HomeMy WebLinkAboutBuilding Permit 01-0299
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4~;VOl
AND UTILITY CONNECTION PERMIT ~ \
APt{ - 2 LuUI M (). ,'IA "" e...-
; ';:i~i:' ~:~y I PERMIT NO. O/",o..,nq I
3_ Yellow Applicant [;,J7 ,
I (
I I Z'fZ7 (officeu,,)
(Please.!VD~ or orint and sign at bottom)
ADDRESS
/7":<6/
</J!:~,R'~ w!7A(/~ S"E"
LEGAL DESCRIPTION (office use only)
;? p.
LOT BLOCK ADDITION
~~ e>?~
PID
OWNER
(Name)
(Address)
BUILDER
(Name)_.-?4'. ~,<,,~ -:~.
(Phone) .
Date Rec'd
:)5.... 37~-Gb4~
----
(Phone)
~57-..;?~-?'/a;;,
PROJECT COST /V ALUE (excluding land) $
d~6z;5"?
Contractor's License No.
b''[,OCO ' CPC)
BA ( . rytj
8t"Jg, I~ I
42. tJ() I
I Park Support Fee
I SAC
I Water Meter SiZ@; I";
1 Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other <i.HU
I TOTAL DUE
#
(Address) ..3~59 ~/V Oil( .y;e- .;;UY/ ~ 6"S7.;?~
I
TYPE OF WORK ~New Construction ODeck OPorch ORe-Roofing ORe-Siding
OLower Level Finish D Fireplace DAddition DAlteration OUtility Connection
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 t"~y';"ni and that all construction will conform to all existing state and local1aws 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.
'-~~
I Permit Fee $
I Plan Check Fee $
I State Surcharge $
I Penalty $
I Plumbing Permit Fee $ I p\6 ro
I Mechanical Permit Fee $, DD I'.)C)
I Sewer & Water Permit Fee $ 35.!57J
I Gas Fireplace Permit Fee $ 4() _ 00
/)
( l/ftlo~ :1s~our Buililing P;~t;~;::7
~~cial Date
f/ U ~
This is .to certify that the request in the above application and .accompanyin? documents is in accordance with the City Zoning Ordinance and may proceed ~s requested. This document I
when Signed by the City Planner constitutes a temporary Certificate of Zonmg comphance and allows constructIOn to commence. Before occupancy, a Certificate of Occupancy must be
i"US:t.-,l~r~t;:~~~ 4Jv:!O\ ~~e~~nyfiWr~~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
o Misc.
x
c:;.'
,.
Signature
R.t.i"'~h\YI
--
Y>&7,,ffCJ5
0..:3 -aCJ-o/
Date
#
$ ~sn.ml
$ '1lsn.m
$ I :;) S- . t'J1}
$ 4S.C1;3 I
$ 'I? (')(') . rol
$ ~ tJO .eX) I
$ ISOfJ.QtJ I
$ 3S.s.---o I
$ 7.377, f6q I
#
#
I PaidiJ"5?7, 'l[<-t
I Date '5 "do ~() I
Receipt No. ~q5 ,~k'
By CJ-"
~
White - Building
Canary . Engineering
Pink - Planning
Thr{"f'ntuof Ih.. L.k..Couolry
BUILDING PERMIT APPLICATION DEPART~NT CHECKLIST
NAME OF APPLICANT n k> No v-I-of-J
APPLICATION RECEIVED LI" ~ - 0 J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is ~roposed at:
/7;).4 / /)~d /kJ) jfJAJ SF
Accepted
Accepted With Corrections Y
Denied ~)n ~
Reviewed BY~V\p.."..,~
Comments:
Date: 1- i ~2lo(
~~ cJ& ~~M
~~(A
v
~
2e)C) L"f- L'lA....Q.
~~ ~~I.'tf\...-?,>
"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."
~~
White - Building
Canary - Engineering
Pink - Planning
Th~ Crnlu of Ihr L.b eo"nl!')'
.BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ;
APPLICATION RECEIVED J
I
r
. - () /
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
, ".'" r-
I ". / / //.. {>I / /j <!-
Accepted
Accepted With Corrections
~
Denied
Reviewed By: UA/l-. /~ ~~--- ,
p- ~
Date:
tj/{'l/D (
zrvrJd ~~y--~ ~ ~~"< ~.~.
_~l),^. [AM{1 VJlJS ~ ~)~)~,
"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."
Th, C,"", of lh, La'" COU"lry
IJq,'n F,'1e..
White - Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ]) 12 J.J 0 v-f-ofJ
APPLICATION RECEIVED LI ,. ;) - 0 J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/?:J--0 I j)~.PMA'tJ CrY JOA.) SE'
(/
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
Nit [3
Date: '1-6-01
Comments: 'See Reverse Side for Additionallnformatinnl
::>ee Attachments: 1) Grading Plan, 2) Erosion Control Measures
::\\ Frn!'\ion r.nntrnl PI::In
.
"The issuance or granting of a permit or approval of plans, specific:ations 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."
€~~
+'NlVESO't"
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
i;':" ~~i~" I PERMIT NO. o/-.;t 9 9 I
_(Please .!We or orint and sign at bottom)
ADDRESS ZONING (office use)
112k1 l)1n--hfJdh .~E. /7 I
LEGAL DESCRIPTION (office use ouly)
LOT Dr BLOCK 2- ADDITION
r J.
tQ_~/) AI(~tJ/~ d-~
""
PID :<5"-37.1- ()!;L{-,?
~':e~R l)~ \-\Ddt/\
(Address) -3~ W~.9~lh~kvt Ave
~~;;~~ANnIJlaJ1f vYlf'LIrlCUl/CaJ
(Address) .~fhD !(fJH1f.beD'l)f ..\til~ \
, r. (Address) .
(Contact Person) ,)P.t1'rt0' (J~
. APPLICANT SIGNATURE ~h f/ 1Jmtn1Y/ntU1
. Iv' U
APPLICANT PLEASE COMPLETE BELOW
[9I<ffiW CONSTRUCTION 0 REPLACEMENT D AL TERA nONS
FURNACEMAKEANDMODEL g,'~f- 38~k.A-VD2J/D1D. FUEL f\l1fu..raJI
FLUE SIZE L-\l\ G\o..Sc;, & RETURN OPENINGS t+ _ INPUT 1D, DnD ounUT 51f1, bbf)
(Phone)
SWtc 1JJJ .~ Ml\J 55/2-1-
(Phone) 1tf5/ 45l-lT}5'
(City) (ZiP Code)
(Phone) ~5 / 451.- 2/76
~DATE '-I/23/D/
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OWann Air Plants
OOravity
o Mechanical .
lE1\ir Conditioning
[i:PfOnt. System
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1 % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & Ale (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
Estimated Cost $ Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(OfficellseOnly)
This Application Becomes Your Building Permit When Approved
I Paid -----
I DateS-_II~ 0,
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
.
13lJ. /)-41 D
. lL./:),tv, WIlt.
G PEr
I, ~. ,
Receipt No.
BYtf
APr. 2. 2001 10:18AM
GENZ RVAN PLUMBING AND HEATING
No. 0 9 II
P. 41/41
L
2.
J.
.~', 4 .
5.
6.
........ -....
Tm.r.GW .. "II'PUC"'"
GOLD . ar"
CITY OF PRIOR lAKE NO/)/- }Jlf
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be rasistered
with the City_
APPLICANT:.r......._l("I~- I2tf.nPh...om\n'~ U>afi-uc=. PHONE;~1-4?-3-'J4L-l
ADDRESS: 14,r.lE> Sr.llr-dAlll2.'f" -r"" r<~V"'r S"!O"Clla DATE: 4/2 It:, I
SIGNATURE: IJ\ .~~ 0_ BLDG. PERMIT #
SITE ADDRESS: fyp~~.QoDLSE:.PIDitJS- -31,;;2. -o.9{-O
FILL IN THE BLANKS
40'
Estimated length of water service
t(
feet.
Size of water service
inch(es).
Location of any couplings from s~ructure
Type ~!'sewer pipe. ABS PVC X Cast Iron
Estimated length of sewer line~' feet.
Clean out (if required), located at feet from
structure.
feet.
=====:;:=----_.====~,-~-==::=.=:====:=:=.~;;;;=:;==----- --
_ _ =======:=;======.:;o;=;;;;;;~
This application beco~es your permit when approved.
BY D~TE:
=~=.==::::======:oo;::::;;;o;;:;;;;;;;=:;;;:======__._" _======:=!____======~=:!:!!!.=:::!!!!=~======~!;:!!!O=~:::::!:=
FEES:
S
$
;;
Sewer and water line connection permit.
Surcharge
TOTAL
35.00
.50
35.50
* Fee for either sewer or water individually is $20.00 plus
S .50 surcharge,
Sewer and water permits issued for new construction must be
recorded on the buildin~ permit card at the time of issuance
to insure that no dUpl~cate sewer and water permits are
issued. PAID WI'-
DATE PAID Ij- Iyj-Ol AMOUNT PAID ..BUILDING p~'r~;v,'-'
Qu
V
*
RECEIPT If
REC'D BY
.. 4629 Dakota 51. 5E, Prior Lake, Minn,,-,ota 55372 I Ph. (612) 447-4230 I fax (612) 447-4245
AN EQUAL OPPORnlNm' EMPLOYER
Apr. 2. 2001 10:16AM
GENZ RVAN PLUMBING AND HEATING
No, 0911
P, 34/41
Co,
llIe e,,"e.... or lhl ~ko: '.11"'".
QuanUty
L
I
,
I
2-
\ I
\ I
I
I
2-- I
,
L BI~
2. Gold
3.. Yr.1Iaw
..,.-
at)>
ApptiClDl
# ()/- (),l-'iy
Phone: I "F--j- ~7~-114~
1Lr-..~ 1tY"'6'cuAT ~
_ -:Jluj
~
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: ~2.-k'tr '" Plh--+ W:n~
Address: \ U-, l V=-... ~ ~b ~ T ~ ~
Signature: IA. J.. ~.
Legal Description: Lot~ q Block?.-. Sub lY..Aie.Qo
Site Address: ','2l '"" 'TX>~....li'\:",Q,,'~ S-E.-
Building Permit II PID # ;) 5' - ::( 7)" -Os. <j- 0
NOTE: This permit ~ill not be processed without complete information.
FIXTURE UNITS
",:.:"
Type otRxture
, Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
(
R-/I
(
Rough-ins
Water Heater
Water Sollner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (APZ, Double ChllCk, PVB)
Backflow Assembly Test
Lawn Sprinkler
other
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
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
$
$
$
$
.50
GRAND TOTAL $
,.
This peJ:T1lJt 15 ~t~ upon [he express condition that sI1d
contractor. shall comply in alll:'l:Sp<<:t5 with the ordinances
of the State Plumbing Code and the am~dments Jh/reot..
RECElPTNO. ~-I'i?-(/; DATE
'A"'- ATTEST
U
Call for all inspe~tions 24 hours in advance.
8" PAID ""
, u/LDIN vVlli'
G Pc:,
"""
16200 Eagle Creek Av. S.E., Prior Lake. Minnesota 55372 / Ph. (612) 447-4230 I FAX (612) 447-4245
An Equal Opportumty Emplcyer
PRIOR LAKE DEPARTMENT OF
. BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 19~ (,,1 'Ueorh'elJ [')J-.
NATURE OF WORK A.J.Q.,W
USE OF BUILDING SFB .
PERMIT NO. OI-OZ!l3.. DATE ISSUED ,/-,-?r->(
CONTRACTOR J.1V. . ~ PHONE e:,S-/- 2S/. - !.l;,r?
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
lNSPIll:J"OR DATE
I FOOTING I (~ I S--17-0~) I
I FOUNDATION (Prior to Backfillr~ I (a, Lf/{;,!)/ OJ ,';'fJl\tJ%OJ1) I 1:J7. ~~~I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN' SIGNED I .
ROUGH - INS 1iP..e- f$.r. 51'~4o,
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING ~<k, ~ ~/~/D/
HEATING (if required~~. ~. '5'1'3oJ~
JM'K:ft:ACE " -/j, ,
, GAS LINE AIR TEST"f;f. (:. ~, tbr, /ol/z/tJ.'
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
,
I A/wbfJ~ ~. IrJ!/~tf7 I I
, FINALS
0-k
/0/1'2-1,,/
10"/ [l/bl
tb . /~I/ le)/
""'-.M-""4' ~ -:;,.. r./II /d'
GRADING (Prior to Sodding)
BUILDING'CU. rJj~' I!bl,- frr 1411 /6(
ELECTRICAL
PLUMBING
HEATING
I
DO NOT OCCUpy UNTIL ABOVE HAS
N.QTICE
k.~
, ,
J'/f9/01
I,!;-J IV/o!
,
BEEN SIGNED
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
j
I
'-
ADDRESS 172C; \
OCCUPANT _
HEAT LOSS_
SOLD BY
Electrical Work By
TYPE OF HEA T
~"~r(,<lJ
DA TE HTG. lNST.
JOB #
HOUSE HEATING TEST RECORD
{) r\v<L-
APT. _ FLOOR
OWNEP
CITY
~UBURB
INSTALLED BY
Go s Line By
GA _ FA ~HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
~ GAS DESIGN
MAKF l""y..._T-
Model 37"'J....AVO)I.C)7<:> A-\3.A
Serial ~b't:)IA.<c.\"l...79
INPUT _ 69 t>o<:, <<Tv
CONTROLS
THERMOSTAT ~,_e-,,,,-,,,"\\ Heat Plug
Valve
Limit
Limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Model _
;l.;:>.<:;,"
\-\.<, J>...
Pilot Timing
L.W. Cut Off
'.),:$
Percent CO2
Percent O2
Percent CO
Pressur...
Input CFH
Stack Temp. 3-.7 8'" ~
Form 235
~.,-\
(...9
- 0-
CONVERSION
MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE
Model
Vent Sizl"'
L-j" {l- V c.-~
KIND OF LINER
SIZE
_ NONE
Draft Hood
Filters
RegulaTor
Size \l..,c. ~ ~, Numb.r
\
Chimney Location
Chimney Construction
Inside
Outside
Smoke Bomb
Draft
Door Pressure
~Wirinr'
Test Tar'
lighting Inst.
Dot. Tested _ \'J.-S-tl)
Company Testing Alliant Mechanical, 3650 Kennebec Dr., Eagan, MN 55122
Name of Tester )(.<.~\."""""--
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
4-1<'-03 lI:l5"O~
ADDRESS /72f#/- /72.{p7 .DeFff/6LO O.e.
SCHEDULED
OWNER
CONTR.
PHONE NO.
PERMIT NO. (J/~tJ1-qq. 300,30 1.30z..
- . f
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING Rl
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~//l/rJ L- GtV1D~
I
b "e..tU. I c9 k..
L,,/b Kd.!tl,
(.9J(
,
XWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTlON BEFORE COVERING
Inspector:.t?1~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOT1
ADDRESS
17..2-~(
DATE TIME
SCHEDULED ~ 9:/S
I)~
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Or -~"t9
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
@D WATER HOOKUP
o SEWER HOOKUP
'p!f PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
C~MME,NTSffJ. n~~, f:..> r " '>-- 'ff"-!"T ..f.r-c; ~
.~'.-' p,...-. ;) ~h'-dCAJJ!J
fD rl.o~~ '~ (',~ .
~/f'
\A~ fllAAt)
-~
.4-P~
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
:s::~:'EC~~L FOR RElNS~::::::::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIMt..
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
17.)(P/
SCHEDULED /~ 10: 'f;,
I~.IJ !t..,
CONTR.
OWNER
PHONE NO.
PERMIT NO.
~(- d5J?
o FOOTING 0 PLUMBING Rl
o FOUNDATION 0 MECH Rl
o FRAMING ~ 0 WATER HOOKUP
o INSULATION l1:/ 0 SEWER HOOKUP
1ll FINAL /10) ~MBlNG FINAL
o SITE INSPECTION '--J:5/ 'f5J MECH FINAL
COMMENTS:dJ? ~"1~ ~~ (])-- ""M..12,.,
Cz.~ ~ s.. ~ J.y~~{J~----
_ ~ V-------r'
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GAS LINE AIR TST
o
r
-r:c..o, ~
oj riot....---
~~,
o WORK SATISFACTORY, PROCEED
~CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTlON BEFORE COVERING
~
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH of SAFETY!
IN$/'iOTJ