HomeMy WebLinkAboutBldg Permit 05-0344
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom
ADDITION
OWNER
(Name)
DeLI..'
(Address)
17tJ>) tvllb~i2'HT:'S';.
BUILDER
(Company ame)
(Contact Na
(Address)
Date Rec'd
L/_.;;L9-05'
White
Pink
Yellow
I PERMIT NO. 05'-, l' 'If I
File
City
Applicant
ZONING (office use)
d2
PID
8'70-~ '/-
(Phone)
,/1;2- <::/'7'0'- ~1'(J5~
ItrV ., '5' n c_
g"HI
1rZ f5&Y-iyo~~
'1c;-(:- 88"1- 610(..
<:;-<)-!',/20
50
ORK 0 New Construction DDeck OPorch ORe-Roofing
DAddition OAlteration DUtility Connection 0 Misc.
CODE: 'MI. .C. DI.B.C.
Type of (fans ction: I II III TV V A B
Occupancy G onp: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding ~el Finish
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
s- 6c:-, cz-'
I hereby certify th t 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 ownef or authOrized agent for the
ill conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
e, I ht'rf'hv ;lOrf'e Ihat the city official or a designee may enter upon the property 10 perform needed mspccti s.
:;;,;::::: . / 97"f' ,.. . ? ~
Contractor's License No. Date
x
Signature
Permit Valuat"on "2 000.00
Permit Fee $ (,Z -Z?;
Plan Check F e $
State Surchar e $ l ,,()
Penalty $
Plumbing Per it Fee $ /fti. (10
Mechanical P rmit Fee $
Sewer & Wat r Permit Fee $
Gas Fireplace Permit Fee $ f~. C-V
This Applicati n Becomes Your Building Pennit When Approved
~U
Buil in!!OHicial
I/z9h5""
Dak
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE tnut;;.7;> ". :z.~~(" f $ / f3. z.5"
Thls IS to certify t at thr n:quest 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 th City Planner conslltules a temporary Certificate of Zoning compliance and allows construction to commence. Before llccupancy, a Crmficatl' 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
LOT
OWNER
(Name)
(Address)
APPLICA T
(Name)
(Address)
(Contact P rson)
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blue File
2. Gold City
J Yellow Applicant
I PERMIT NO~ -,W~
ZONING (office use)
WI!.- >i"11..--I.A-"S S
It'lL.
ADDITION
PID 2') - ,7 ~ -01.4-0
(Phone)
(Phone) 9S2 179- "7 wi,
DATE s-: /0-05"
k: Hl'/Mi1fe-
f<.--~
rs-z- -Y2-5- 7ft-Ie.
~8'
(Zip Code)
(Phone)
~ "'" / ~"7<>' "--'
(City)
APPLICA T SIGNATURE
Quanti
(
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
Rough-ins
Water Heater t.~,,-,L
Water Softner fZ-l-k,.."-tr:
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
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 $ if fXJ <I. oC/
Building Permit #
0':; - 34L
\NV' '" \
.50 \'\J G
,
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
uilding Permit When Approved
I Paid
Date
I Receipt No.
By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
-
"'~~J CITY OF PRIOR LAKE Date Rec'd
~eJ~ E
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
.t,; tI
~lVlVE S
L Pink File I PERMIT NO. S- ~7f
2_Green City
(Please ""'e 0 3_ Yellow Applicant
f urint and sim at bottom)
ADDRESS ZONING (office use)
17035 WILDERNESS TRAIL
LEGAL D SCRIPTION (office use only)
LOT BOCK ADDITION PID
OWNER
(Name H hME ENHANCERS (Phone)
(Address)
APPLlCAI ~
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME (Phone) 651-633-2561
(Address) 2700 NORTH F AIRVIEW AVENUE ROSEVILLE 55113
(Address) (City) (Zip Code)
(Contact Pe \'son) BRENDA HUSTON (Phone) _651-633.2561
APPLICN T SIGNATURE BRENDA HUSTON DATE 51235
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE \1AKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWann Air Plants o Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
OVen!. System o Other Devices Setbacks
FIREPLAC MAKE AND MODEL HEAT N GLO 6000TRI-IPI
FEE SCHEDULE
Industrial, Co Inmercial & Multi-Family 1% of job cost Residential, Gas Fireplace $39.50
Residential, 1- $39.50 minimum
eating & Ale (New Construction) $99.50 Residential, Additions & Alterations $39.50
Residential: l- eating Only (New Construction) $64.50 Residential, AC Only $39.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PE FEE
r
RMIT
$
(Office Use 0, y)
This Appl cation Becomes Your Building Permit When Approved
Paid
Receipt No.
Du Idin!!: Official
Date
By
Date
l______
24 hour notice for all inspections (952) 447-9850, fax (952) 4474245
~ I.
~ -
Residential Building Permit Checklist
Baseme:J.t Finish or Inte:-ior ~.iJter:ltion to Sin"'le Family Homes
" .
Y: ~' Mp Dale: [/- [2CJ--S-
Building Permit 'i Pill: Zoaing:
jiteAddress /-'/tJ3S- 'l//c/dC~~A. ~ r-
/r
...-- ~
Legal: L B Subdivision:
~.risting srruc:ure@ or NO
K:;ONFORlvIS TO ZONING Y"ES NO
b RD INA..L'l" CE
r YES NO
~ this an ~xpansion of cb.e e7isting footpTwc ar Rete:- ~o Plamllilg
wIding height') ,va
:.s tile propert"jlocated within tile flood p laiJ::') I Refe:- to Flawing I
100
)Joes the alteration include any additional ~c:ccher:s? I Ref=: to Plar.ning I
PO
pees the pro-pose:i alte:ation inclu.de any outSide' I Refe: to Phn~~g
ptr'..Ilces otile:- tha:: patio doors? tJO
I
s tte proposed use of ::he fu:.ished ~ac~ or Ref~:o PlaI'l""~""g
alt~rian for a..""1y-rhiI:g ocher than 3. not:nal single No
farn.il~1 home (ace::, g:r:lt.l? ceme. Cay C2I~. ~~c.)?
THIS CRECG..1ST MUST BE COMJ'LE"TED-,,'Il) [J'lCl.1.iDED [J'l TRE B~lLD[NG PERLVIIT FUE TO
'IlAll'IT .UN .-\. R.E C 0 R.D 0 F THE R.E VIEw,
;] IC(
lOR LAKE
I SPECTION RECORD
SITEADDRESS .J,015 1A);L~~
NAT REOFWORK ~f:'&,.. Fi~ fH
USE F BUILDING .5.~ .
PER IT NO. ~ DATE ISSUED ~
CON RACTOR ... ~ PHONE. · Ole
NOT : THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPEC1'OA
FINALS
DATE
OCCUPY UNTIL ABOVE HAS
NOTIGE
This card must be posted near an eiectrlQII. Servlca cabinet prior to rough-In Inspections
and maintained until ail inspections have been approved. On buildings and additions
r--::=~::;;:~::);;:~~
DATE TIME
L~S-
/ 70.]>s- U./-/~~ ediJ' 7/1
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.,JI FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
;!-1~ (/
.
S-..?y~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
C)j~
ORK SATISFACTORY, PR
o CORRECT ACTION AND PROCEED
o CORRECT F EINSPECTION BEFORE COVERING
Inspector.
OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
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