HomeMy WebLinkAboutBldg Permit 05-0011
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
O~ PR/O
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(Please !VUe or 1 rint and siJm at bottom)
ADDRESS
I'll-Ie, 3
LEGAL DE' ;CRIPTION (office use only)
LOT/6 BLOCK I ADDITION
OWNER
(Name)
(Address)
BUILDER
(Company N Ime)
(Contact Nar ,e)
(Address)
White
Pink
Yellow
File
City
Applicant
I PERMIT NO~OC::> II
~~ctJ /10u,
Date Rec' d
ZONING (office use)
)< .;;L,
lid
Plo,(S- (/tJl- OIO-J
(Phone)
C' 0 V\ c,+. (Phone) '1,s-;).. - ~ C / '-.;l.?Y9'
(Ph~;er-'J t, -:; - .?O? '/
J-J (' 'C# ~ Ia s 4.-, {"" M. LA. c.-e;- r'\ RR
B
S U
ORe-Siding ~Lower Le,vel Finish
BCi.-t::h
PROJECT COST IV ALUE S
(excluding land)
12tJtJ-0'~
V ~ ~ \ J- fUo- ~ ~ y. ~+~ ~e~
Ll!ij,::? neLr.c.~; Id f\(' s f;'
~ f) r-\-e..r t" e.,.ei(..
Q ^ >1. l-J--c,,- ~" ....."
;Z~ ,,~ ~ CA v'\. 0. ~
TYPE OF W ORK 0 New Construction DDeck DPorch ORe-Roofing
DAddition DAlteration DUtility Connection D Mise.
CODE: Mi.',c. DI.B.c.
Type of ~nstpIction:
Occupancy Gnup: A B
Division:
I
E
IIIIVVA
HIM R
2 3 4 5
o Fireplace
--
/00(j.
I hereby certifY tha I have furnished mformation 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-menlioned r :operry and that all constmction will conform to all existing state and local laws and will proceed in accordance with submitted plans_ I am aware that the building
;",1 "nrr';~ :~;.;\~~ "'" ,hot 'h, "ty ollie,,1 Ot, des"n" m,y ,nt" "pan th, ptop,ny '0 p"rOtm n"d'~'i;t;'o ~
Signature Contractor's License No I - Vate
Permit Valuati m
Permit Fee
Plan Check Fe,'
State Surchargl
Penalty
Plumbing Pern .it Fee tJo Nit-
Mechanical Pe mit Fee
Sewer & Wate: Permit Fee
Gas Fireplace' lennit Fee
II
F
1
$
$
$
$
$
$
$
$
It)i';t'),-
3l/, 7~
'00
litJ.-
-
Applicati( n Becomes Your Building Pennit When Approved
~ //3/05
Date
Park Support Fee
#
#
$
$
$
$
$
$
$
$
$
'l5-d~
SAC
Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other ".J-
L''-/] Ar1r r-
I TOTALDUE
#
#
Paid
Date
"7f7 -d'J ./
1- "3- 'j
Receipt No. hi )J{/t.(b
By /"'.?
U'
ThIS IS 10 certify thht 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 th9 City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
Issued ,
Planning Director
Date
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
Residential Building Perm.it Checklist
Basemeut Finish or Interior Alteration to Single Family Homes
JY:
~
--7 '/; A
~ Dare:
3uilding Permit ;#
,;i!e Address
Pill:
~eg:1J: L B
~:risting scrucrure@or NO
:::O!.'1-FORvIS TO ZONING
I}RDINAJ.'fCE
] s tiris an expansion of the exi~wg footprw! or
l uilding height?
I j l the property located within the flood ?lain?
I ] )oes the alteration include any additional :<lIchens?
1Ioes the proposed alteration iLc!\!de any outside
'ntrances other than patio doors?
I ~ the pro-posed use of the 5J1jshed S'92.ce or
~ Ite:-:1tion for anything ot.1.C ~.ha.."'l a nonnal :.:;ingle
h:c..iiy home (office, grou~ home, day C2.re, e::.)?
1- 3 -():)'
--~ II
{)!J
/7~ b 3-
Zoning:
L~~(r-dce ~
Subdivision:
Y-'E S
NO
YES
NO
Refe: to Plaril'J.L.,g
Refer to Pla.-w..mg
100
t--Jc
rJo
Refer to Planning
Refer to Planning
NO
Refer co Planning
tJD
Tms CmCKI.lST "rUST BE COMPUTED .'w'fD INCLUDED Ii'! THE BUILDfi'lG PERMIT FILE TO
(','_.\Ji'fT..lJi'! A RECORD OF THE REVIEW.
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.... #0."-
----- 1--------
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....
PRIOR LAKE
INSPECTION RECORD
SITE ,~DDRESS /?'1' 3 7) ~I ~"jcl! iJ)"...
NATURE OF WORK ~~
USE OF BUILDING 1= .
PERMIT NO.. · 00 J I DJ\T~ ISSUED ,/- ~ - 5' _
CONT 8ACTOR p1J..lJ-e I' '-~ I<. PHo*/.;I. 7(. ~ '1fL~?
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
ft~~
FRA~lING
INSU _ATION
ELEC TRICAL
PLUP,IBING
HEA ING (if required)
A/U
'/
#t':fA
,HC-Lt-
0/ /;s--
/ / /~f5~
'1/4/4r-
/~//t?<)
.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
_ft
/~
BUlL[ liNG
ELEC'rRICAL
PLUMIBING
HEATING
,
,Zf 2/&S";
t'/z.ylaS~
~ j/ jGJS'
...2 /2/~-
, ,
BEEN SIGNED
/lP'I
~
[10 NOT OCCUpy UNTIL ABOVE HAS
NOTICE
T~IS card must be posted near an electrical service cabinet prior to rough-in Inspections
a d maintained until all inspections have been approved. On buildings and additions
were no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/7YCl
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,...G-f'lflAL
o SITE INSPECTION
COMMENTS;.
C/<P ,.. rr; Cc;. (
//kc4~
/'
/;.' I
1~~Cf (
-
DATE TIME
SCHEDULED ;2/ ~ ~
/J I J
Ceerf;~/L /JV
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ECH FINAL
CJ.5-- / /"
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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h h.,. /" Ck?1-L1"
~/
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y)!
L./ i-'-
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4~
............
(~ /,1)
/6^5e ~r
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~, :A':L i.2'-REINSPECTION BEFORE COVERING
Inspector: I~ -- Owner/Conlr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
lNSI<On
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please '!vpe ~ r nrint and sim at bottom)
ADDRES~ .
]. Blue File I PERMIT NO V
'Gold C;~ .~c.--()()J
], Yellow Applicant l/-.:T /
IlliG '7
.
000-1 0~ 0/
ZONING (oflice use)
LEGAL DESCRIPTION (office use only)
LOT
3LOCK
ADDITION
PID
OWNER
(Name)
t
fll; 1/ ~
/l Yt3
<;trJz.<>r
?~ 1../1 ) '/7 f1- ~rI-
(Act;;'ss)
De-rr....-r"'v.
?!_~
J'
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
tv ';'1"",\ <) ..Jottg. ~
/)Q(>.( ~i-..Jl ,or.
(Phone)
(Address)
PUn L..L. y'J1r-.
APPLICA 1fT
(Name)
fJ Jw.L
l.1J::
(Phone)
d 9"0 L/ft'7 ~.;)S-
9v~r1+- G37r
, (Zip Code)
-?/J- yt-t! '-/)3 j
7"J;;A./ ;)-eJ~C-
(Address)
tv..." 51-
(City)
(Contact P, :rson)
(Phone)
~
, - '------Y
DATE
APPLICA,IfT SIGNATURE
Quantit I
I
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential. New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
BJ lilding Omcial
Date
I Paid
I Date
,&1B\lJ
1,1) -O~
Receipt No.
(Offiee Use Oily)
This App lication Becomes Your Building Permit When Approved
24 hour notiee Cor all inspeetions (952) 447-9850, Cax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
BY