HomeMy WebLinkAboutBuilding Pemrit 03-0116
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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J. While
2. Pink
3, Yellow
File
City
Applicant
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I PERMIT NO'03 .D/I& I
(Please.!VDe or orint and sign. at bottom)
ADDRESS
rl>o I b'331
Ti ~J'6 (!fF5:r '1J(2_iIf e 5. E. I
I ZONINGCoflk,u,") I
LEGAL DESCRIPTION (office use only)
LOT L BLOCK.2. ADDITION (00)
'hm'BU1 6U?T /JnfJlrlVJ-1h PID
OWNER ?. /J
(Name) --/-lLb.fE-. Ht)1!tEs tfJr
(Address) fiJ~ tJkl/.dlltIE-c.r
J1lh
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(Phone)
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BUILDER
(Name)
(Contact Name)
(Address)
$1mf3-
6tnr 'ZMsr#.v.,J
(Phone)
(Phone) (;/2-27/ - ~tf-s-
TYPE OF WORK
JittNew Construction
DLower Level Finish
DDeck
DPorch
ORe-Roofing
ORe-Siding
o Fireplace
DAddition
DAlteration
DUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
&~ t-S~
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 property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted pia 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 property~r~neededins~s. ~~
x/-u;/ ~~~ g~-/57/ /d'.: ~O tJc.
/" ,- Signature Contractor's License No. ate
I Permit Valuation 11(05.000,00 I Park Support Fee # $ I
I Permit Fee $ 74 J?, 7~ SAC # $ /Z 7S.0d I
I Plan Check Fee $ ~.Io'} I Water Meter Size 5/8"; 1"; $ - I
I State Surcharge $ 3Z,~ I I Pressure Reducer $ --- I
I Penalty $ - I I City SAC and WAC # $ J2.Do I 00 I
I Plumbing Permit Fee $ /O(J .C)t) I I Water Tower Fee # $ 700. D a I
I Mechanical Permit Fee $ lOa. tJ a I I Builder's Deposit $ - I
I Sewer & Water Permit Fee $ I I Other $ I
I Gas Fireplace Permit Fee $ """.1/",0;, I TOTAL DUE $4-,~ eZ-. q.?-I
Building Official
/ /da:-/IJ 3
Date
I Paid "7/~ e.Z . q~
I Date /- , (- CI:J
I Receipt "!Iv.
By ~
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This Application Becomes Your Building Permit When Approved
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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 consttuction to commence. Before occupancy, a Certificate of Occupancy must be
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Planning Director
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/- 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
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See Main File
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BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
app,zt3n i lnstruction activity which is proposed at: :'{f}';- <;1'i:://':;2.(...r:'/);L(l1!-
Accepted
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Accepted With Corrections
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Denied
Reviewed By:
1YJ4f3
Su (Y1c,rYt Flft'
Date:
/-27-03
Comments:
"The issuance or granting of a permit or approvai 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."
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Thf Crn!r. of thr I..k.. Count")'
White - Building
Canary - Enqineering
r Pink - Planni~
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: :. >+- .
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Accepted Accepted With Corrections ----
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Denied
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Reviewed By: ~~p Date: /h.:>-AJ:3
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Comments: ..du ~ ;Z~
"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."
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PlliMElc'O ?ER..\UT FEE S
STA TC SURCf-LA.RGE S 50
TOT.u. PER.,lIT HE S
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PRIOR LAKE
INSPECTION RECORD
SITEADDRESS ~I Til\A. :T ~,C.
NATURE OF WORK NEW )~sr~l~
USE OF BUILDING _ S".. A". .
PERMIT NO. ~ DATE ISSUED -.l/t2.tA!
CONTRACTOR -ew.T!' tj~~O ~..... PHONE~S
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
(. ~ MAI'N FiLE
DEPARTMENT O~' ..4 ' ~ ,
BUILDING AND INSPECTION
INSPECTOR
DATE
I FOOTING MiM
, FOUNDATION (Prior to Backfill) ~.", I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING if re uired)
IM.M
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0~.?o4'!r
S'---S-~ U>
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I'VP
L-j-:]d4'J
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
1M?'
~I
OCCUPY UNTIL ABOVE HAS
NOTICE
(.rlJ_U)
G - Ih-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.
FOR ALL INSPECTIONS (952) 447-9850
"
DATE TillE
CITY OF PRIOR LAKE (.~2-0
INSPECTION NOTICE SCHEDULED
-
ADDRESS I (. ~3 I 1, 'VI ~-v l-rr-, I-
OWNER CONTR.
PHONE NO. PERMIT NO. "]-11 (p
o FOOTING o PLUMBING RI o EXlGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~SULATION o SEWER HOOKUP o FIREPLACE FINAL
INAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
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)'!"'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspedor: ~ ~ J-:3 (]) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNOTl
DATE TIMe
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ro./!
ADDRESS
1(.; "51 1.""k......f
OWNER
CONTR.
PHONE NO.
PERMIT NO.
J-tJllf,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
jjf PLUMBING FINAL
b MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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1 WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~O~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: r ~ / f9, J (- U} Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH <l SAFETY!
INSNOTI
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BVKN~~.LLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
,
Ors1at Test Report for Job' 56<0 '1
Address J& 3' I -r;,-,,".. r..
Occupant
Date of Ins1all 5 ~~ . c> 3
Type of HT. F1A '- HW
Other
CPt "'5" Do
.-,
Cily if' \c;<z L A~ I:.
Space HT
UnitHT
i
Make
Model
Serial
Input
J. rJrJO\.
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;?l"Jd (..
5B03D07.0-~'3
.f,~..(). ")'~)() h-ru ~
Pilot Type HOT SURFACE IGNITOR
Pressure 3.'3- I. Wi.. CO2 C, ,,,'
Input CFH .~>() 02 .~ d
'J SlackTemp k)1 CO iA
Date Tested
Company
Technician
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BURNSVILLE HEATING & AIR CONDITIONING
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