HomeMy WebLinkAboutBuilding Permit 04-0757
O~ PIlIO",
'" >t'
.. ~
~ :0:
U '"
+J'JyNESO't'"
(Please ~ or mot and si2ll at bottom)
ADDRESS
4fJ7Cr.
&ul'~
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File ~:;y
3 Yellow Applicant
I/$I' ~1!7'S
;RAr~
LOTH BLOCK I
LEGAL DESCRIPTION (office use only)
....,...
ADDITION /IMJU.R
OWNER
(Name)
/JUL.iE fI~M~S
gK;' .vClllH M/Es-r PAU IJ rAY
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
~/M4E
C.VIl.T I5L A5iH~o
Date Rec' d
~/dS1J~
I PERMITNO.O+: 07571
,
ZONING (office use)
f)tl/)
C.11fJ7'
(J/fllk. _
PID~5-tltlOl-- -()t.fCj-()
(Phone)
tb'/ - 4('2- ,-zre
/If~ S-.r-/2/
S~7'E /-ItJ
td&..(1J/
(Phone)
(Phone) "'12- ZZ!- -Ifer
TYPE OF WORK. Qi(New Construction DDeck DPorch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc.
CODE: OJ.R.C. OJ.B.C.
Type of Construction:
Occupancy Group: A B
Division:
J
E
II
F
J
illlVVA
H J M R
2 3 4 5
9t.~ ~O
B
S U
PROJECT COST IV ALUE $
(excluding land)
I ht.'reby 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 constru .on will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
;c~07:.e~il ~u" hermo". I h",by '",eo that the ci~ oij';': d"~i ;7" upon the property to perform n; 7;;7 tJ1
17" Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
'9h,l)OtJ,{)(J I
$ 'In z. 7. so I
$ tlIo7.?K I
$ 'Id',OlJ I
$ I
$ ItXJ. C)D I
$ loa. OC I
$ 3 s. $"'0 I
$ t{o. tJo I
This Application Becomes Your Building Pennit When Approved
--3e{~, ~. ~I-'
Building Otlicial
7(ah,if
oat;! -
I Park Support Fee
I SAC
I WaterMeter(S:e5~1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE $ G; S'~. 6fJ
b 6 - h,5, f X I Receipt No. q/} 1./,:) SC
Q _' By r- .
o 2-
#
$
#
$/35"0,(JO
#
$ Z-SO.DO
$ y::;. ClC)
$ 12.Cd DO
$ 70C,Ot!)
$
$
#
-
Paid
Date
ThiS is to certify that the request in the above application and accompanying documents is in accordance with the Ciry Zoning Ordinance and may proceed as requl.'Stcd. This document
;s~PZ;;C;' tem~orycertific"eof;hc;~CC;d'lIowsconsttuCliontoS"eefOMaiirFilemustbe
Planning Director Date Special. Conditions. if any
24 hour notice for all inspections (952) 447M9850, fax (952) 447M4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
See Main File
~t.. - ~i1ding"')
\,;anary -1!:nglneerlng
Pink - Planning
Th~ ("..nlt'r of Ihr L.b ('ounlry
NAME OF APPLICANT
BUILDING PERMIT APPLICATION D~TMENT CHECKLIST
9~~
I iI-- a5~ Lf
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction aC7J~ 1i~ ~ prZ;;~:li ~ ~
I .. ~v'i)
Accepted
v
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."
~~
See Main File
White . Building
Canary - r;:nqineering
~l<_ . t'lannlnlt>
l'
Th~ ("..nln of lht l..kf ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLlSI
NAME 9F APPLICANT
APPLICATION RECEIVED
Ai iJo /Jlj?:\
!;J -) 5 --0 LI
.
._ The Byilding, Engineering, and Planning Departments have reviewed the building permit
." Il:PPlication for construction activity which is Pfo~o~ed at:
(If( /) &, - O~J-i, A) lit} oJ .
, ' ( '(
I
.
Accepted
DeRi~d
/
Accepted With Corrections
!
,
Revi~wed By:
~
r
-;;e ~~
Date: ?p/dSl'
.
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
White - Buildins
t:' CanarY - l::naineer'iRD
Pink~lanning
Thlf ('..nl"f of Ihr I..kll' ('O""lry
BUILDING PERMIT APPLICATION D~RTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
)-' , '
I, -"G J /"kl1 ~
/..u..K-...{)... r-:; (j I lLJ,/(\
/ --''''''Olf
('.f!~ /;J ::' ~ /
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activi~ which is pro'p'p'~ed at: r (!
llr1&- O&.Lt(~ llt/) ~
Accepted
Denied
x
Accepted With' Corrections
Reviewed By:
Comments:
/YYJ8
.sa /1le-I"'" Fr l<..
Date:
7-/7-0<"(
"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."
c4-2004 TUE 10:05 AM VALLEY PLUMBING JORDAN
FAX NO, 9524922617
p, 01/01
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Plea.!C! tvDe or DrinC and siRII at bottom)
. '7ri 6k.U-+JO 'l~rd^ ,~
LEGAL DESCRlPTION (office IlSC only)
LOT BLOCK
ADDITION
OWNER -D f\ t
(Name) Ifl \ .11. _ 0
(Address)
~~;~~ANT\J CUI 0 0 1 P i \ t ~i Y\
(Mdress) 5<lrn n toJc 0 ^ ~
(Address)
(Contact Person) .s:.4ho Y\ 1 0ruYl \ f 1 \ 1\ 1\ 0
~u ,
APPLICANT SIGNATURE (' JI [/l ~IJU-^
:~: ~~ I PERMIT NO. / /~Hrr-rrJ
~. Y~IIQW Appllunl ~' . /0 - 1
ZONING (olli,.",,)
PID
(phone)
(phone) Q ~rl- L4q ;:)- ~ \ ~ \
jJM n (111 ~C::;3 S ~
o (City) (Zip Code)
(phone) Q~ - L\Q ~- r').dOq
nATF - ~~
--~~-
APPLICANT PLEASE COMPLETE BELOW
'1 Quantity Type of Fixture quantity
I d- Bath Tub with or without shower ~
I ( Dishwasher
I 1 floor Drain
I ~<, Lavatory (Bathroom Sink) I
I I I Laundry Tray (lor 2 compartment sink __3
I I Shower Stall
I \ I Sinks
I I Bar Sink
I ... I Water Closet (Toilet)
FEE SCHEDULE
Industrial. Commercial & Mul\i-f3mily 1% of job cost with a S39.S0 minimum
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Om"U.e Only)
This Application Becomes Your Building Permit When Approved
Building Orocill
Date.
Type or Fixture
Rough-ins
Water Heater
Water Softner
Stand Pille (WashinR Machine)
Sewa~e EieCtor -
Backflow' Assembly
Backflow Assembly Test
Lawn Sorinkler
I Other
Residential. New One &. TwOrPamily $99.50
Residential. Additions IIr. Alrera,ions $39,50
.50
~At" n."""'.,
~H'U)'~l!'I,IJ,_Ul'l '~
"'\:II "...,~-""
~- ,~J~VI~ ~
- ..-.j
o ~i~ ~ U \!Ilf "I Receipt No.
n. ~'6G 0 2 2004 .;:; By
14 bour ootle. for .11 in.pe<tioo. (951) 4' -9850. rn (951) 447-4145
16200 Engle Creek Ave., S.E., Prior ... . ~
JuJ 20 04 00:24a
METRO GEM
ERAl SERVICES
763-420-2960
p.4
GRU. . ,IU.
fEllOW. A'PlICAIIT
GOLD .. CITY
Sewer and Water
contractors must
be registered
with the city.
APPLICANT:J]ttfktJ _ fk1lJvjf: Sf'YV6oNE:ljiI3.il'lX'}{rf(;~,
ADDRESS: F;r;4') (J/1AJ1f. JliH~ 11F DATE:
f j 'r'I. -
SIGNATURE: i'Ullh tJ),"l(./;f:/. BLDG. PERMIT f
SITE ADDRESS: -~1{1 8./JJiC /k/fJ/7f-'\ ~#
.FILL..,IN THE BLANKS.
1. Estimated length of water service /5{) feet.
2. Size of water service III inch(es).
CITY OF PRIOR LAKE
SEWER' AND WATER. PJ:RMIT
FAy.. ~S~ 'I,/7-1/"l/r NOTE:
S.W. NO.1J!/..OSJ
"-....
3. Location of any couplings from structure {'j feet.
. "
4. Type of sewer pipe. ABS pvc 4 Cast Iron
r'
5. Estimated length of sewer line ~)(J feet.
6. Clean out (if required), located at feet from
structure. /J.l"
===============~=====~====~============~===c==========~==========
.
I
This application becomes your permit when approved.
,
BY
DATE:
,-;;:.,";. '''.::ri.-;
======~=~;j~=~~~===~=~===========~=============~===========
FEES: aid" p.,,~t>< >1- " Sewer and water line connection permit.
" , ,Surcharge
NtJ re~ . TO'rAL
*
Fee for either sewer or. water individually is $20.00 plus
$.50 surdh~rge.
SeWer and water pe.rudts.issue.dfor new construction must be
recorded on the . ~ permit card at the time of issuance
~o ins . fi~ cate, sewer and water permits are
lssued U
,
AMOUNT. PAID 1-;:>'1':1>
REC t 0 BY !~'lt:j'i.Daiid:.l!..1J
."~"'JtJI'
-... ~ L
*
;
': :~)
". r. ,,'
. '.':
.;'<;[f:"-""DATE ipl\.:t'p
"~~});~~:~P.~.' ,.' . . :;:~;.' 1,,"
C{2,Y/~;\: RECEIpt' #
\I \I 2 9 2004
BY~'
'.,,- .'. ~ .'
':,.>1~?!ii~F':f;'::, ". .',
"':;';'(,;:16200Eagl~:Creek Av. S.B., Prior Lake;:Minnesota 55372/ Ph. (",2) 441-4230 / FAX (9512) 447-4245
. AnEqi1a1 Opponunity Bmployer
;S52 aS4 0925
# 2/ 9
Date Rec'd
CITY OF PRIOR LAKE.
HEA TING/AIR CONDITIONINGIFIREPLACE PERMIT
I. Pink
2. Green
:J. Yellow
F!~..... I PERMIT NOo,. .If'/!:JII
I ZONING(o/li<eu..)
q"Jease lVIM! or crint and sim at bottom)
ADDRESS
Lj xlto hi (j (?-'
/-J-k'JT((:u "~t
LEGAL DESCRIPTION (ollice use only)
LOT
BLOCK
ADDITION
PID
HA (;'k f/()()'V.LJ
(Address) '8["') UJrfh/,L,'(c;I lh.J;)u,(.X:U /
. ' ~
OWNER
(Name)
(phone) {O\-/ - f./.SZ62{)tJ
U 0Ct/J d7/7 55/2/
(phone) q"),..) -gqc.../-(Xns
iJ/l./o
APPLICANT
(Name)
(Address)
3;.;;~.:;.-r1.....: ICiO~;II~ ~ ~'~I LL.(:,
12481 Rhode Island Ave. So.
vQ\'a~~.lvr(X~O.IILL.
(Zip Code)
(City)
(Contact Person)
(phone)
J11\..~LlIYL/)O/7
/;J. ;;;';;;J.()c/
./
APPLICANT SIGNATURE (')' /}rJ '
DATE
APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACEMAKEANDMODEL /iJJIJIOY r;.'-I:2,I/I-I;}<"{,~()~/<;- FUEL tlCi....fc.(k.L! j
FLUESJZE RETURNOPENINGS II-of'f-cfS INPUT i./-(J~f 'ii OUTPUT 'tIH(x')
TYPE OF SYSTEM HEATING OR POWER PLANT
OW8r!!1 Air Plants o Steam .
OGravily . 0 Hot Water
bl Mechanical 0 Radjation .
~r Conditioning 0 Special Devices
OVcn!. System 0 Other Devices
1'I,.1i:A!!Ji:N9TE:
Air c::p!'ditip'!llI'(J!'its
C::!IJ1DQtJ?'!8'ollch' bito
Requh-edSideYard .
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial <It Multi-Family
FEE SCHEDULE
1% of job cost . Residential,OasFireplace
$39.50 minimum .'.
$99.50 Residential, Additions <It Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Residential, Heating & AlC (New Construction)
Residential. Heating Only (New Construction)
Estimated Cost $
Building Pennit #
,~~
.","
HPATING PEltMIT
~rATEStJR.c
TOTALPE .
..,-.::-'",.:,.,,:::;.
:~:. " ',';'.' .::'.
.......:..:;..,.;.;-;
.'.TIii. ApPU..tlon B~,,#i~Your~iiildlng~eruljtW#~~~iipfO*#cI< ')~~~~~I~~I~~~;C~j;!~;~2~?'\
i iriate- c' '. . :; iB)' . .... '. . '.
nate ' . Ii; :i'.<:.,:'
il' .,.. .... ......,
14 hour~;t~~;~;m~7~~~f(~TIi:r..ul
",.'0"
Building Orn.ial
-
I
I
Ii'
I
I
I1,i':;
i
'i~:
;1
d
:;<;
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS l/.f -; ~ 11' JI':-~ H61SItTS !y';"
NATURE OF WORK .Mil", ~AJsrAlu.cr I~
USE OF BUILDING ,..~ A I ._
PERMIT NO. .-fl4-,0'757 DATE ISSUED ..2h.VtJl/
CONTRACTOR RVLrl" Ntllfl'n PHONE ~/,2 - ~S
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF See Main Fil,
BUILDING AND INSPECTION
INSPECTOR D~E , .
I FOOTING I ~ I W!J'/oY
I FOUNDATION (Prior to Backfill) ..I'"'J...,..!/ ~f~ ~ I o~~jY
PLACE NO CONCRETE: UNTIL ABOVE HAS BEEN SIGNED
ROUGH. INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING (j, d //4' ?~
HEATING (If required)
FIREPLACE _
GAS LINE AIR TESrJf'-"'h.J '7f/ rJf~,r ~ Jk/~~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
//J/vt? ;
I1U
j
I~(~
</IY Ip,~
1M?'
;/1 ;f/O
l~/t.- ttr
j,-ft-CfS:
,
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
~
H'?:Y
OCCUpy UNTIL ABOVE HAS
NOTICE
-J{efP ~:'h h7e..
#F jft//qs-
J/lojf:6" /
~/,7-JI<ar
.Yr/as-
BEEN SIGNED
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until ail inspectiDns have been approved. On buildings and additions
where no service cabinet Is available, card shail be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
Qtedifitab of @nupant\!
CITY OF PRIOR LAKE
~rparfttttnf of ~ui1~ing Jnsptdion
~inal Permitted 0 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 was in compliance with the various ordinances of the City of Prior
Lake regulating building construction or use. For the following:
Occupancy 1)rpe
R3
Type Construction
VN
Fire Zone
Bldg. Permit No
N/A
01-.6757
PUD
Use Classification
SINGLE FAMILY
Zoning District
Legal Description
L49. Bl, TIMBER CREST PARK
Owner of Buildinr
Contractor's Name & Address PUL TE HOMES,.!} 15
--/
_ ROBERT D. HUTCHINS~
Date: 0~ng?cial
Site Address
4876 BLUFF HEIGHTS TRAIL SE
PKWY., SUITE 140. EAGAN 55121
DON RYE
NORTHWEST
City Plann~"
Date:
ADDRESS
_1"f7~
DATE nIlE
SCHEDULED ,~k~
aj)fi #- p:/
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
U - ?s/7
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.,...er1'INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
--;'/ ,. I ~ / /
r:/ -e ern M ///1,.,/ rY/'J"'1.e
/
J//o~r
~q/
~ ./
/7/(.
~.
~
//~' '!
\ ~/SS'C ~~ ~/
'--=-- ---------
XWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT wom; ~LYOR REINSPECTION BEFORE COVERING
Inspector. ~ Owner/Contr.
CALL 447.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
...,.""
D(JR~","\~.LLE
Heating & Air Conditioning, L.L.C.
12481 Rhode l,land Ave S. StlWlge, MN 55378' 95~-894-0005
0l's1at Test Report for JobI {J17 3
Address 487(P l3/..ut=t= !lO(,lfl S 1i.?A IL- _ Citv 7R'O~ LAI'cO
Occupant
'DiI1eof Ins1aIl 1-ILl-O~
TypeQfHT. F1A t/ HW
Othel'
8p!Ice HT
UnitHT
Make Lt..NNO'?
Model c.~3u." - 24&- 04C; - 01
Serial 5"'10 /.f~ /5"12"'2...
Input '-11/. ODD 6T\A ~
PUotType
Pressure
Input CFH
S1lIcI<Temp
HOT SURFACE IGNITOR
~.-.; /we CO2 10.9.
44 02 q q
'1 S- CO 1<0 p:pW'\
.
Date Tested 1., - IS. 0<;; .
> Company .
Technician
L
BURNSVILLE HEATING & AIR CONDITIONING
\.-eo
\,