BEFORE COVERING
Inspector:
Owner/Contr:
CALL "7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSliOTl
BUKNSVILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
Ors1at Test Report for Job' b qOIi
Address <-169;; /3udf 1/L-/6/f15 -rR Citv f-k1O~ L/lK.C.
Occupant
Date of Ins13l1 17.27. Q<../
Type of HT. F/A ./ HW Space HT Unit HT
Other
Make UN>..lO"-
Model ~q?\J...C - Z4r2,- D4<; -Cy
Serial 5<joyLO'-(?<./"3
Input L\t.1, DOO l)TU.l-l
Pilot Type HOT SURFACE IGNITOR
Pressure 35 lWc... CO2 /,.,.~
Input CFH 44 O~ CUt
Stack Temp 91 CO (p pp"""'"
Date Tested 2- \-00;-
Company BURNSVILLE HEATING & AIR CONDITIONING
Technician Leo