HomeMy WebLinkAboutBuilding Permit 01-0093
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2 ?ink
3. Yellow
File
City
Applicant
(Please tvQe or orint and si2D at bottom)
ADDRESS
.:Y'V"t:77 ~/V ~O'-4"r ~
LEGAL DESCRIPTION (office use only)
6Ioa5! en tP/Z//T Y
~ JH.OC~ ADDITION ~<-'-->>"9~<:7 d-rc:J
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Name)
Date Rec'd
g2-
PID 2.5. 313 ~ ()(Tl... - cJ
(Phone)
p~/-~-7/.:5"'...s::;
~~~ ....;t7U?
v?Aj.
d-Y6P
(Address)
~.......:-
..:<<7-y"
~i.J,.;....,....'
~J<i1'S"R~
~
~New Construction
OLower Level Finish
ODeck
OPorch
ORe-Roofing
TYPE OF WORK
OAddition
OAlteration
o Fireplace
o Misc.
~.;r.:?
ORe-Siding
OUtility Connection
PROJECT COST IV ALUE (excluding land) $
I hereby certify 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
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.
~ ~e"-~
Signature
$ ~.OO I
$ Illt;O.oo I
$ c:> I
$ U I
$1.~O.frl.
$ rzOtJ ~
$ 6 1
$ I
"It, Bee' es Your Budcling Permtl When Approved TOTAL DUE $ 6t 6/~_7~
lh ~() I I Paid 5$'1" 7 tI I Receill'MJ'l' Vitt.{ /
Buddmg o,tCIal Dare I Date ?..l ( ~ ;-J/ Bv /j/.J/I1....r .
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and miroceed as requested, This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
i"L~ 'P/_ _,,-_ 2/g/o (
"7 I -'1\6.- Plannmg Director Date Special Conditions. if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
x
~~S7;;~"Y
Contractor's License No.
I Permit Fee $ rl'tn 75 1 Park Support Fee
I Plan Check Fee $ , - I SAC
~13.qcr
I State Surcharge $ ji) 50 I I Water Meter Size 5/8"; 1";
I Penalty $ I I Pressure Reducer
1 Plumbing Permit Fee 1 $ 10{). 00 1 I SewerlWater Connection Fee
Mechanical Permit Fee 1 $ ItJ{).0t5 1 I Water Tower Fee
Sewer & Water Permit Fee I $ 3S".CJ?J 1 I Builder's Deposit
Gas Fireplace Permit Fee 1$ 40-00 1 Other
/_~..y---GY
Date
#
#
#
#
5~\
The (~entrr of the (,.kt' CouOlry
White . Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
fJ. f.2-. HO!<Tr'A)
1- 25 - () 1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
5407
I
FAVJf\J c.-OU(<-l sf:.
Accepted
Accepted With Corrections
Denied
Reviewed By:
Date:
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."
"~1
01 ,oo~3
TheCenl..roflh..I..hCounlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
J). I~. H(~c..J(/~)
1_ C) ,- -. /' I
t::..-_J (
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'-)"4(7 F f\\\~fJ LCl/i'-:- ( --:-A:::..
I
Accepted ~
Accepted With Corrections
Denied _ ~
~. -
Reviewed By: YAA,,' '/-:-..
Date:
~/c!J {
Comments:
~fjf/d2 51,~~ ctO "'l~ r~fiP8V1~ tr{J-
~ ~~ tJ~ IJ.. + ~~ ifJ~ ~ ~.QOeQ
_ :<11& Az:)..J;~ c
"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."
~~
D I /Doq3
Thr rrnlrr of lhr I..kr Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
D. \<-. HOITnt\J
1- 25 - ('){
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
5407
I
FAWN ~UR:l 56
Accepted
Accepted With Corrections X
Denied (2 If] j
Reviewed By: .;/ f}(l'1" ~
. I
Date: ! - J{ - 0 (
Comments:
~ 5t(()C.( h-pr4.JIA ~ (1.L.<hAJ...-L~........... ~ tot;;.
"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."
JRN.29.2001 4:36PM
GENZ RYRN 6513226147
NO. 049----P. 9/9------
I. II.. I'i1o
2. CioI4 City
l. YeU- Appli_
OI-DOQ'3
CITY OF PRIOR LAKE
. PLUMBING PERMIT #
Applicant: G~^7. - ~ jI'"") Phone: (~- 1./7.?'--, -II LlW
Address: 1Ll1l..\-r ~ ,f~ -TIIU_ ()~ V'fY'O.l VI,... ~ S'mtaR
Signature: tk \D d - -j
legal Description: lot Block Sub..J::)>PfffPOi". \JIll Q '"
Site Address: J';~O'\ -FA, "-,, 1L.1 Do/"<"" r I..J..""'- .\!:
BuildingPennit# ()/- {)nq~ PID#--2-h-n]-oo1..-o
NOTE: This permit "'!ill not be proQ8ssed tkhout complete infonnation.
FIXTURE UNITS
T'\koC"'ft.".t.-,CClllltI1'7
QuantitY
I
I
t
-z..
I
2-
Type of Fixlure
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (bathroo m sink)
laundry Tray (lor 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
Quantity
I
fGl,
I
Type of Filrture
Rough-ins
Water Heater
Water Soflner
Stand Pipe (washing machine)
SeWIIge Ejector
BackIIow Assembly (flPz. Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
$
$
$
$ .50
\S'!\i\-\ .,-<'
f'f>.\O yc:?-\'.;;\'
$ e\;}\l O\~G.
This permit is ....led upon the ~pr... oondiu.ll m.. .aid
conlr.1CtOt, sball comply in IlII ""peets wjth !he Drain.nees
of tho Swe Plumbing C d d "",ood"",,,.. !hereof.
~ kl; fA Z,.(./1.01 DATE
I _ ATreST
Call for all inspec ions 24 hours in advance.
.. _._-_.__.,.,_.._..----._".._-"..__.~-~.__.__..,-_._....---
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 I FAX (612) 447-4245
An Equal Op!Jonunity Employer
feE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
G~AND TOTAL
JAN.29.2001 4:35PM
GENZ RYAN 5513225147
NO. 049
P.5/9
_......
'rl!U.OW. __"T
GllUI . CITy
CITY OF PRIOR LAKE NO. ....QI- 0 0CI3
SEWER AND WATER PERMIT '
NOTE: Sewer and Water
~ontra~tors must
be registered
with the city.
APPLICANT: ~n't.=-r;LlJ')p~hl~ ~,,~..._ PHONE:J-.51-42:~-114lI
ADDRESS: 141Lle.~.....::2.'" ~,,~~~........."'... S'.~DATE: ,/2Of It) I
SIGNATURE: Llln-ll....u n ____ BLDG. PE~IT ';,t()I-()o13
SITE ADORESS:~';,~ 1.:....,,., 1Ll~r.JllLstli'ID# 25-373-002--0
FILL
Estimated lenqth
of water service
"
I
IN THE BLANKS
40'
feet.
1.
2.
3.
Size of water servi~e
inch(es).
Location of any couplings from s~ru~ture
feet.
4. Type of sewer pipe. ABS PVC X Cast Iron
5. Estimated length of sewer line~' feet.
6. Clean out (if required), located at feet from
structure.
---===========~-r
I
Thi~ apPlicatio1
BY
:.==~ii-____~_~_._._.=____ ..
=====;;;;;;;;A;i='=
your permit
wnen approved.
Z-(4 .0 {
D~TE:
~==------~=~=
__~__=====__~_==___~~DE=__________=~.=_~___~==
FEES:
$
$
~
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .sa surcharge.
# Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued. \I'l\"\~ ~.\"t
DATE PAID AMOUNT PAID ~~}~ V€.~
...\ \\V"
RECEIPT # REC'D BY ~
. 4629 Dakota St S.E, Poor tAke. MiM~ota 55372 I Ph. (612) 4474230 I Fax (612) 447-42'1S
-------------^-------_._----
CITY OF PRIOR LAKE Me
16200 Eagle ereekAv. S.E. Permit No. .QJ - () oQ3
Prior Lake, MN 5.5372
TYPE OF STRUCTURE
,
,
Si"gie Family
Commercial
Two-Family
'"dustrial
Date
Fee Schedule
6"~ MN5'5IZ.z..
J
Industria~. Commerdal & Mulli-Fam~y
Residential, Hear.,g & AC
Residantia~ Healing Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1. Pillk
2. GrCl!1l
3. y~u..w
'"'"
City
c.,,,,,,,,,,
,
,
Multi-Family
/,../
,
,
Public
Other
.
c
"
.
>-
,
<
1%'01 job cost 1m. 50 minimum)
$99.50 PLEASE NOTE: ~
$64.50 Air Condi lioner Units Caru1l :
$39_50 Encroach Into Required Side ~
.
$39.5C Yard Setbacks. ::
$39.5C ~
.
"
Remember 10 add the Stale Surcharge on Ihe bottom 01 this application.
TYPE OF SYSTEM
Warm Air Pianls
Gravity Additional inspections wil be biUed al $35.00 each.
Mechanical ~ . House Healing Tesl Record must be submitted with bulldino Ilm!lli! number belore bUIld-
Air Concfltloning .iSr 1.Ia.n-t 2. TIln ing certilicale af occupancy will be issued.
Vent. System 1.-5'Ocn..... bai-l\+'A.hS
!:lEAI CALCULATIONS REOUIRED with number of supply and return openings listed per
HEATING OR POWEE! PLANT room with CFM's per opening. New structures or additions send floor plan with supply
Sleam and retUrn locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
Radiallon CREEK AVE. S.E. PRIOR LAKE, MN 55372.
Special Devices
The price of your ; .~",;.." permil includes one ",ugh-in and one final ",spection.
Supply Openings
Relurn Openings
InpUl10. DDb- Outpul5lJ., bO {j
Edr.
City Hall business hours are B a.m. - 4:30 p.m.
C1m.
~Ob
Other Devices
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447_
~)
__ U
Building Oft'cal's Signature i
.~ ...".- ,
'PL. FA;-! 447- 4248'
TYPE OF 'NORK
Alterallons
~
Replacement .
New Construclion .
Repair
Est. Cost $
Est Comp. Date
Bu'lding Permit ~
01, OOq~
HEATING PERMITFEE$
STATE SURCHARGE $.
TOTAL PERMIT FEES $.
.50
PAID WITH
Receipl # BUILDING I--EP.:,:iT
~
~
~
.
M
c
-
-
~
.
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~
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>
~
"
3)WtJ/
Date
MAR - 8 2001
Date
IE;
c
c
...
FIRESIDE CORNER #5403 P.004(00B
CITY OF PRIOR LAKE Dllte &c'd
HEATING/AIR CONDmONINGIFIREPLACE PERMIT
i: ~ ~::, I PERMIT NO. 1- 03
'J. Y*1I1;1W AppIl<IlJIl -J
~1~ "p!. gr nrim 3nd sim w. boIJDml
ADDRESS
5'1Q'" __~.. n. {!r se-
ZONlNG (._...)
,R-~
LEGAL DE-BClUe uv" (omo; use only)
<
LOT dBLOCK I AI~lJwON I ivy # ci.
PI,D ",:)s'- "3 f3 - Cb~-c)
OWNER
(Name) ~ /I..
A4A.A
(phone)
(AdrlJ:e:ss)
APPLICANT
(Name) ALT. lED l"IRESInE DBA FlR:E51DE COllNER
(phone) _ 651-633-2561
(Add,ress) 2700 N. p.ll.ll'l.vn,,,, AVF<Ilm'
(A<ldrtl',)
aRENDA BUS'rON
(Contlle! Petllon) ~
APPLICANT SIGNAT1JRE 1!5?,..i2 1-1.'.~
1>.:l"''''''Tt.t..E......J!l'''
(City)
651-633-2561
(Phon,e)
DATE __-_-__- ,._
""-" ,
(Zi,p Code)
-.
APPUCANT PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETlJRN V~r.I",,,GS INPUT OUTPUT
TYPE OF S i ;>''''M IiEA TING ORPOWBR PLANT
OW.1m Ait Planls ":J St..",
DOtavity ::J Hot w.rer
o M..hlllli<:1l1 ::J RIIllJotJoo
OA.it Cond[~onin,g J $peciol Dni"".
OVenL System J Other Devices
FIREPLACE MAKE AND MODEL ~.. JJ Cu. & 7.l1mz...
PLEASE NOTE:
Air Conditioner Units
Cilnnot En.croacb i1Ilo
Required Side Yard
Se1bll"ks
Industri.l. Cam",etet.J &. Multi-Family
FEE SCHEDULE
1% of job eo,t R..idcnlllll, 0.., Fi,..",'''''e
S39.50 minimum
$99.50 RcsldentioJ, Additions <It Ai=ion'
$64.50 Rlosldentiel, AC Only
539.50
Resid.ntial, Hollllng & Ale (N.... C<lnstrUr;I.ion)
Residentj"'. HUling Only (New Cansnu"'l.n)
$39.~0
$39.50
Estimated COS! S Building Pe<mil II
flEA TING PERMIT FEE $
STATE SURCHARGE $ .50
TOtAL PlRMIT FEE $
b,. P"II.'D
, ""V/L./jl. ft!,;,
/'Va " 1;,
r'l~> .
'"
",
(om.. 1111< Only)
This ApplicatiolT Bcc:ome, Your Bolldlng Permit When Approved
Bn'Idi"l: omd.r
!lilt
I Paid
I Date C:, ~'7-0 J
Ro:c:eiCl No.
~4 hour nnllce for.1I 'n.poetloo. (952) 447-"l1!O, r.. (9S~) 447-4~45
By ~
U
PRIOR LAKE DEPARTMENT OF
.' BUILDING AND INSPECTION
.
INSPECTION RECORD
SITE ADDRESS ,"")l./t)( t="11.~ 0~
NATURE OF WORK ~ )~-'-' 1
USE OF BUILDING S:; ~A
PERMIT NO. n{-mq~ DATE ISSUED {-3{-?oo{
CONTRACTOR n IL ~~ PHONE (,,<:::;' - 2<::;:;b- 7!3fp
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING N/e.-/ -&r, r>/~ ~ I I
, FOUNDATION (Prior to Backfill) I iff, I 4//7 /0 I ~, ~ ~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ~/~/b)
ROUGH - INS
SEWER { WATER I SEPTIC
FRAMING ~ 0~ f4-. 5/;tf'/a /
INSULATION ~. /?r;r, 17//2 lor
ELECTRICAL .
PLUMBING~u~. ~. L(hcJ/o{ /J..a!<1I501-01
HEATING (if requiredw.~ ~_ t.f/u/ il &
FIREPLACE . . ,
GAS LINE AIR TEST .~ t; F:P,
-
I#r.
~,
&-r, _
~
lol?-'if"!/~/
71d/1);
a _ ia/.-/s--/t;;
6-r. /;/a~/
fol/5'/~ I
.,
~~/
GRADING (Prior to Sodding)
BUILDING T.c.o. tW '1/I';~{
ELECTRICAL i
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/1 ~J 13
It+. 8/;;/ /d I
,
(0"" J,tl-() ~
e?/ ~
Bre
JA/1//)!
. h;)~/CJ/
. .
BEEN SIGNED
This card must be posted near an electrical 5etvicl1'..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
i
I
I
I
I
I
I
~J
ADDRES~ C;l{07
OCCUPANT
HEAT LOSS
SOLD BY
Electrical Work By
TYPE OF HEAT
""0'-"-)'1
HOUSE
(.&/.",--1 <. r
HEATING TEST RECORD
JOB#.
APT. _FLOOR
flWNER
CITY _
SUBURB
DATE HTG. Itft.T. s;(--:J -() I
/'
MAK~ I-{hl(/.. +-
Model "'29'(1' AurjJ '--(O:JO
Se,;ol =J&Ci/A i;:;;T..f;>-g-
INPUT !c(~ ~::X2:)
INSTALLED BY A/I.'...",/ J/Vl../c t..,
';.,s Line By A I (',' ~ . of ),11-;" C 0
GA _ FA"A-HW _STEAM _SPACE HTR. _UNIT HTR. ~OTHER_
GAS DESIGN CONVERSION
.MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE.
Model
,
CONTROLS
THERMOSTAT i I
,; ,
l;.........,
Heot Plug
Vent Size '--(
KIND OF LINER
SIZE
NON~
,
I
)
Va Ive _
Limit
limit SeHing
Fan Setting _ . t-
PilotType_
Pilot Make
Pilot Model _
Pilot Timing
L.W. Cut Off
,1..../"..../
++
,
--
r (
J..-I.-. .
Draft Hood Regula,or i';'\/:<--./ '/
Fi Iters Size J! 'i ),/?R._Number
Chimney Location Insi~" Outside
Chimney Construction 1" ....
Smoke Bomb
Droft .
'-"'-
Wiring. "',.
Test Tog
lighting Inst.
Door Pres sur'"
Pressur.. :.... " \..-V ( Percent CO2 'I
,
Input CFH Percent O2 Cf ()
It Stock Temp. <' <ocr Percent CO /')
Form 235
Oat. Teste...'
Company Testing
Nome of Tester
s;:.-} -0 f
Frederickson Heating & Ale, 3650 Kennebec Dr., Eagon. MN 55122
~ .rl./
I . /
/"
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
/1-,:;.0- d-...
,.;;L/65' - sLlo7 Fdw/f./(!-!-
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
(
SCHEDULED
CONTR.
PERMIT NO. () (- Ci! '1--- q \3
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
.-.--
~ ( ( (fB)
I
J 6Sc_
LJ
I I f-e-
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~Jr~ CALL FOR REINSPECTION BEFORE COVERING
Inspector' rr I/'-)/-OL OWner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE g/.J.-l!O (
INSPECTION NOTICE SCHEDULED IUS-
ADDRESS C:4() 7 ~ ~
OWNER CONTR.
PHONE NO. PERMIT NO. OJ - ~ 5
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATIO~ 0 SEWER HOOKUP
'lIl FINAL fI'D,~ PLUMBING FINAL
o SITE INSPEC ~ MECH FINAL
COMMENTS((J ~~~ ~ ~
(2) ~i.~{) J a v
o EX/GRAD/FILLING
o COMPLAINT
@J 0 FIREPLACE RI
~ FIREPLACE FINAL
o GAS LINE AIR TST
o
i
(
T".CO,
u___~
'1( (~/cJ)
I
W~~~
~~;J
o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Inspector:
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ