HomeMy WebLinkAboutBldg Permit 04-0669
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please ~e or J rint and si2D at bottom)
ADDRESS
4-2.30
qlV"'ilNWOOO
LEGAL DE: :CRIPTION (office use only)
Date Rec'd
6 - L/-oLj
I White
2 Pink
J Yellow
File
City
Applicant
I PERMIT NO. 04-. o(pYfI
(!,./ teC-LAS
NC.
LOT4BLOCK 5 ADDITION ~J(!AINWOOO PI'I!e1<-
OWNER
(Name)
~'1 ~"4;"
lJJ::t.n (t..AI'... l.l~ r'}r
ZONING (omce use)
RISD
PID Z5. 034-. 003. () ,
(PhOne~\ 'Xo-.t~<;'
( GtS:;\ '1'10 - 3ib....
(Address)
$1..'", '-"').f' , m~,
BUILDER
(Company Name)
(Contact NaJ ne)
(Address)
~.
7
,
8t7.tQ1,~ ,p '-~
( ~ l.dd)~ \
'fJ1r'l (';',.,A/iU "JA<"r\ c:,...
(Phone)
(Phone)
Pr.'"rL",}~ . /11.,
TYPE OF ~ 'ORK ~New Construction DDeck DPorch ORe-Roofing ORe-Siding
~Additlon DAlteratlOn DUtility ConnectIOn 0 Misc.
CODE: DI. l.C. DI.B.c.
Type of Cons mction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
Lt'/:J) ')5()-1afB,/
DLower Level Finish
PROJECT COST IV ALUE $
(excluding land)
o Fireplace
I hereby certify It it 1 have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the ownef Of authonzt'd agent for the
above-mentIOned ~ropeny and that all construction will conform to all existing state and 10ca1laws and will proceed in accordance with submitted plans. I am aware that the building
offici,j con '~ ,S p'n~ fo~.con" Fnrth'.rmore. I h.~ebY agree that the city official or a designee may enter upon the property to perform needed Illspecti:ns.
X ,I:; '--" j ,__ _ , q,q 01/
.",...- ~-Sig~ature - Contractor's License No, . Date
Permit Valual ion
Permit Fee
't
." 179.t)(JI~ atJ I
$ )/S27. 50 I
$ 0/9 Z. fl? I
$ '~"t. So I
$ I
$
$
$
$
Plan Check F ,e
State Surchar ~e
Penalty
Plumbing Pel mit Fee
,
Mechanical rermit Fee
Sewer & Wal ~r Permit Fee
Gas Fireplao' Permit Fee
100,00
/0 0.00
3S. S" 0
.i!fJ,OO
This Applica' ion Becomes Your Building Pennit When Approved
::&u-~ ~
Bui din1!: Otl1cial
t,!t7/o"'/
, Date' .
I Park Support Fee
I SAC
I Water Meter rS:Ze ;/~ 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
/
Paid 4'1. (, IJQ,_3,y
Date 7. Z.()4-
$
$
$
$
$
$
$ f~oO,OO
$
$4/~~O_3f) I
i
I-
I Receilif No. 4-7JS7J I
By Ij . I
o
#
#
#
#
-
2-~o. 0 0
~~. 00
-
ThIS is 10 certify that the request in the aboye application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested This document
when signed by he City Plannef com\Jtutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate nf Occupancy must be
'",oed . 0- 1/ I /0':1
~ Planni .:L-J . bate
V
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
Special Conditions, if any
~~ PRIO.." <'
t ~'~
u . rn
While . Building
C!lnary . EnQineering
(" PInk - I'lannlng,,)
lhf (('nler If lhl' ".Ill' ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NJI ME OF APPLICANT
AF PLICATION RECEIVED
I
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Ths Building, Engineering, and Planning Departments have reviewed the building permit
ap Jlication for construction activity which is proposed at:
/ 'i
( (. '\ ..
/ /
-~,.r"..,._/
Ac cepted
./
Accepted With Corrections
DE,nied
RE ,viewed By:
~
'0-
Date:
7/1/04
,
C< lmments:
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,,- 'he issuance or granting of a permit or approval of plans, specifications and
c)mputations shall not be construed to be a permit for, or an approval of, any violation of
a,y of the provisions of this code or of any other ordinance of the jurisdiction. Permits
p -esuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
./
~~ PRIO>\, (
t ~'~
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~ Wn!tp . FlJ.lJ.IIlIntr--.
Canary - Engineering
Pink - Planning
--
Tht' (-..nt..r ~f tht' L.k.. ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NJl ME OF APPLlCANTkaM ~
, . / /
ARPLlCATION RECEIVED (:..:,- L(- 0"-1
Th ~ Building, Engineering, and Planning Departments have reviewed the building permit
,.,U~t;O" foe OO";;~;O'UF'~t ~
Ac ~epted Accepted With Corrections /
De nied
Reviewed By: _~ ;;~
;(P1WQ t1.ff ~ou1QJ.
t1U ;k- ~1"''''''~ ~ ~ -.Il ~
L~ ~ ~ ~ ~. (1__A.;_"./}
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Date:
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.
Co mments:
"T le 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
ary of the provisions of this code or of any other ordinance of the jurisdiction, Permits
pn lsuming to give authority to violate or cancel the provisions of this code or other
or,jinances of the jurisdiction shall not be valid."
CITY OF PRIOR LAKE Date Ree'd
HEATING/AIR CONDm,.iH.....~G$EPLACE PERMIT ~ ' Z.=, . (54-
~.V '
" ~~~ if H::. S-IPERMlT~O<l,.~,;1i
!P\we....'._lIDlhi....._" '
I AD~m b Y-/.flIj h l/V1Yr-L. Ci!2-.
,
, ,
I ZONJNG(.-..., I
~ I'ESCRJPTION (oJlicc....cmIy)
(Lor) BLOCK A.vJ.lluvN
PID
g;:~t~ -VIlA" (~~ (Ph~tP.1Z)J~r5~({2{~
, (Address)
:~~4bttdh (JJiiJoXjJ~i2d~F?a'Pt{~~li#;
'(COmaal'erson)~~hLitl~ (Pbone~I-~))
APPUCJ NT SlGNA'l'URB _ DATE
f' APPUCANT PLEASE COMPLETE BELOW
~- STRUCTION OREPLACEMENT; OALTERATION~. ,
FURNAC:! MAKE MODEL, '10-1 [( ,-I) . FtiEt. '",' '., \
FLUESlZE -RETURNvrGl.....GS '"'i INPtlT ~ OUTPUT 01) "
TYPE OF SYSTEM HEATING OR. POWEll PLANT
~. Wonn Air PIanls "J Slam
.my ]HOlW_
. caI , J RldiIliOD
CJAir CqodIdonIag J SpcelaI Devices
OVen\. Syswn J 0IIler Devices
flREt'LA ::E MAKE AND MODEL .J-.- ) \...p..,
PLEAS! MOTE;'
Air~Units
, C8mlot iluCi'Oilch into
RIqUind SicIC Yard
ScIbac:ks
FEE SCHEDULE
1 % of job cost Residential, Gu fircpla<o
539,'Ominirnum . --,~..
Residential, Heating'" Ale (N.... CO\\llNCdOll) C 599JjD, " Residential, Additions" AlnnIillDS
Residential Hcatins Only (New CollSlnlClion) $64,'0 Rooidcntial, AG Only
. fA CA~()O
Estimllll:d Cost $'"" -4~..W I, - Building Pennil #
HEATINGPERMlTFEE $ 9~..s-o
STAn: SURCHARGE' $ .50
TOTALPERMlTFD S-'-O"J.'Z!-,
':.':::-Y_--,:-" :~~J~L~ ~ ~o:f"
Z4 hour notic. for ,II i..po<tio.o (952) 447-I18Kr f.. (95:1) 447-4U5
\BY
Industrial, I ;c.....,...:.l '" Mulll-FlllIIily
S39.50
S39.'0
539,50
'.
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~J., ! t"~:::..,,~~
""-!."''''e ....,i....'
":}' '""....t;t
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Date Rec'd
(P. Z5. 04-
CITY OF PRIOR LAKE PLUMBING PERMIT
?: \}
C~e;
,V\
V"'r . ,.,,,,\C I. Blue File
\. \ r'r..>', 2 Gold City
\V \-r 3 Yellow Applicant
(Please type or pl int and sign at bottom)
Lfl~) ( ::'\ VA,\ Y1\NDrD G\ ~,
~ Dm CRIPTION (office use only)
I (LOT ) BLOCK ADDITION
'----"'"
~'::&.I~ \~hA~ (~(*,1AiI/
(Address)
I PERMIT NO,i-/.. i. c;f(
ZONING (office use)
PID
(Phon~lf41.J lSb- wm'
~;;~~A1\-\41Jv +\10\ ~ 17\0\ ., (PhOn~ ~n-;~TI:l-
(AddreSS)\U,?-\1f) ~^\~IArl12G, t:tlfJY la'ye. ~~~lDt
(\ (Address) (City) (Zip Code)
(Contact Per ion) 0) \;\<::Ui.1I1 Sr J1 L-i V1 \L (PhOne)~W,- 5A?C) ,
APPLlCANr SIGNATURE DATE
I Quantity
II wk,,1 pc. ,,\
I
I
I
I
I
I
I
I
APPLICANT PLEASE COMPLETE BELOW
Type of Fixtnre Qnantity
Bath Tub with or without shower I
Dishwasher \
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
~ @'fQ ~l'inks
. Bar Sink
I r Water Closet (Toilet)
r
FEE SCHEDULE
Industrial. I :ommercial & Multi-family 1 % of job cost with a $39.50 minimum
Estimated Cost $~I
Type of Fixture
\
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
I Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
Residential, New One & TWO-Fami~
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use OJ Ily)
This App ieation Becomes Your Building Permit When Approved
D' Iii ding Official
Date
$ q::;. SO
$ ,50
$~.~
I Paid
l Date
Receipt No.
By
24 hour uotice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, M,N 55372-1714
AUG-09-2004 07:11 PM STAR PLUMBING & EXCa
952 aS4 7468
P.01
_. Nt
YIWIW . ""LICMr
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.
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
S.W.No. (')4, O~(P7
NOTE: Sewer and Water
contractors must
be registered
with the City,
IPPLICANT: S~ ffi
~~,
1.
FILL IN THE BLANKS
Estimated length of water service (~
I',
size of water service inch(es).
Location of any couplings from structure
feet.
:2 .
3.
feet,
4. Type of sewer pipe. ABS PVC~ Cast Iron
5. Estimated length of sewer line (~d feet.
6. Clean out (if required), located at
structure.
feet
from
==~=====~=~=======================================================
T,lis application becomes your permit when approved.
BUll PA;D V!m1
IJ.DING ~..
......"
~~@~DW~~
till AUG 1 1 2004 ~
By
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
8,3 I. c4--
(Flease typ~ or ~ !'int and si~ at bottom)
ADDRESS
t..fz :~D ~afl-ft,JVJ(J(JjJ
;~: ~:~ I PERl'UT NU. 04-. 0/-1-0 j
J. Yello.... Applic.nt lPUI'l
C IRe. L.E....
ZONING (office use)
12150
LEGAL DE: ;CRlPTION (office use only)
LOT
B.OCK
ADDITION
PID u: 0$4-.003 ,0
OWNER
(Name) Jlo'l.J- MJt.{L'f
13EA l.lVIITS
(Phone) b /2. - 7Sb - fa 'oS</-
(Address)
APPLICAN~
(Name) MA"rnte.uJ D/HlIl.L5 .JA..JL.-- (Phone) b~{ - '-1'2..3 - 3730
(Address) _t5J- 30 CIt-ft.t.w..C,'LL Wit'( f2c.<'''zI.MJulo,rr:- /"ll0 S)O(;,K
(Address) (City) (Zip Code)
J1...rrl.Jl. Tl>N. (Phone)' fn q - '-I 7.3 - !?t"3c
iI!..(!lY/--t;b W DATE ?h%r.f
/ / ,
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Draip
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Contact Per :on) OAo-J
APPLICANf SIGNATURE
Quantity
.?
I
1
3
{
(
I
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
I Lawn Sprinkler
Other
/
I
I
3
This Appl cation Becomes Your Building Permit When Approved
FEE SCHEDULE
Industrial. ( ommercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50 \J
Residential. Additions & Alterations $39.50 a;,
Estimated Cost $ Building Permit # o"".o(,~9 \) V tz.
PLUMBING PERMIT FEE $ \ 1'1,s-~~ ,nt\\r.t,
STATE SURCHARGE $ ~~;.....~' \ V\P
I TOTALPERMITFEE $ /.............../~.no 't>~1;i
rPai~
I Date9, 1.04-'
Recei~
By
~
/
(Office Use On y)
Bui Iding Official
Date
14 hour notice for all inspections (951) 447-9850, fax (951) 447-4145
,
PRI,OR LAKE
INSPECTION RECORD
SITE A JDRESS ---1.ut> SteA.l J! AM~1) e;~e- P. G: .
NATURE OF WORK NS~ CJ>.~'c.('nC\~ I ~oiJT7fJ~
USE 0 = BUILDING ~. . .
PERMI r NO. f2.4-. O(e~? DATE ISSUED r. f '''/iJ''
CONTRACTOR ~A.UJlAir PHONEk!Z..?$().""sr
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDIN~' AND INSPECTION
INSPECTOR
/,\" pJJ 1)-
I FOUNDATION (Prior to Backfill) I fit?' 7-~
FLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS " , ,.
~ 7P!!~'i
typ / tf -'" /
if'#? /CJ/~ 1 / ~
,{fj
DATE
I FOOT ING
Wu
SEWE:R I WATER I SEPTIC
FRAN ING
INSUI.ATION
ELEC TRICAL
PLUN BING
HEAT ING (if required)
FIREF ILACE
~$r~~Rre~ I
, COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
llATJ '.&..jtJIl.rUAfl:) ~ I I
t FINALS
GRA ING (Prior to Soddin.g) ;1! I> ,':) /J
BUlL ING I~ J.o 5:"j-oo . i.fD
ELEC TRICAL f
PLm IBING
HEAliNG
)0 NOT OCCUpy
A,Jc...
9.28
IO.'B
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Cfhn?
I I
PI! ~ 2/11 ~
f( f~ 12/ II Jt'b
UNTIL ABOVE HAS BEEN S(GNED
NOTICE
1 his card must be posted near an electrical service cabinet prior to rough-in inspections
a nd maintained until all inspections have been approved. On buildings and additions
v here no service cabinet is available, card shall be placed near main entrance.
, ~c..
FOR ALL INSPECTIONS (952) 447-9850
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The' ('C'nlrr <If lht tJkt Counlry
White - Building
~arv - EnQineerln])
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
Nfl ME OF APPLICANT
ARPLlCATION RECEIVED
k:), i I:~::,
I
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Th ~ Building, Engineering, and Planning Departments have reviewed the building permit
aplllication for construction activity.,which is proposed at,
, '-') ,,' I / j
t/j ~)( . "fJ/)/2/,),~)>CCd (i.~_j
/
ACI :epted
>\
Accepted With Corrections
De 1ied
Re (iewed By:
Ih4 trs
Date:
h ~,2 'I-Oil
Co Tlments: . See Reverse Side for Additional Information I
See Attachments: 1) Gradinl! Plan, 2) Erosion Control Measures
"Th e issuance or granting of a permit or approval of plans, specifications and
cOrlputations shall not be construed to be a permit for, or an approval of, any violation of
an~ of the provisions of this code or of any other ordinance of the jurisdiction. Permits
pre ;uming to give authority to violate or cancel the provisions of this code or other
ord nances of the jurisdiction shall not be valid,"
I.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS _f130 &('&I'......VOor/ C.'r-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
Gf'ttA-"'lf--.
DATE TIMe
)-;).'"/-()J
6Jf-t~,)
"'--E.~ LING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
.,{ WORK SATISFACTORY, PROCEED
, 0 "cORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
In.pectOr:~~ Owne,/Contr:
CALL, 447.P850 FOR, THE NI;XT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
,""",n
This Certificate issued pursuant to tM requireT1U!nts of Section 307 of the Unifonn Building Code
. certifying that at the time of issuance this structure was in compliance with the various ordi1UUlces of the
City of p;or Lake regulating building construction or use. For the following:
Use C1assificati.,.. ~,,,,<, I.. (0 .." \. \). L r~",)' Bldg, Penni. No t./ - (; (p iJ 't
u -.J
Occupancy Type .IF <; Type Conslrucoon N Fire Zone N l) Zoning District P, D
.,
LegaJDescription Lo'i<-/ ['{.xl. S C;,,,,,,^c,'ooc9 H"C
OwncrofBuilding f C~ \..1 lof( ell \)rt" S C\ilc Address I J.-.....-' ( ~" , ,i L
J
Qrtrfiflrate at OBrrnpaury
CITY OF PRIOR LAKE
mepattment of .uiIbing In'pettion
D.Final-Petmitted ~Conditional C,Q, Expires AVCjl,.,l- I
....
C
Contractor's Name" Addres. .:,c '^"-r
'-, 0vn'
1.[ ,I,)! I"., .' Vir)
/! Building Official'-, ,._._w__.'/
'] II / r-
(
'~ity Planner
, 1/
J(I " -f .I( (1 ((' f -eJ
-/II/cr~
Dale:
POST IN A CONSPICUOUS PLACE
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CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS ~l2so (?J;Q.htWbe1J
OWNER CONTR.
PHONE NO.
PERMIT NO.
~-D~
o FOOTING
o FOUNDATION
o FRAMING
~ ~SULATION
Z~~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
o GASUNE AIR TST
o
COMMENTS:
J,' .'\ ~ l .~ n I
O~ ~ ~t.' l,1J
/
~RK SATISFACTORY, PROCEED
o CORREC CTION AND PROCEED
o CORR CT , CALL FOR REINSPECTION BEFORE COVERING
Owne,/Contr:
Inspector.
-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
IN$NOTI
. ....... .---..', ......_...,.-._.~--~- ---"'-<" '.
Job Address 'f;lJ:l 6IJJ.A;oA IIIr1DcI
Heating Contractor
Name of Tester
Date
Cle8rwot8r Plumbing & Heating
.tf1*-
12 -11-11'1
f. f
1ft;
10fl'I"/
g(
Percent O2
Percent CO
Percent CO2
Stack Temp.
Combustion air is adequately supplied per
lIMC ~ ElM