HomeMy WebLinkAboutBuilding Permit 01-0301
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
4- ' z.,-O I
I. While
2 Pink
3. Yellow
File
City
Applicant
PERMIT NO. 01-0301
(Please tyP~ or Drint and sign at bottom)
ADDRESS /
/7.??66- ~~CJ ~/~.se:
ZONING (office use)
R -I
LEGAL DESCRIPTION (office use only)
// ,<
LOT BLOCK ADDITION ~~ -<'~
PID ~ , - :31:2 - 051.:.-6
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Name) 0.P. ~.....~/l/ ~
(Phone)
.6''57 -,,;rSlf;' 7/&
(Address) d.y# ~~ ~ ~~o-y
~- U!J'" -'\/
$67':<;2.
TYPE OF WORK ~New Construction ODeck
OLower Level Finish 0 Fireplace
OPorch
ORe.Roofing
ORe.Siding
OAddition
OAlteration
OUtility Connection
cff3:9t::JS-
-'
o Mise.
PROJECT COST /V 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. r also certify that I aqJ. 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.
,>u"'~~
L2...
P'
=<~$S7
~..:?d-O/
x
Signature
Contractor's License No.
Date
8' tf, cx:::t::J. CJ 0
Permit Fee $ ~ I Park Support Fee # $ eso.Oc>
Plan Check Fee $ c;'J\ . I <J I SAC # $ I.I~.OO
State Surcharge $ 4-? .(!)O I I Water Meter Siz~; I". $ I ~S'.CCl
,
Penalty $ I I Pressure Reducer $ 4<;. eJ,""J_
Plumbing Permit Fee $ LCV.o~1 I Sewer/Water Connection Fee # $ 1.200.00
I Mechanical Permit Fee $ 100 . ()O I I Water Tower Fee # $ 7a-J . dO I
I Sewer & Water Permit Fee $ 3S. ~-o I I Builder's Deposit $- 0 - I
I Gas Fireplace Permit Fee $ 40.w I I Other S",-!,.,) t:Q, rw..p $ 3S'.~ I
~jC-~'~f:~i:(" I TOTAL DUE $ ~ 817. 89 I
Paid 5 gr;'/. '6'1 Receip!.No3'1,) ~
Buildin fficial Date Date C;~ ;:J -iJ i By tr .7
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when si ned by the Ci Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be
issu
Ll/V2..1 /9'(
~~I~s~~L~vJ;((
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
~~
~.,."...:';;;
White - Building
Canary - Engineering
Pink - Planning
Th~ C..nl..r of thO' L.k.. Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~iJ '! I i U j + 0 I,)
APPLICATION RECEIVED </ ~ ;J. - () / .
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
...:; ~ c. .f- I ..- frJ 1\ i/
/1.2 LS I 1". ,_ ) ~ 5 f:::
Accepted
Accepted With Corrections
t/
Denied
~/
Reviewed By: / -#- . Date: t,f /f{/ 6 (
Comments:
~ ,~. ~(p- L~\h _4~~ ~
---L72h1 vl:\ee:A~ ~rN': ~ 6-vJt'r~<
"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."
..:::~---
-t::
White - Building
Canary - Engineering
Pink - Planning
Th~ C~nl~r of Ih~ L.Il~ Country
mllI.DING PERMIT APPLICATION DE:PARTMENT CH~CKLlSI
NAME OF APPLICANT
1Jp
- '-
q-Jot-+o;J
l./- :;;/--c?-/I
.
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the builc;ling permit
application for construction activity which is proposed at:
/ '7 ~~5 np~~Y (',' ~ tel /) V . 51::::
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
Comments:
N/I-.B
f,~e melt'" t=,'k
Date: ~-06-o I
"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."
6~~
White - Building
Canary . Engineering
Pink - Planning
Thr(:..nluof Ih.. LabCounlry
BUILDING PERMIT APPLICATION DEeARTMENT CHECKLIST
NAME OF APPLICANT 1) It iJor+o0
APPLICATION RECEIVED '-1- ~ - CJ I
.
The Building, Engineering, and Planning Departments have reviewed the buileji/lg permit
application for construction activity which is proposed at:
11U5 ne~Y-P"e/IJ /)v.5~
Accepted Y Accepted With Corrections
Denied &4~ )/VO /
Reviewed By: ~A-- Date:
'- I -
'/7-~(
Comments:
(2~J) oJXLa~cW
~ ~ fJla.l~ {.r( R
,~
- - ~'t-----
I-k-JL~-
"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."
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
; ~;~, ~:~ I PERMIT NO.O - ~,' /.
). Yellow Apphcant I 3 V
(Please type or Print and siJm at bottom)
ADDRESS
1l'liP5 Dur-Add Dr- SE
ZONING (office use)
1(1
LEGAL DESCRIPTION (uffice use only) ,
LOT II BLOCK L ADDITION I Q 0 Q.A) .I 0 jl eJJ ;) fLCi
/J~-\'
~":e~R l)(Z \-\Dv--hi!
(Address) '3~ Wlt9Vt,~~/1;n Avi,
~;;~~ANlitl'I(ln+ vYlUJlttfUCtU
(Address)3ft:0D k~LYmfber/'T.)( ..<;ttl+ec \
(Address) .
(Contact Person) -.Jp_tttfJj _ (" ~.
APPLICANT SIGNATURE ~'h f.l 7JtYlJJUYtnaI1
'IV tJ
. APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACEMAKEANDMODEL B/'1jtnf- 2>g?JltA-VDl-4blD FUEL f\W-uxaY
FLUE SIZE L-\l\ tALlS';, P, RETURN OPENINGS L/- INPUT 1D. DDD OUTPUT 5/0, bbD
TYPE OF SYSTEM HEATING OR POWER PLANT
PID ;;/tJ- 3 7;;:r 650 ~
.\JAi-k znd
(Phone)
.~ M/U 55/21-
(Phone) 1tf51 4'52.-2175
(City) (Zip Code)
(Phone) wS I t./5Z - 2--/76
f1Y11))DATE t/-/Z3/0 /
DWarm Air Plants
DGravity
o Mechanical ,
l0f\ir Conditioning
ijJXOnt System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
I FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Penrtit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
50
SUI PAID WP"
LDING Pc
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building OfficiAl
Date
I Paid
I Date
C;-/I-OI
Receipt No.
24 hour notice fnr all inspeetions (952) 447-9850, fax (952) 4474245
By g c-
14:25 651 633 8884
FIRESIDE CORNER
CITY OF PRlUK LAJU;
HEATING/AIRCONDnnONING"mEPLACEPERNUt
#2055 P.003f004
, .,nlJe~'u
SEP I 1 2001
I.Pirlk
2.""""
3. YIlIICJII'
~:~ I PERMlTNO._ -----.1
....;.." Ii30J__ _
{Pleas.; type or t:lrlat iUJd rd~, at bouoml
ADDRF..5S
II~s fb~~~. .fE.
LEGAJ. DESCRIPTION (olliee use only)
LOT I( BLOCK .A.nDITJ.ON I o~;~rO ;;;zd
ZONING (offi.. .,.)
~I
prD d.S-- 75 7.;l- ()~6 -0
OWNER
(Name)
~
dv.~
(Phone)
(Address)
APPl.J.CANT
(Name' Ar..LIED FIRESIDE DBA FIRESIDE CORNER
(AdM"'s) 2700
(Phone) 651-633-2561
(Contact Person)
APPUCANT SIGNATURE I' t;:$'/jn..fl (.,.l~
N. F~IRVIEW AVENU~
(Add_)
BRENDA HUSTON
DJ.)[::;EVi'l"_T.,;;; """1
(City)
651-633-2561
(phono)
~1;,11:
(Zip Code)
DATE
q..J7~J
~
APPLICANT PLEASE COMPLETE BELOW
~EW CONSTRUC1'10N 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEr. FUEl..
FLUE SIZE RE'T1JRN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWann Ai, PlllJ1ls 0 SleMl
OOravflY 0 Hot Woter
o Meenbnlcal 0 lWIiallon
OAit Condil;oninll 0 Special D.vl..,
OVent.. Sy5tml 0 Other Devices
FIREPLACE MAKE AND MODEL ~ ;.J (0", ~ 1Sb1l<<-
PLEASE NOTE:
Air Conditioner Un ilil
ClIllDot En~roach !Ilto
Required Side Yard
S.lba.cks
Industrial. Comm.rclal &. Mullj-F"",iIy
FEE SCHEDULE
1 % of job coSI Rc,ldenllal. 0... Firepl_
U9.50 minimum
$99.50 Resldenliel. Addition. &. Alleral;on,
$64.50 Resldenual. AI:. Only
539. SO
Residential. Hcalj.ng &. Ale (New Consuvotlon)
Residential. Heoting Only (New Con,truetion)
$39.5Q
$39.5Q
EBlimllted CI)Bt $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
5
.50
'L_ PAfDiA;;;,., ~----..,
p, III r"\'~ r_vrl I,.,
~ .
tom" 11.. Only)
Thill Appfll:lltlon Beeo..... Your Building Per...lt When Approved
Paid ____
Receipt No.
lJalldl... omel.'
Do"
D~"_(R' -/
By Q:: ~
Ii
14 hnur nntlee for RUln.peellon. (951) 447-9850, fRX ('J5Z) 0147-"'145
Apr. 2. 2001 10:18AM
1-
:2 .
) .
.,... 4.
5.
6.
.'
GENZ RVAN PLUMBING AND HEATING
No. 0911
p. 39/41
_......
TElLO.. ~IIT
taoLD - ClT",
CIT'! OF PRIOR LAKE NoOI- ~/
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City.
APPLICANT: r-,,;.n:i!..::.J?P#J r"I Ph.--vn'ol~ ~Al('~ PHONE:~1-47-'3-"L.\L.l
ADDRESS: 14~ 1l::::s;r ....-...,' t?~..,"I">Q, ~r !!>~~ DATE: L/ /2 Ib J
SIGNATURE: . .D}l 't 0 -.... BLDG. PERMIT if
SITE ADDRESS:~ ~.vhi&.o~PID# c;(~~ 37;;;"- ()Sb-()
FILL IN THE BLANKS
40'
Estimated length of water service
"
feet.
siZQ of water service
inch (es) .
Location of any couplings from s~ructure
feet.
Type ~f sewer pipe. ABS PVC X
Estimated length of sewer lin~ ~'
Cast Iron
feet.
Clean out (if required), located at
structure.
feet
from
===----=====::~~==;=========:::II:::r._-_._.,-_-,- _
---------------
<-------- --------
This application beco~es your permit wnen approved.
BY
D1';TE:
~==;==~=~=====-----=~~===----====-~-=---=~= ==~
-------~---
--------
FEES:
$
$
$
Sewer and water line connection permit.
Surcharge
TOTAL
35.00
.50
35.50
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge,
Sewer and water permits issued for new construction must be
recordea on the builainq permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued. . r
DATE PAID 1-1- If? -0/ AMOUNT PAID , ....E1(JIL~~~1tV17:4
:REC'O BY We......- t::>l2r,"
v
*
RECEIPT 11
. 4629 Dakota SI. S-E., Prtor Lake, MInnesota 55372 I Ph. (612) 4474230 I Fax (612) 4474245
APr. 2. 2001 10:17AM
GENZ RVAN PLUMBING AND HEATING
No. 0911
P, 36/41
.,.--.
CITY OF PRIOR LAKE
PLUMBING PERMIT
L 111_ .Al..
1.. GQlcl Oty
3" '"t.ellow AJlpliQlal
r:?/-n 30 I
nl!' C~mct "f .Ill!' L...Iui: C_ln
#
~
Applicant; (-!....>JfI7_-(.2U n_PI~ Un=--Phone' (nf'--<-U7"'--II4-11
Address: lU-,Llc::... ~ ~ lilT -.-vLl ~ {2,n~I~:L1Jr\T ~-lr&
Signature: vLJ.. ~ ~ .J\~ I~
Legal Description: Lot~ II Block 7-- Sub 1Y"'-^tciLD ~
Site Address: 112lo'::::::> ~Qr..Q" 'LM - s.,E
Building Permit It . PID iI' ;;( c;- -:S'/ ~ rx;(, 0
NOTE; This permit wjll not be processed wnhout complete information.
FIXTURE UNITS
. >
-"
Quantity Type orFfxh,re
I Bath Tub with or without shower
I
1 Dishwasher
I Floor Drain
2.. Lavatory (bathroom sink)
\ Laundry Tray (1 or 2 compartment Sink)
\ Shower Stall
I Sinks
- I Bar Sink
2-- I Water Closet (toilet)
Quantity
Type of Fixture
Rough-ins
r Water Heater
1<../1 Water Softner
r Stand Pipe (washing machine)
Sewage Ejector
8ackllow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
> Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Anerations
State Surcharge
$99.50
$3950
$
$
$
$
.50
GRAND TOTAL $
r
Thli permIt 15 grant=d upon the express condition that .satd
contractor, shall comply in &.11 respects with the. ordinBJIces
o~ the. State Plumbing Code and the amendments jeteaf.
. REcriJPTNO. j,J- /2-0 _DATE
Q- ./" A 1 u""
Call for all inspections ~ ;ours in advance.
,I3LJlitilf WliH
GP€R'fl".
'VII i
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 I FAX (612) 447-4245
An Equal Opponunlty Employcr
PRIOR LAKE' DEPARTMENTOF
~, " BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 1'7Q (oc;- ~,.. C~\ol 'D..r--.
NATURE OF WORK iJe.-.J
USE OF BUILDING, SFA
PERMIT NO. -Or-0301 DATE ISSUED <I.9~4:s:0(
CONTRACTOR DjL. ~~ PHONE (;.5l-2.,t-,-j/?(?
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING I I
, FOUNDATION (Prior to Backfill) I 'K .llo-w., 5'!;:z.~ II ( I If?:;. , 5/.;1 j1)1
PLACE NO CONCRETE UNTIL ABbvE HAS BEEN SIGNED
ROUGH - INS -tik~o~?/~~~1
,
I SEWER I WATER I SEPTIC
I FRAMING fir,
I INSULATION J~
ELECTRICAL
PLUMBING I t~ .~, (I) (g/DJ fh-, Ijel/ t /67" .
HEATING (if required>1~, U 'br "iJl:f(or -(',.\#11"" r1}--, Millo/ P=J-./of$1
I FIREPLACE /?r 161M It> I /" /, I f.... '
I ~ /". I VI /'/ ~,
GAS LINE AIR TEST ~. f, OJ. ~ ~ f7t--, /0;' ~!'tJ,
" COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
l~ ~. J6//,NOt I I
, U I FINALS
I GRADING (Prior to Sodding) ] I
I BUILDINGf.~o.-t:;1 'tft!o1. fd;,.. \<'/"6/
" ELECTRICAL ' . 2!
I PLUMBING ry/
I HEATING IiJ::i.
,
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
/04r1n /
/~/.1'0)
IUIo{o (
I~,jtf(
BEE~ 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 'shalll:.e placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
ADDRESS \ 7J..r.:. .,
OCCUPANT _
HEAT LOSS _
SOLD BY
Electrical Work By
TYPE OF HEAT
O..,r.\\ dJ.
DA TE HTG. INST. .
HOUSE
\)r'\~ "--
HEATING TEST RECORD
APT. _ FLOOR
OWNER
JOB #
CITY
~UBURB
INSTALLED BY
Go s Line By
GA _ FA ~HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
GAS DESIGN
MAKE
Model
Serial
()ry._~
-, 7""\ L-A,' D.3 L D ") 0
-:Loo \ A ('~ /,
t..9ooc> ~",\J
INPUT.
CONTROLS
THERMOSTAT \\....,-'-"\ _ Heat Plug
Valve
Limit
Limit Setting
Fan Setting
Pilot Type
Pi lot Make
Pilot Model
Pilot Timing.
L. W. Cut Off
Q-:;lO'"
\A<;"",
Pressure
\,r
Percent CO2
_ Percent 0
L
_ Percent CO
Input CFH
Stack Temp. -J-7 q 0-
Form 235
2('. :l
7.0
- 0_
MAKE OF BURNER
Model
Mox. BTU Rating
MAKE OF FURNAce
Model
Vent Size
'-4" 6-v<---'t
KIND OF LINER
D,aft Haad <,- "
Fi Iters
Size _ I ("..x;;a.())I.. ,
Chimney Location
Chimney Construction
Inside
Smoke Bomb
Draft
Door Pressure
CONVERSION
SIZE _NONE
RegulaTor tt\.~.l-\-'" 3'
Number
Outside
Wiring
Test Tag
Lighting Inst.
Date Tested \:l-S--()\
Company Testing Alliant Mechanical, 3650 Kennebec Dr., Eagan, MN 55122
Nome of Tester \l.'t'\..,,",--
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
12./;9/0 I
9:3'd
ADDRESS
I 7 d-.fo c::
~?,[} !JAJ'
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
o INSULATIO N'" 0 SEWER HOOKUP
I/DFINAL ~ PLUMBING FINAL
fO SITE INSPECTlO ~ MECH FINAL
~OMMENTS: f}J.Jo, ,
~~,~ ~:r:~
I. c.,o. -t..gJ B( \ lo'Z..-
A-1MJ- t&.~
{j I - ~C I
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
'. +-.
o WORK SATISFACTORY, PROCEED
)1U CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESs
1'1~('5
~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING (iJ 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL }I( PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS@ ~ (i, .
~-~
lAM.li-v ~ ~
DATE TIME
I~h/
/1: c-o
{Jt-3o/
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o WORK SATISFACTORY, PROCEED
)r CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447.9850 F;; fE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
II'ISNQTI