HomeMy WebLinkAboutBldg Permit 04-0575
(Please "!ype or print and sign at bottom)
ADDREltJ.. .
J3 ~()
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
S 2-1-, c4-
; ';;::' ~::, I PERMIT NO. ()AI_ .0 r.::-Z cT
3_ Yellow Applicant ..,-- ~ VI J I
W Dodc\ut\<--- T\-t~/
LEGAL DESCRIPTION (office use only)
LOT YbLOCK 3 ADDITION
The I)J l1~ ADtill1
OWNER T.~ ~()\\JIt
(Name)
(Address) Va ~()\t SI
BUILDER 1 L e. ()l'\j) + .
(Name) (Contact Name) cJ-t'Yll'\d
(Address) r,D. Be'L ~JI
TYPE OF WORK
~ew Construction
OLower Level Finish
o Misc.
I I
ZONING (office use)
I!!-/
PIDZ5. 382../0 0.0
J
(Phone) q So. 401-]Cl ~ y
SSDaD
q:J'Q 4101-3'1&4
Park Support Fee
SAC
I Water Meter Size 5/S@
I Pressure Reducer
I City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
#
#
o Fireplace
DAddition
DAlteration
I,,\D,oOO
ORe-Siding
DUtility Connection
iU I D \l)+-
I
PROJECT COST IV ALUE (excluding land) 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 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
;te~~rtyt~or:1~~inSpectiOns. I () ik !J--/ f -0 </
/~gnature Contractor's License No. Date
$
$
$
$
$
$
$
$
i(../ OJ OtJO
~/i7. )~
Cf73.<;(/
rs-. no
ukD ) VV\V\
(Phone)
(Phone)
ukc ) rY\V\
sso aD
I Permit Valuation
J Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
\ Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
11)0 . " 0
I~() .C)O
.:IS-. CD
f{o . 00
DDeck
OPorch
ORe-Roofing
$"; ;fii1~~.OO
$ J. .?~O.c;()
$ . ~()cJM
$ 70. 8 I'l
$ ',2Ql'J.c5lJ
$ 7&':l. ~D
$ / ~t:)f).('J d
$ r -
TOTAL DUE /1 (, IZ 0-<--'
r/J/J '1'. or
gi i/ '7e;
(.,,- {(r') -OU
$P>9,//.7Q
1 . I I
I Receipt No. I.{ (0'/)'/ '(
Bv r;.
cr-
omes Your Building Pennit When Approved
{r 7-0 I(
Date I
Paid
Date
ThiS IS to certify that the request m the above applicatIon and accompanymg documents IS m accordance With the City Zonmg Ordmance and may proceed as requested ThIS document
when SI the Planner constitutes ~te Certificate of Zonmg compliance and allows constructIOn to commence Before occupancy, a Certificate of Occupancy must be
ISsued
PI lrector Date SpeCial ConditIOns, If any
v .M hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
.:..~~x PRioit (
f.-. ~
U ;-:1
While - Building
~ - Engineering
(;.fink ---= Plannmw
_/
lh~ Cfnln of lh.. I.Mk.. ('ounl')
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
I;"
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity whicr is proposed at:
- <) l ///) (/, /.U F. i:J 7-'
Accepted
Accepted With Corrections.x
::::::edBy:V/i k--
Comments:
Date: &-7-0 t/
(;2 kcl1/Jj a Itz (! C4 ( /J! c;.; 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."
@)
- --~~
(White - Buildi~
"Canary - Engineering
Pink - Planning
lhf Cfntfr of thf L.kf C-ounlr~.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
r: c. , (}g-y~
. .5-(;2l/- Y
The Building, Engineering, and Planning Departments have reviewed the building permit
application for /~r;; ;tivili'~a1:~ ~ TI--
Accepted
Accepted With Correction0
Denied ,9-tl/J tJ_
Reviewed By:(jt:f ~
Comments:
~
Date:
(,-7-0 t/
~d J1 bif~ /i-J ~
~ - 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."
~
G~~
White - Buildinq
C-Canarv - EnQii'1eerina--:,
Pink - Planning
Th~ ("~nl~r (It lh~ La"~ COllnlrv
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
/)
.,,__ i /' I
NAME OF APPLICANT ~ , .. _>;;"7(.0. L<--
APPLICATION RECEIVED
?; . :'1/- '- /
_.,./ _/, ;I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity. I~~i is pr? p_~se~ at:
Ie-'~'- '"" // -"?I_I.,~' /.7':.
,-) -) _ -;.--/. A _ 2::VO ,:~//9~ /' ~ i r--
Accepted
Denied
/)(
Accepted With Corrections
Reviewed By:
/J/}(}f)
Date:
~-I()"C)'I
,
Comments: See Reverse Side for &:Witinn::!1 Inform::!tion!
DrivF>way Mllst Have A Concrete A';'1',u""ch
"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,"
08/18/200.4 . ~1: ! ~..
5073344811
.-..... . ...... ............. .........
CANNON VALLEY MOTORS
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PAGE 01
!/llOOl
CITY OF PRIOR LAKE
HEArING/AIR CONDmONINGIFIREPLACE PERMIT
Dati Ru'd
rr~ "'2'!/! >rkoc UId .... .. ........\
I ADDRESS ! 535..;) LlnI.~"d: 7n
i 5:. s....I I'ERMlT NO. Lj- 51 ~ I
, ZONING 1.......1
LBGAL DBSClUl"TION (.lIet .. oeIy)
1.OT BLOCK AIlDmON
PID
OWNER '-r'"-:. C',' A,'J'''''-
(Name) It. ~ " ~",.,f
(
-
(phor.e) f;:5- riJ :1 f P,/
(AcIlbas)
APPLICANT /JI.^ ~.
eN lII\el t::t1f - .
(Addzess) ; y?7l/ F ~ G '.t(- (-d)~ A-
nt)
(COl1tac:l Person) ~I
APPLlCAl'-'T SIOXA'I'tJRi, .
(phone)
9f:L--7fJ' ~'7J1'7
. .
. LlCANT PLEASE COMPLETE BELOW
, VP:;;/;/ 0"""-- OALlDAnoNS
f'UIlNACIl MAKJI Al'lJ? 1)90Dlll. Ft1!L ~
Fl.UE SIZE 3'" 'fVf/.. OPENtNOS INPUT f/),. Nt> Ol1TPUT j':3 ~A
TYPll OF S . ~ ,"'..{ REA TlNO OR. POWER. PLANT
~IOJ\ Air Pion.. 8 'wam
Or..11Y Hot Wl.
. M..hlllleal Radlallo.
ir Condi"onln. 0 'poc:loI 0...,1...
Ven,. S,,,,,,, 0 Other Ocvl_
(O?} (tip Cook)
(PheM) yS i/ ~ rrr ~ 7.J 7
DATB :,. -fI, ...p,/
,
'LEASI: J'(OTI:
Air COIIdldoner Uni..
C_at ErlcroaclllnlO
lequ~ Sldo Yon!
llllblckl
. l'U\EPLACl! MAX8 AND MOD!L
IEZSCHEDUt.1
l_d.wlll. Commt:r<l.l A M~lIi.'arnl:y ! ~ of job coil 1P.eo1_11l. 0.. PInp!"".
139.'0 ",tnlm"",
lleIldondal. Houlq A AJC (!-l... COGIIN.tl.n) "9.'0 Ilcolclc;lIlill. Ad4l1lo!llot AI_I...
",..idondol. HEIllln, O.1y (Ntw COMMtlOn) ~,'O 1I.1I14mUal, At OlIty
139.50
$39.'0
'39.'0
Estimated COli S
Bu1l41.C PellIIl1 #
REA TING PEltMIt FEE
ST A tt SURCHAR.QE
TOTAL nRMlT n:1:
$
$_
,
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~~~
(<'~.
11ptNo. ......
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TIIII '\',pll_Uo. Bocom.. You ..lldln.'.....lt Who" Ap,,"'V~
hlll'lII OllcW
D...
WilE II \111 ~
I
g-
Z4 bour ..II.. for .11 ia.p..a... (952) 447-
FROM :FARMINGTON PLG & HTG
FAX NO. :6514637835
Aug. 23 2004 02:35PM Pi
CITY OF PRIOR LAKE PLUMDlNG PERMIT
Dale Rec'd
(Please tvDe or Driln JlId aim &.I: bottom)
ADDRESS
IS~SA
LJ~ h...k-
\...1
LEGAL DESCRIPTION (olli<< use only)
LOT BLOCK ADDITION
OWNER
(Name) 1'"";.. Co"",,-.! r '~L-\-;O"'---
APPUCANT I
(NlIlIIeL_~.rYY\i"ff4",^- ~l~ ~
(Address) ~I03 4 G~P",;;Q..)<.....
( )
(Comad Pcaoa) 'T),.. '" ).1; n.,.
APPLICANTSIGNAroRB ~ ~"Q \._~
(Addrels)
Q...ucy
~
I
I
4
I
I
I
"3
>+.!.
-d
It.. IL-
-
; ~ ~:~ [ PERMIT NO.1 L5'1 5 I
I V,11ow ApptleMll. l./"{ _
ZONING (om"u",) I
PID
(Phone)
(phone) &.~I-L/ (n ~.... 78).. U.
~~~t~~_ S50~~
(CitJY (Zip Code)
(PiIoae)
DATS
~-~~-o\j...
APPLICANT PLEASE COMPLETE BELOW
Estimated Cost $
Typeorr ~.: '" .
81th Tub With or Without &bower
DIshwasher
Floor brain
laVatory (Bathroom Sink)
Laundry Tray (1 or ~ compartment sink
ShoWOf' Stall
Sinks
BlI'Sink
Water Closet (Toilet)
Type of FIxture
I
I
I
I
I
I
I
I
QllaaUCY
"7,.
1
I,
I
Rough-Ins
Wa. Heater
Water Softner
Stand Pipe (Washing Machine)
Sewsll:c Bjector
Baclctiow Assemblv
Backflow Assembly rest
Lawn Sprinkler .
Other
FEE SCHEDULE
InduJIrlal. Commercial It MulU-funny I of Job..,. with I 539.50 minimum 1l;'Wcw One It rw...PamUy 599.50
Raldcnllal, Addk.... It A1_11olll S39.50
PL 0 PBRMlT FEE
S SURCHARGE
OTAL PERMIT FEE
, ~::'?iI
" ~~
i rA;~ ~~ ~o~r~~t~
I ()
--=sa
(0IIIn tile 00Ir1
nil AppIIcaClo. 1Ieco.... Y o.r a.Udl.. P_i1 WIll. ApPNyed
.
....... 0IIIdI1
DI"
14 ~lor ..tko lor IUIOIpectI... (lI51l"''''' ~. ru (952) "'.01145
. y-
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUll-DiNG AND INSPECTION
SITE ADDRESS l.S;~.5:;) u~ <:t;:..
NATURE OF WORK . N..v
USE OF BUILDING ~Fn
PERMIT NO. 04,0575 DATE ISSUED .fp-7-U C(
CONTRACTOR -r:- c. (' =A.J..k PHONE 95"'). '/t,j-3'l1? ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELO
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
, FOOTING
luc I 6~ l)
{..-~
r
SEWER I WATER I SEPTIC
-
FRAMING we. PJ:J
INSULATION ptJ
ELECTRICAL
PLUMBING rF ,t? 9_/ ~. 27
HEATING (if required) / ~ 7',; ~
FIREPLACE !:l" J I
GAS LINE AIR TEST ff/i k?Z 7 jtPV
. COVER NO WORK UNTIL ABOVE HAS BEEN ~IG~ED
, t.~ I ()L) 9-G I
g~/J1~f.J~S
GRADING (Prior to Sodding). . 7
BUILDING<To..rb S'I-oc:l~tJ I~ v><'
ELECTRICAL
PLUMBING /.Jc...
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
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.
t:,Pf//o/
-"/0
~
Vb
~
V1b
,-!; .0-,
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 15~ 5;(, Wa.&. \c)udL
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
Ii FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
DATE TIME
~
4- 5lJC
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
;~S",~AIR TST
J. t:;...O ~ rLt,\~\A7l_ /)1>1J'
/
, l, V./
,/ Vi
.'1S l::) ~
(\ It/-' /l V"
V /),'
o WORK SATISFACTORY, PROCEEO
J!'..CORRECT ACTION AND PROCEED
o CjlRR T RK, CALL FOR REINSPECTION BEFORE COVERING
Inspeeto : Owner/Contc
L 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
"""""
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
7..(;'Qj
i(;39- W~~tLt:- T.r-
CON";. T C C),//<!
tYI-51S-
CITY Of PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PHONE NO,
PERMIT NO.
o fOOTING
o fOUNDATION
o fRAMING
o INSULATION
~!NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING fiNAL
o MECH fiNAL
COMMENTS:
~/,c,ck - rJL
C 1/ Ii) }),,)1<' 19 e:..
X EXIGlOOi1l!ILLING
o COMPLAINT
o fiREPLACE RI
o fiREPLACE fiNAL
o GASLlNE AIR TST
o
SrI
\*ORK SATISFACTORY, PROCEED
o 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.
''''''''''
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 1535'~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
Ai. FINAL
C d'''sITE INSPECTION
SCHEDULED
LJ....'O ~~
,
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o 'PLUMBING FINAL
}lMECH FINAL
fl~
c/- 57<5
o EXlGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
). r...,J b~ i~~ ~ ~
(J~_ ~jJg;P
v~. ~~ ~7.r-~
~ iU'2.v J)/",,'tJ+l ~ /
tJ'(ff. _ ~ ~ l",~~ ~+a '1l$Q /I-n .?~IU,f*'
t., r- ,'lot. ~b1 01A I
~ ~J ~4Ft ~p '15:;. 'I'/7-18f/3
""t:I fl. ''It. ., I ~ ','(
~:-W- '
p~ f~ &~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
J.. CORRE:liCORK' CALL FOR REINsPECTION BEFORE COVERING
Inspector: Owner/Contr:
CAL .9 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE~IREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS /5352-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED /01- 2r,jof
{,~ 'C\dn
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
,;:e:.PLUMBING FINAL
o MECH FINAL
COM~ENTS. : _ ()
~"iJ ~ ,~
'2. L.Pf J~'r'" Uvu... TV
.3. tala" (\UIJfl<-1~~
L{ - 57:;-
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
4,l{7-'i~T&
o WORK SATISFACTORY. PROCEED
)(CORRECT ACTION AND PROCEED
o CORR7JicT. . CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CA 50 FOR THF NEXT INSPECTION 24 HOURS IN ADVANCE.
--. .
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNO"
Job Address
Heating Contractor
Name of Tester
Date
Percent 0
Percent CO2
Percent CO
Stack Temp.
I :)]5-';" ~:,JrJ"(k I'
Prl(j~ (cd>;!
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/1M rf
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