HomeMy WebLinkAboutBuilding Permit 01-0174
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
14. OWNER (Nama) ~ _ (~dres.) I""l __ (Tal. No.) "\
M \ 1\ E;L.~"'/'A.EoT \VVO~ s: ~ 'hU4. c "M 0 f'.I
5. ARCHITE\t(CT "';;)(~m;' C;;; ~ ~ l'>.. (!-'~ r E 1% l(Tal. No.)
6. BUILDER - (Nama) I.v~dres~JG (Tal. No.) 15. NUMBER OF OCCUPANTS OR SEATS
7. TYPE OF WORK FlraplacaO Sattl(; !-fer: Re~~n:~ S::-~I~l \ :::ANTS
New Construction a Alterations CJ Addition a Finish Attic (] Re-sidlng CJ FInish Baseme 16. P~JE~T COSTNALUE
Chimney 0 Misc. - .;::;. -l.J ~
Ie. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CUI.VERT SIZE 17. C~PY':TION 7ATE
Sq. Ft. Width Depth Yes No ~ / 15/ "Z-co \
cert that I va furnished In:_.......__.. on this application which Is to the best of my knowledge true and correct. I also certify that I\m the o~or authortzed agent for
va nstructlon will conform to all existing state and local laws and will proceed In accordance with submitted p s. I ~fware that the
thi \ rmit for just cause. Furthermore, I hereby agree that the ~oq=ier~es,gnee may enter upon the property O~ r~73~.;nsl
Signature license No. --, lSate -
I2ATI= ;:n=r:c\YEQ.
3-;5"-0/
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
8EFO~E PERMIT IS ISSUeD (Please Print or TY.E.8 and sign a.t bon~
2.slTEtsElss~ 1 W~ ~c K \!<Ale..
1.0) lJ Dr:)
3. LEGAL DESCRIPTI.9I"r1
LOT ~'I
WI L..9S
BLOCK ->
S-!.:
ADDmON
.,
1. White
2._
3. Yellow
File
City
Applicant
Permit No. D (- 0 1/4-
1. DATE
oS .,~ .. 0 I
NIf.J
BUILDING INFORMAll0N
11. SIZE OF STRUC1\JRE
(Hoiglt) (Width) lDooth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~,....,...Q5)
Front
Sad<
S"",
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I Ii III IV V
OccupancyGroup A B E F HIM R
Division 1 2 3 4
Permit Fee ..................,................ $
S U
City:
,c.L7C;-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $:
Plumbing Permit Fee ....................... $
I.r;o
40. 00
Mechanical Permit Fee ..................... $
i:~~;~~t
Cartlflcate of Oocu~cy
Issued
Side
MATERIAL FILED WlTII APPLlCAll0N
SOIL TESTS 0 ENERGY DATA 0
PiliNG LOGS 0 PERCOLATION TESTS 0
PlANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
AmountBroughtFOIward .................. $
ParkSupportFee ........................... $
SAC ......................................... $
Collective Street Fee .............n........ $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ....... ..................... ....... $
Water Meter .....n.......................... $
SeWBr& Water Connection Fee ........... $
WaterTowerFee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... ~
Total Due ................n............ $
Paid /..SZ:,. z..-r;- Recalpt
Date 3"/~-()1 By
15L...Z5
(jtJes-
This is to certify that the request In the above application and accompanying documents Is in accordance with the City Zoning Ordinance and may
signed by the City Planner oonstttutes a temporary CertifIcate of Zoning corJ1)liance and allows construction to commence. Before occupancy. a Ce
CilyPlanner
Date
24 hour notice for all inspections (952) 447-9850
Special Conditions" any
requested. This document 'Ntlen
of Occupancy must be Issued.
1.-
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CITY OF PRIOR LAKE Me
16200 Eagle Cr8ek Av. S.E. PllllI1il No. Of - 0 174-
Prior lake, MN 55312
HEATING APPLICATION' PERMIT
Da...-3J.,:J.3!.w PlU. 25 ~ ~7 - ~37 - ()
SiteAddr.': J5},f1 /~{),)Mri ~
lol 37 Block I Addllion We- Wll.,OS 3teO
Owner" Nanle !hrllk. 'Y/LUU ~s.
~ OF STRUCTURE
'"
-
-
'"
a
a
T1IO-FamlIJ
Indusbial
MLftl.ftImiI1
P\DIo Other
Single Family
Commen:iPl
....
-
'"
'"
'"
....
Fee Schedule
Induslrlal. Commeldal &. Mufti-Familr
Rosidenllal, HlIllling &. M;
Residential. HeaUng Onl,
Residenllal, Glm F"nplace
ResidenllBl. Additions" AltetalJons
F\esIdential, AC Only
I'll. ...1 job ~I ($3UO mInbun)
'99.50
$64.50
$39.50
139.50
139.50 .
'"
w
w
ro
ro
ro
-
MdrellS
Healing Conl1ada' ALL IED FIRl!SlD"E dba l'IllESIDl! COll1lER
~llS 2700 N. FAIRVIEW. ROSRVILLR. KH 55113
Tet8llh""o' -..!51-633-2561
FtllBPLACE JJ...
IMntfIl Make "Model ~ JJ C, Co
Model SiD{ fA ~/;
Reme.......' 10 add \he Stale Surcharge on Ihe bottom of IhIs IIpfIIcaDon.
....
H
The price 0I)'OW '-UIg pemil inc:flIdes one l1MIgh-in and one llnlII Npeclion. 1::
'"
H
Addilional1nspeo:lions wi! be biDed al $35.00 ead1. t1
'"
HIIIJS8 Healing Test Recard musl be !IIIlHmhd wIIh buiIrIna gmd IllIIIIIIm: be!ole bulg
lng cerIiIic,,1e olllCCl4>8l1CY will be issIIed. ~
'"
I:If& CALCUlATl~ REQUIRED wih number of .~ IJI1d nlum openings Is"'" '"
room with CFM's per . .. " c,. N"" slIuclures or .~ und-llaor plan .....1IJIlIlIr
and return IocaIiuns shown. HEAr WSS CALCUUlTIONS, Pl\YMEHT AND
APPUCATIONSMAYBEMAIlEOlOTHECfTYOF.......lAKE.Ie200EAGlE
CREEK AVE. Sol:. PRlOA lAKE. MN 55372.
CRy Hall businese hours are B e.m. - 4:30 p.1I\.
,
All WORK MUST BE INSPECTED (ROUGH-lN AHD RNAl) . CAll C(JY HALL
441-4~O
I herebyappl, IOf a .. . .: ....nloal syslems pennlt and I acknowledge Ihat lhe :;
inf<mnation above Is complele ami accurale; 1I11111ho work will be In confonneR!:;
willi 1110 ordinanoe. and codes 01 \he oily and with"'" slalo bulldhlglnlrll:hllnlt'"
codel; lhallhis lorm does not becomv e pennlt unlll signed b, the BUllDtN:"
OFFICIAl; lhatlhll wo,k wll be In eccordan<:e wilh lha appTowd plan In thl;;
'~:~"_"''''-''P~ j
$. 2./iJ . 0 /
0&Ia
TYPE OF SYSTEM
Warm /VI PlanIs
GnwiIy
Mrldllmlcal
Nl CandMbn/ng
Ven\. Syllem .
HEA-nNG OR POWER PLANT
Sleam
Hal Wall.
R"d'llIIton
SpecieI Devlcet
Com. Load
Fuei~
Sul'PlY OpenIngs
Rolmn 0pelWrgs
Flue SI18
OUlput~ cJ:>;)
Input
Edl.
0111o, Dlvilm
C1lfL
lYPE OF WORK
k
N"" Con",udon
Repla<:ament
AlIBrallons
Est Comp. Dalo '1/ -#D I
Building PlllmU 6 /; 0/74-
PAID WITH
BUlLDlNG pERMrr
RepII/1
EsL Cosl $
JlOQoo
HEAlING PERMIT FEE $
.50
STATESURCHARGE $
TOTALPERMITFEES $
~.
I
PRIOR LAKE .. DEPARTMENT OF
, BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS /C;/~/ WOOD f)(JCJ:::... IK- N vV
NATURE OF WORK LOWFK!.. L.6V6L-
USE OF BUILDING Je.6S 1'0/' ~
PERMIT NO. ()/- Q 174- DATE ISSUED 3-/5 -0/
CONTRACTOR /"11 r r I'-L.....,rn~ PHONE C951- SSZ.~/7{ J"'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
,..... I I
, I I J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
4!4\cll
FRAMING 'R,\t-/L<hj
. INSULATION {)lL ~\l'
ELECTRICAL r:l . \' 4 J\ .'t
PLUMBING J;\-\lBi" v
HEATING (if required) 1') -\' l A 4-,bl'
FIREPLACE .g,_~..4 \1:-\bIJ
GAS LINE AIR TEST ~ ~~ "f j~ () r
COVER NO WORK UNTIL ABOVE H~S BEEN SlnN[ED
I I
FINALS
~\\~
~~\r~
IZ t\ 11 >oJ .
OCCUPY UNTIL ABOVE RAS
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 shall be placed near main entrance.
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
7 }""Jflf
I ~ .
li~ Jpr
~}("~Jfl f
BEEN .1SIGNED
Call between 8:00 and 9-:00 A.M. for all Inspections
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED? --5-0 I LJ xJ 0
ADDRESS 151 $B r &J~c>d l)t.L.d-
PHONE NO.
CONTR.
PERMIT NO. eN - 0174-
OWNER
o FOOTING
o FOUNDATION
o FRAMING
!'L.-S-INSULA TION
TI ~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~EWER HOOKUP
LUMBING FINAL
MECH FINAL
COMMENTS: ~&- Level
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
~IREPLACE FINAL
o GASLINE AIR TST
o
:t'
/'
~ WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORR"X\CALL FOR REINSPECTION BEFORE COVERING
Inspector. \~ )a)JfJL Owner/Conlr.
CALL "7.8880 FOR THJ NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
Y<3NOTJ