HomeMy WebLinkAboutBldg Permit 04-0145
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please tvQ~ or orint and sim at bottom)
ADDRESS
Date Rec' d
l. White File I PERMIT NO
2 P',k ehy ./'1)L.J _
3. Yellow Applicant L.../-'
,Jo
ILlS]
36S-d-
Fo/ fa ,I
Jr
LEGAL DESCRIPTION (office use only) a
LOT I'f BLOCK~ ADDITION ~1 t!M41U d,.v
OWNER
(Name)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
~Lower Level Finish
ODeck
p(FirePlace
o Misc.
ZONING (officeu")
i?y
Plo-75-3f5"-o t;;3 t)
(Phone)
DPorch
ORe-Roofing
DAlteration
/6/nr:k () k. 7YcJ. ,~Ph'll)e) 9~2 Z; l/ (L6)6J
3{o t)R '/0)(0/1 ~!f /VtU) B.16yk,~j )1~ 1(l/2-
C:"I~)
(Phone) &lJ - ~O -OlQ 73
PROJECT COST IV ALUE (excluding land) $
OAddition
ORe-Siding
DUtility 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 property and that all construction will conform to all existing state and local laws a.nd 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.
x
Signature
('3000, 00
7tf. 7~
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
i State Surcharge $
I Penalty $
I Plumbing Permit Fee 151./ OWI/C-V'
I Mechanical Permit Fee 1 I $
\ Sewer & Water Permit Fee $.
I Gas Fireplace Permit Fee ~ 't.
/,6<:)
L/IJ. CJ 8
1{cJ. (70
This Application Becomes Your Building Pencit When Approved
~<: ~~ Slls/~o/'
Building Official . ------, Date f
Contractor's License No.
Park Support Fee
SAC
#
#
Date
$
$
$
$
$
$
$
$
$ /5G.(J.'O
~
I ~~c;.:o.q&'f,;f-/
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 of OCCllpancy must be
issued.
I Watet Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
IOthet
I TOTAL DUE
I Paid 1~"',;;;0c7
I Date ;:3 - 11.0 -0 Lf
#
#
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447.9850, fax (952) 447.4245
16200 Eagle Cteek Avenue Prior Lake. MN 55372
",
r '
'.
~..
:~ .
.
-
Residential Building Permit Cheddist
Basement Finish or Interior Alteration to Single Family Homes
BY: ~-~ Date:g)s-~y
Building Permit ;:
Site Address 3 C. S- 2-
Legal: L B
PID: Zoning:
~~ //U'.
Subdivision:
E.xirting Si:ructur~r NO
I CONFOR1.v!S TO ZONING
ORDlliAJ.'1'"CE
YES
NO
I
I.s tbis an apansion of tile e.-'..sting footprint or
building height"?
:as
NO
Refer to P!amri:ng
fJo
I I.s tIlc propc=:'f loc:1tcd within tile flood plain?
I Docs tile alte:"'..tion include any additional kitcb.=?
Docs tile proposed alt=rion include any outside.
c::ttranOCS other th:m patio doors?
Re!c:- to P!amri:ng
,Jo
t--lo
Re!c:- to P!amri:ng
Refer to P!amring
No
I.s tile proposed ilSC of tile finished space or
alt=tion for anything otller than a n=al s'.ngie
falmiy hon:.e (oEce, groll!' hOr:le. 6y c:!!'e. e:c.)~
Refe:- to Plm:ning
tJA ,
THIS <...=0<1.15T :'IreST BE COMl'L.ETED .",'1]) Ii'iCLlJDED E'I THE BllLD[;'iG PER-,IlT fT.lE TO
:'IL.\l?'ITAll'l A RECORD OF THE REVIEW.
.
.
.
.
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File I PERMIT NO
2. Gold Ci~ .
3. Yel:low AppIiaml
~ ~_or print and sion at bottom)
ADDRESS
3/05) pEJJl /;5 / /
~/// /
,
)IV)
I ZONING (office
....)
LEGAL DESCRIPTION (office UBe only)
Lar BLOCK
ADDmON
PID
OWNER fd,kJ ,/,
(Name) CA-
(3Jsn(( )
--.-'
(Phone) Cf <) 2 ':4,dJ 6 /tZ
(Address)
=~ANT~O;{ (?~
(Address) 'J 652. /"OK ~I '/ y'.I'2// /
(Address)
(Phone)
f)./ ,,3/Ai k.k~
(Oty)
!2;yz
#k
<('.tIO (j, /02 ~
ffp~_
(Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE ......,.Ji~~ DATE ~~ 3ft
~ .
APPLICANT PLEASE COMPLETE lELOW'
Tvoe of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundrv_ Tray (l or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantitv
Type of Fixture
~
1
"
Rough-ins
Water Heater
Waler Softner
Stand Pine (Washinl!. Machine)
Sewi'!le Eiector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other '
"
I "
., V-
FEE SCHEDULE
Industrial, c..,.___ .:al & Multi-family )% of job cost with. 539.50 minimum
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ Building Pennit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
(0fIk0 u.. 00Iy)
This Applieation Becomes Your Building Permit When Approved
Paid
Receipt No.
Date
By
BaUd... 0lIIda1
Dale
24 bour noli<e for 811 inspeetions (952) 447-9850. fax (952) 447-4245
16200 Eogle C...... A.... S.E., Prior IA.... MN 55372-1714
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
f!'!!:ose_ tv>< or orint and..... at boltom)
ADDRESS I / · j
7~ ,;2- ~ hd j;o/t //!<</
L Pink Fil. I PERMIT NO
2. 0Iee0 City .
3. Yellow Applicant
WNING (office
....)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
~':: U~/1 r7~ 9)'2 ~ro0';h~one)
(Address) 3c:')2 /---o,r" 7~-,j17e;1// /~/ /i//J/ k~~
APPLICANT . 'J /. A /. '. ry}
(Name) ~,t~
(Phone)
tJr?
~~ LI~(J '" /0-;
.
(Address) ?{,'-)2-/~J('7l:I/~/'( o/'/6j/1v~, V'h~ '-r~'L
. (Address) / r' (Oty) / - (zip COde)
(Contact Person) I2lrci_ Cisi'J1'/ d (phone) 9'S..e. o,qj5'2 ~7
APPLICANTSIG~ATURE ~::f~~.,y-"~ DATE '3~..2A.y-
7' APPLICANT Pi:E'KSE COMPLETE BELOW r
[]NEw CONSTRUCTION qREPLACEW:NT ~ALTERATIONS t
FURNACE MAKE AND MODEL Le,AJrJ i ' meV'1 i 5e V' l~~ FUEL Iv
n .)
FLUE SIZE f RETURN OPENINGS 7 INPUT _
TYPE OF SYSTEM HEATING OR POWER PLANT
DWann Air Plants 0 Steam
DGravity 0 Hot Water
I~!AI ~echan~ca1 . 0 Radiation
,Ai,#- IiiJAirc" .,g 0 Special Devioes
DVenL System 0 Olher Devices
FIREPLACE MAKE AND MODEL J.JJ.jnY}, 1-/./1,.,,,,, tuc..<J'
, FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
OUTPUT
.....,
""'-
?
PLEASE NOTE:
Air Conditioner Units
Cannot 2..........:....h into
Required Side Yard
Setbacks
N~
Industrial, Commercial & Multi-Family
$39.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
(0Ilke U.. Ooly)
This App' ... ", .. Becomes Your Building Permit Wheu Approved
IItd"'_ 0lIIci01
note
I Paid
I Date
Receipt No.
By
14 .....r BOtice for .U iD.pectiuDs (952) 447-9850, fax (952) "" /424S
AUG-25-2004 16:24
UIERECK FIREPLACE
861 0456 P.01/01
~,.A*rJ L;,\)~,.o.- CITYOFPRIORLAKE L~i..n, i...(j.'-\S
i~~j~ IlEA TING/AIR CONDITIONING/FIREPLACE PERMIT
""NJ.<esO"l'"
Date Rec'd
(~l~.:~~ r,"O~"Or cr:.:-:.~ a.nci.li~ at bC:10i':'!';
ADDRISS
i ~~~~~;~~'''"' I PER!YlIT NO'04, 01+6"1
ZONTN'G,.(~i"f:'':- ua)
3"52 FOXTAIL TRIlIL
LEGAL lJESCRlP'rrON (of,,,, m on,,)
LOT
BLOCK
ADDITrON
PID
o \lINER
(Name)
PATRICK OLSON
3~52 FOXTAlL TRAIL
(1'11,,\,.) 952 440 b 7DZ
, (.A.d=!';:~:s)
I APPLIC,NT
I (Narn' VIERECK ~/R[PLACE SALES
i (.^.cc:w\ Ifa/51 MAIN fI~~;,,~~
(Ph"oe) 952-'1'10-5(,20
~/DRLAKE 55312
(Cir/i
(Zip Code)
(Cont,,", 1'<',00.) STEVE RJVEI2A./1 (Phone) 952- 440-5{'ZO
I/.PPUC.~.l'!SIGNATU~:-~- ~ ) DATE 24 AtiS. ?Dl)/.J ______
..... - " '--
APPLICANT PLEASE COMPLETE BELOW
UNEW co"smUCTlON 0 REPLACEHE"T 0 ALTER" TlO1'S
,
: FURNACE ~"IAKE AND MODEL FUEL
i FLUE SIZE RETUR.>.i OPEi'iTNCiS INPUT OUTPUT
D\\iaml A(r Plf(';!S
UOrll'lily ,.
o Ml:l..:b~.nil.::.Lj
OAir Condilio:-'.il\g
OVd,H, S,Ym::m
HEAT1NG OR POWER PLANT
o Stcom
o Hot W;u:r
o R:J.d !t:;~ion
o SP':Cilll De'..ic:s
5S Otha Dc"c:s r/Kf PUlU'
?LEASE NOTE:
,~.ir Condicion~r Unirs
Canno~ Encroat:h in{.,
R<qu1r.d Side Yard
Setbacks
TYPE OF SYSTEM
FiREPLACE 1vl.AKE AI'D MODEL FIREPUICI XTRDRDINAIR BED' BRfAKFA5T?1 OV
lilJu:mic.l. C!~;7IlT'o:::cj:j &. I\:ulr:.f';lmil:.
HE SCHEDULE
1% ori.,b 1.;C)!:t R.'::ji(~c:.r;fi:.:.1. Gas Fircpl"'I;r.
S.i9.50 minimum ' , ,
S~9.51) R~siJ=nti~!. Ad1ilions & ,':"I~~":::'::ol!S
$6J";I) ft::~i.::r!d:d. ,J..C Onl:-
53950
Resid.~:'Hi:li. !'i,;;~~;,:g eo;, AiC C<~W Con::i(....:~rion)
R':Sil':t.::1~i:J. !-:;;-rJ.\.r..~ en]:; n';~w CG(1.~:.:-..;:~icr.)
53950
SJ9.5G
(()ni(~,=L';e Oni,\)
HEATI~;G PER\lfT FEE
STA TE SURCHARGE..
TOTAL PER,V!IT F.D:'{
s
s
s
PAID VV 11M
BUILDING
10 PbKMIT
'r:: ~ ~"; ]1:::",,,,,,---
I
By
TOTAL P.01
Es~im~r~d Cos~ S
Buiidi,-Ig P:-rmir .::
Tl1il Applkntion eeel'","' Your Iluilding rermit When Appro,ved
eulJJinlf omC.i21
O:Ui!
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 3 to 152.. ~ ~ ,A "L.. 'TILL.
NATURE OF WORK l.!J.. . ~;~ "'fl~
USE OF BUILDING ./ S.r=: n.
PERMIT NO, ()L-/--- 1/11; DATE ISSUED 3f''5 10&.1
CONTRACTOR ~A-TR.i~ OJ,.'r'"J PHONE,..lDl'2.-&"O-~73
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH. INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
(}X.
tJc
"\
~
~
,
~I
. J -2.. 7
7-2~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/J/
ttt};1
,', I
I
c&
.
OCCUpy UNTIL ABOVE HAS
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
j "
/ I
6 / I !J/ o:!J
I 1/
BEEN SIGNED
FOR ALL INSPECTIONS (952) 447.9850
~DATE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS s~52 t;.k 7e:-) \if
nME
OWNER
CONTR.
PHONE NO.
PERMIT NO.
(j-/cfrf
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
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
'v~ ~~+v~
/lJ
Ulos.e.
fA 1'1
~ tIC;
o WORK SATISFACTORY, PROCEED
){CORRECT ACTION AND PROCEED
/0 bOR RK, CALL FOR REINSPECTION BEFORE COVERING
Ins
Owner/Contr:
50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
E REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ