HomeMy WebLinkAboutBldg Permit 01-0768
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
1- ~O-Ol
(!.'lease tvoe or 1) 'int and sign at bottom)
ADDRESS
t!163 /f;Killih,F7i: ~ E
L Whi<, FII, I PERMIT NO.
2. Pink City
J. Yellow Applicanl
()1-(J1r.,~
ZONING (office use)
,1(/
LEGAL Dm CRIPTION (office use only)
LOT q BIOCK;).. ADDITION W:rJJDI1'M
OWNER -:;; r L
(Name) ----"0" IC]:T""
.v Gr,-h- he.n.JbrK~
/lmdtl"I1J If: ~.f,.; DClfY I--llKt.J
PID Z5J.3?k; -01'1 - 0
(fA!) {.C:;I- ?,:;,r:; - (.LID
(p~ne) ~I)- q30~
fY\k L.5~ ~ 'lQ?
(Address) '!~ ~~
BUILDER
(Namp\ St I{-
(Contact Nan Ie)
(Address)
(Phone)
(Phone)
TYPE OF W)RK
o New Construction
~Lower Level Finish
DDeck
IlJ Fireplace
DForch
DAddition
ORe-Roofing
ORe-Siding
DAlteration
DUtility Connection
o Misc.
PROJECTCOST/VALUE (excluding land) $ /.<;:000
I hereby certify t tat 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
;ter upon the Y' 'y"', to M needed inspections. "1 /i.,lm
~f Signature Contractor's License No. Date
I Permit Valuatic n 3.000 . 00 I Park Support Fee # $
I Permit Fee $ 7~_75 I SAC # $
I Plan Check Fe< $ I Water Meter Size 5/8"j 1"; $
I State Surchargf I $ /.50 I Pressure Reducer $
I Penalty I $ I Sewer/Water Connection Fee # $
I Plumbing Pern it Fee I $ 4-(). 0 0 I Water Tower Fee # $
! Mechanical Pel mit Fee I $ I Builder's Deposit $
I Sewer & Water Permit Fee I $ I Other .n./...; ~I 1$
I Gas Fireplace I ermit Fee I $ 4-d. d7J I TOTAL DUE ~ JJ.J.P:. p' v, 1$ /...5fD. Z5
. ,A_
ThiS~'B (~es I I
B. ding p;Z7roved I Paid Ie; ,-. 2-" ReceiPt No. 4--0 I In-
I Date 7 (z-,,>Io( Bv I!.-f)H
Building )fficial Dae
This is to certify th2 the request in the above application and accompanying documents is in accordance with the City Zoning Ordin-wce and may proceed as requested. This document
when signed by the :ity Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
: 'Ianning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3, Yellow Applicant
I PERMIT NO.()J~
I
I ZONING (office use) I
(Please type or print and SiWl at bottom)
. ADDRESS
~ {b~Af IR.
c;::_ E Vp(\Y'
,
l Q kc> -----'!1rJ
LEGAL DI SCRIPTION (office use only)
LOT q I LOCK,;;? ADDITION WTl\JT)C"TAR
PID
(Phone/qS;:;) \4JD -q-z,Otp
, \:- ~
(AddresstJ: JtPS e()(\(htlfL017 c: J. j funr I G 1'R, mAl
~~;;~~~ tee: ~ Gi"-.*" ~ ~(1(1L" (PhOne)~ L/LJr;-(1301['
(Address) ~~t02., ~r\l/ifJl\I(-. (3-, t>(2\\)Ll.ok& SS~~
(Address) -4 (CitY) (Zip Code)
(Contact Pe :son) ~ W ~t1('\ (PhOne)~Q ') t./4{)~q ?-,o/"
~ J ~
APPLICAI'T SIGNATURE 4Ittf1l- DATE 7- /q-()/
OWNER-r'" rc /" ~ \/.
(Name) <..,'1/?1T :. ("'5(('6TC.,\\HJ -VA-R~"
I
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Quanti!)
(
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial. I :ommercial & Multi-family 1% of job cost with a $39.50 minimum
Residential, New One & Two-Family ~~
Residential, Additions & Alterations 39.-
Estimated Cost $
1.500
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3'V;O
.50
'40_0"
.
ur Building Permit ~en fpproved
7/&-3,;;'/
) (Date/ '
Paid
. Receipt No.
Date
By
24 hODr notice for an inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. Pink
2_Green
3_ Yellow
~::y I PERMIT NO." 11011/-(/ I
Applicant I~
(Please !VDe 0: orint and sien at bottom)
ADDRESS
ZONING (officeu,,)
LEGAL D SCRIPTION (office use only)
LOT q ] lLOCK .z ADDITION w.rNlh T Prft.
PID
OWNER_ r::
(Name) ..../~ ........ t;rk('npr'I p/lrk's.
(Address) i. rt/{o:3 ftnd \JlfuJV c::.. E.
. J
fun\"" ~
,
(Phone{~5~ 1Jpjo -Q.2f"J(;
Qy. J <;. ':53 7..;(
~;;~~3j€-4' T" r ~dt QL ftgJ:.s.
(AddreSS)J!dto:2, ~-rf' <::.. ~__
(Address)
(Contact Pe rson) 'JE'+f' (1.lt"1::::s.
Md12L.-
(Phone)
(Phone) ~) '/t./O -c/=lf).-;,
prIor la.vp mJ h537a
(City)' (Zip Code)
(qS'>)1fI./O- '1.301.
DATE "'/Iqbl
APPLICM rT SIGNATURE
. ,
APPLICANT PLEASE COMPLETE BELOW
~ ~NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE I1AKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWann Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACJ: MAKE AND MODEL HC4l~ '/II GI. 5L 750 TRL
Industrial. Co nmercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
~
$39.50
$39.50
Residential, J-: eating & Ale (New Construction)
Residential, I- eating Only (New Construction)
Estimated Cost $ ~<DO
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3'1- 5'0
.50
1/().fX)
(Office lJse 0, Iy)
,
ecomes Your Building permitrhen/pproved
7 Ii... jor
/ Date'
I Paid
I Date
Receipt No.
By
24 honf notice fOf all inspections (952) 447-9850, fax (952) 447-4245
U-.J... U...>...> voo':o
I:...l\,I:,oJ.i.....,I:, ....UN~L:.l\
HEATING/AIR CONDmONlNGIFIREPLACE PERMIT
If'.... "'J ~ ","tinl and olm ""_
ADDIrr ~S
Wb5 1dn~(J~
~o-'/ ...0:-
.
LEGAL DESCRlPI10N (__..ly~
WT0 BLOCK .:) Au.......ON, {, / ~ I /YId ~
~=1t~'1.~ ~r
(Add=)
APPLIC JIUIlT
(Namel ALLIED FIRESIDE D8A FIlU!:SlDE ~w..."'...
(Address I 2700 N. FAIRIrIEW AftXUF.
[Addrm)
BRENDA BOlt )
(Collta<:l Person) .
APPLICI\.NT SIGNATURE ~_ ~
y .
!=. 5....1 PERMu 1\oJ. /-t(,'i{
(Phone)
Z"",...h,1,.G(offil:e:1IIe)
p,(
PIDdS - 3:;1(" -0 (Cj /C
(Phone) 651-633-~1
Jl:>SE\7TT 17 IJ::: M1\1
(City)
(Phone) 651-633-2561
DATE
S..rz..11J
(Zi.p Code)
APPLICANT PLEASE COMPLETE BELOW
pw.W CONSTRucnON 0 REPlACEMENT 0 AI. TERATlONS
FURNA( E MAKE AND MODEL .. FUEL
FLUE Sr;';E RBTtJlN OPENINGS lNPI.JT OUTI'UT
TYPE OF ..1.....:...1: HEATING OR POWER PLANT
OWIl'IIlAirPl_ . gs....
B~:~-:.I '0:::=
OAir ConclllianiDJ 0 Spo:ibl om:.s
DVonL Sysbm f J 0 0IIl0r Dnlczo;
FllWLA CE MAKE AND MODIiJ. rf.J;4 iJ G.ta ~ 7.0'W_
--r
PLEASE NOTE:
Air Carll:litioncr Vnila
ClIIlDlIl EnCTO""h mm
Requim:! Side Yard
Setbedcs
FEES"",~:,..l/.1 ~J...E
Indostrial, :ommerclal & Multf-F..;Jr l%ol'jolICDSI Raidallill. Gas Flr~l.ce
S39.5l)mfni_
Re3id.nUaI, H..Ung Ii< Ale ~...c. . " . _,-...) S!l9.5D II _..:: _ .-..r. Additions 1/1; Al=ralion"
!lo:sidallilli. Hnling Only (Now (._" . ...-., S64.5D 11_;, _ :,,1. AC Only
Esti...- Cast S
HEATINO PERMlTFEE
STATE SURCHARGE
TOTALI'ERMlT liD
(om<< nor.' mlrl
nls Ap ~'iClt:l"n D_III"" VOJrr BaUdlnl: PII'IDII Wben A,,1'lWtlt
11.lldla, omd.J
Dolt
Z........n.d.dbralllo ,. ...
BlIiJdinG J'el'Jl);t #
$
$
$
.50.
Paid
DallO --;_ ~ /-0 I
..
CJ52) 447__. tllz 1'52) 447-4245
$39_~O
539.'0
$39.S0
PAID WITH
BUILDING PEr.:,.:-r
'--
Receipt No.
BYf/'
-_.._'-'~-----'--'_._--'-'-"-'-"."-"'-~-'-~-'---"-.-.-.-....-.---.... -'----'-'--'-""-'--
5~~
White - Building
Canary - Engineering
Pink - Planning
Th.. ("..nl. " orlh.. 1.lbCounl.,.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
N,AME OF APPLICANT
APPLICATION RECEIVED
PARK.S
1- 20 -01
I
n e Building, Engineering, and Planning Departments have reviewed the building permit
a~ plication for construction activity which is proposed at:
44(03 l=bNO V ISl!\1 -n::-
Ac cepted
~
Accepted With Corrections
Denied
Reviewed By: RDIf- Date:
Ccmments: eEA.O ~ \.-llW'Ae... (,P\!E;,L j:::INISH H--A~D6UI
"Tt Ie issuance or granting of a permit or approval of plans, specifications and
cOlnputations 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 suming to give authority to violate or cancel the provisions of this code or other
ore inances of the jurisdiction shall not be valid."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE A)DRESS 44-"'~ R,~n\Jr.e:.....J""t<l...
NATU~ OF WORK F,...,",,,, L...~levE-"" F.?
USE 0 BUILDING lZ-€-s A-/'z- : . .
PERMI NO. 0 I - 07&, X" DATE 'ISSUED '7/G-f k. I
CONT ACTOR ,-\~.r brze~lf...,..l 1='00'\4''> ~Sl ~.z~ ~ 1. \ \ 0
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
J
J
1-
1=~.rioito.Dackfill) I I
F'LACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
11--"""'" ii"r~ --nrl~
FRAPti liNG
INSUI.ATION
ELEC TRICAL
PLUPtiIBING J.i. Sf ~
r~ {Ib J/
HEATING (if required) (~7
FIREIfLACE ItJ;;.. rr I f'{ / () I
GAS LINE AIR TEST h ~ ~ 8'li f I/J /
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~~ I I
FINALS
Pr
i2,
It? -r
OCCUPY UNTIL ABOVE HAS
NOTICE
1[his 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
~ ,here no service cabinet is available, card shall be placed near main entrance.
.-.
BUlL ING
ELECTRICAL
PLU~ IBING
HEATING
DO NOT
~.
<?/II.//o J
rJ / {gIll r
j
If ~/() I
;'
II J... 0..J~ J
fl/<?ld}/o,},
BEEN SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
tll FINAL
b' SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
IV~ffol
tl:~o
L/~t, 3'
~cJ~
CONTR.
PERMIT NO.
Of - 7b?
o PLUMBING Rl
o MEcH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-~
"I WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ . Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl