HomeMy WebLinkAboutBuilding Permit 04-1171
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please Ope or Print and s!-@!.atbottomt
ADDRESS , ~ /I ~ JeWev:; 4JqS.s
P II" I'D./' ~ h <.., ,/IA. A./ 5'7 J, 7 )...
LEGAL DESCRIPTION (office use OnlY~,-" / /JJ
LOT IdBLOCK -3 ADDITION~A) ~
OWNER \ f1
(Name1, c" IA~ 1IJ I/Ov..r VI
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
I. While
2. Pink
3 Yellow
File
City
Applicant
I PERMIT NOr?f-- Inl I
(Phone)
VJ ~ J,d. ~ "j C> "'" 1>" v'/ 't' J
,J..tl% ~\A(lev",v.,'a,.....
'-fILII ()lrJ S,b/<'( ..Mc.Mov,<d
(Phone) C, ':)1 - a?9-t:o~O
(Phone) Qj,l - .;t 7;; - 4:5 Cf Cj
fiu j/ - E~y~ AA A/" 0\1'):>-
Date Rec'd
1/. /8.04-
ZONING (office use)
/2,J
PI~5- ~q5 - 05g..-C.)
q q,).. ~ J-J. 6 -5'.). '1~
TYPE OF WORK 0 New Construction ODeek OPoreh ORe-Roofing
DAddition DAlteration DUtility Connection 0 Misc.
CODE: tn.R.C. Dr.B.C.
Type of rTolstroction: r II ill IV V A B
Occupancy Group: A B E F H r M R S U
Division: 1 Z 3 4 5
ORe-Siding ~ower Level Finish
Z P1fJ' '
PROJECT COST /V ALUE S
(excluding land)
I hereby certify that I have furnished information on Ihis application which is to the best of my knowledge true and correct. I also cenify that I am the owner or authonzcd agent for tlte
above-mentIOned property and that all construction will conform to aU existing Slale and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke this pe il for just cause_ Furthermore. I hereby agree thai the city official or a designee may enter upon the property to perform needed Inspections.
~ _bG-;;)OL:i;!;33 _" ,~IP-o'-L
Contractor's License No.
x
Signature
I Permit Valuation Z, 000.00
I Permit Fee $ t, Z. z-S
I Plan Check Pee $
State Surcharge $ /.Dt)
Penalty $
Plumbing Fermit Fee ~ $ 40,"4
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $ 40.00
This Application Becomes Your Building Pennit When Approved
~~~ /(ltrlotf
BuildlOg Otlicial I Date
Park Support Fee
SAC
I Water Meter SizeS/S"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Paid
Date
/ 4-..3 _ "Z5
Ji. /8,() ~
#
#
#
#
--------
D Fireplace
Date
$
$
$
$
$
$
$ I
$ I
$ /4-3,~ I
,\
I ~~ce~p -M.3Se
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 signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate OfOccllpancy must be
issued
Planning Director
Date Special Conditions. if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Eomes
BY: ~ ~ Date: /1- /?-OL/
(jL/-I/j!
Building Permit #
Site Address
Pill:
Legal: L
to
B
3
Subdivision:
Zoning:
1511S W~
~S,
E~tingStrucrur~orNo
CO~"'FORi.yIS TO ZONJNG
ORDINAi~CE
YES
NO
Is this an expansion of the existing footprint or
building height?
YES
Refer to Planning
NO
I Is the property located within the flood plain?
I Does the alteration include any additional kitchens?
Does the proposed alteration include any outside
entrances other than patio doors?
Refer to Planning
t00
~D
tJD
Refer to Planning
Refer to Planning
rJO
Is the proposed use of the finished space or
alteration for anything ou'ler than a no=al single
family home (office, group home, day C:ll"e, etc.)O
Refer to Planning
No
THIS CR:ECKLIST MUST BE COMPLETED .~'fD INCLUDED IN TR:E BU1LDING PERi'lllT Fli.E TO
i'lL-\.INTA1N A RECORD OF THE REVTEW.
.';'-:':'"rPT j., ~"'..l. T "'7"',~:..:r-::"" r:CiC
NOV-30-2004 15:32
CITY OF PRIOR LAKE
9524474245
P.01/01
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Ree'd
/2..7. ()4-
I'l/..-G W. of: /17/
u:::: ~~ I PERMIT NO'0"!-.//7/
3 V.UIl1O' A,p1ianl
(PIouo "11.~ o<_..d slm "_"1
I ADDRESS
\S\\B ~~Hu..s
~ASS
I ZONINO(oJIl<o...)
!!-/
LEGAL OIlSCRIPTION (ume:.... oub1
LOT & BLOCK 3 ADDmON JEr~ SO V77i
OWNER :s A ...... <'"
(Name) ....~
pmZS-31~, 6 "'-YO
\ $1 \B
J)s.... W .J
\~,~
(phone) gS.:l- :J~-.s~9~
(Addtess)
-flASf
APPUCANT
(Name) M.\c:.~II,€...I. (' 1"\' r: <'l"OC.j<
(Address) _Sse <... l...\\Lh~
(Address)
(COIlractPenon) },A,-<-u.Jo.i-L- ('- A' r:s,"t"oc:...K
APPLICANT SIGNATURE ~.'. L . . Q. (1....J. ~ .
(phone) ioSI- /.;.q B- Y Bqq
~..pA~L MJ:J ~
(City) , (Zip Code)
(phone) L..S \ - J..'t8 - 4~q"f
DATE 1\- 30-04-
APPLICANT PLEASE COMPLETE BELOW
QlIAIIU~ ! Type of ~tQre I Qllaatity
I Bath Tub With OT without shower I
I Dishwasher
floor Drain
Lavat?ry (~al~09'11 Sinr,~. .
l-IUndty fray. (l9T:/ companment sink
SblilweT Stall
Sinks
Bar Sink
Water Closet (Toilel)
\
Type of Fixture
Roup-ins
Water Heater
IW.er Sotlncr
'1~1&ncj f'jP!' (WaShing Machine)
I sewiie Ejector
Backtlow Assemb!r
BaikfJow Assembly Test
l.wil Sprinkler
Other
\
F1:I SCHEDULE
lndumlll. CommetQial" Multi,l'omily 1% ofjub _ with. 539.50 minimum
Eatirtlated CO~I 5
Retid,ntilL New On. " Two,F""jly
a..idontial. Add~i.n' " All_io""
Bulldlns PermlU () 4-. //'71
599.50
539.50
PLUMBING PERMIT FEE
STATE SURCHAAGE
TOTAL PERMIT FEE
$
S ..---- .50
$ ..........-
...-
o (j~.
fffl{ /fl{;/'-
{)U
(O/lIoa Un Only)
Tbll Appllcatloli BeCQIII.. Vour DulldlnS Permit When Approvod
1IaI1"'~. omdlil,
O.le
p~
Da,z.. "1- 04-
H...eipl No.
~,
-
. 2~ llou<ll/ll.i tor 111,;';".'11... (9!l2)U7-98SO, 1ll'(.5~) 447~4!
161W 1,.IIC...k A,". S.I., ,Prior Lab. MN S537N 1l~
~y~~
TOTAL P.01
6517696856 MINNESOTA HEARTH E&
CITY CF ~I~ L.R<E 952M?4245
CITY OF PRIOR u.n
BEATING/AIR CONDmoNlNGJFIREPLACE PERMIT
PAGE 01/81
P,B14!1
Due Rtc'1l
· - ... I"" m....o.otJffiJ
1. GN. 0, h: _II< .101.. 1'1'
~--
~""IIIII....r"'-'
I 15/: g _Te..{.(usP,,- ~ NW
I ZONJNG~~ I
I x.BGAI.:D~(__~
tar BLOt:!(. ~""'J.uv""
PID
,.'11.,.10& ~r 'AA. '=' f) ~
~) _ IfJfY~ O'(t1\AI1
Wdlasl 1.:51 J ~ ~Tr-fM P"!U NW
R, 'C/(' It.. It-e.
(Pboae)
mN
tt5? -ZZt..-52<1l.:,
55372
~iawrJa..l.J.....D-Y*, oJ.~ (.1'IqJe) lP51-'7b4-("&5~
(AddreM) 1240 E. P1- Dou-,Ic.s I2tL =ILl 30 ('.f,. tt1N 550lltJ
(AMft:B) ~ (lip CoIIr)
~~ Ma.vk.-lYhn.sCV)._ (PboDe) Lrt".))-'J"" -1dS5~
Al'J'LICIOO"SlQNATUltt ~-.e' 0/......... "'- DAl1l /1-/ "II oJ..{
APPUCANT PJ .1i'.4'~ COMPLEIE BELOW
[]NJ!WCONSTR1.wuw.. OBEl'LACllMl!NT DAL'mIlATIONS
FURNACIl MAleE A}olD MODEl.. FUIlJ..
PLUBSlZE kBTtJRN ..........05 INPUT 0U1'PUT
TYPE OP ",... <.t...! HEATING OR POWEll. PLANl"
C1W.....Air~ O~
[J~_..._ .' . o RatW_
0-- 3=-':'~.....
Q.\lr.. ".., B ...................
OV- ~ ]OhtPM:a
PlQPLACIl MAKE AND 1lf0DllL l-Jett+-n - ('.., III (,./IN) JR ():z..k..
I'I.&\SE NOTE:
AirC~_Uaill
c.-;. "" Lin...
lleqairal SicIe Yw
SeIbadts
pn: !lCJUJ)tJU
IIIduslriIILC",,,. _..' tAMllIIH'IIDiIy l"'afJM_ ~o..F~
1"-'11.............
1taidIW:ioI.IblilIa.lr.A/C(NO\lI(:anItNaion) S99.$O :\. ,-. ...,:, L~.I:~
~I.IkaiII&OaIy(N"C. "".;",j $6C-'O ..........I.ACc.ly
I!8tiaweclCostS 30Cil.(() BulIdlllg~lr.'
( t39.5O ' )
~.so
$39.$0
HEATlNG l'BIlMlTFBl3 S ,V"l..;:;t) PAlO W1TH
STATESURCHAR.GE S so peRMIT
TOTALPUMIT IU S 4;/). (J 0- J!UIlJ)tNG
(OIf_ u.: OlIn , -. _ . ... .
TlalaAppl'"...dea ....... V......IIldJ4.1 J'endI w_ ""'- ~< ~ n~ U \1, ~ '11ia.....~...
........_ . . _ . J~ IW:C 2 0 2004 ,) 8y
,
M__....,' ",.. Bia)"~"'~""..acs I
..~~--I- ______ ___.. -....~Q,.. ..-.. __ -
TOTFL p.el
PRIOR LAKE
INSPECTION RECORD
d~
DepARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK I....L .
USE OF BUILDING --..s F
PERMIT NO. e>~lJ:1J DATE ISSUED -''ri./:f:--oV
CONTRACTOR ~""t PHO' :l7"'-II!''I
NOTE: THIS IS NOT A PERMI" FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I...' ;.~ '.1'.
DATE
'rI __ I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
,
FRAMING
INSULATION
ELE". mCAL
PLUMBING
HEAl1NG (If reaull'tld)
;PIR'PLACE
GAS UNE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINAL~. / J
tAl} J 5'/1//6)
I . /
I
J
11
we
Yf1
/
J'?/r(~/
v
1 _ III
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
L-- .
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
TIIIa c:erd muat be poated _ an eIecIrIcIIl Hl'Vice ceblnet prior to rough-ln 1111I" . .,. .,.
and _Intalned until all Inapectlona heve been epproved, On bulldlnga and addltlona
, . no ".'.. ceblnet la evall8ble. c:erd ahllll bepfeeed __In antrence,
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS __I~ll~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~NSULATlON
FINAL
SITE INSPECTION
COMMENTS:
DATE
SCHEDULED ~
~~ rlvP
nilE
CONTR.
PERMIT NO.
1./-117)
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
0t~~DG
/'
4WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREgBCALL FOR REINSPECTION BEFORE COVERING
Inspector. L Owner/Contr.
CAL ~;'l8 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
-.J
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEIlLTH .. SAFETYI
ININOTI