HomeMy WebLinkAboutBldg Permit 05-0766
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~n at bottom)
ADDRESS
(}1y50 \)DbcrJ'fA\'\
LEGAL DESCRIPTION (office use only)
LOT L/ BLOCK I ADDITION
I
Date Rec'd
I While
Pink
3 Yellow
e/~5
I PERMIT NO.tlS- 'ltoc:" I
File
Cily
ApplicRnl
ZONING (office use)
()J fi& d;;;1L
OWNER
(Name)
t\ln ~
J.:x.qJ
t; E"";~, In'Y\~~er
&bCIl--Y In,t\
~~~~~:Name)~ (t"lYl5+rc<+ww\ (Drv1~3
(Contact Name) ~Y\ ,\'h+dl\L"'f~~~ft"F"'i'1 I(~
(Address)t.16LJt1 A ~1\1)")r h Dr ~ IACt
oJ ' (j ~-
TYPE OF WORK 0 New Construction ODeck DPorch ORe-Roofmg ORe-Siding Lower Level Finish
rk OAddition DAlteration DUtility Connection
D o Misr
CODE: I.R.C. I.B.C.
Type of Constmction:
Occupancy Group:
Division:
(Address)
A
B
I
E
A
R
5
(Phone)
PID 8f;),-tJo'-/
I
Q5;l.- L/Dd-.-b /3;;2.
II
F
I
III IV
H I
2 3
V
M
4
(Phone) f,,11-&fJ.c!} -14.3%
M ~PhOne) 'ts:J..- ;J.q;)- 55"1:l
o Fireplace
B
S V
PROJECT COST/VALVE $
(excluding land)
lrnished inf matia n this application which is to the best of my knowledge true and correct. I also certify that I am the owner Of authonzed agent for the
d that all onstr ti( will conform to all rxisting stale and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
I or ISI c 1St' u crmore, 1 hereby agree that the Clty official or a designee may enter upon the property to perform necded mspectlOns.
,. j,64S0f7;1 1{-9:-CS
Contractor's License No. _ Date
x
f
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
1( t?a::J. -
" ,?Z,o.
-
..2- 00-
#tJ. -
$"17. c..-
This Application Becomes Your Building Pennit When Approved
~~4-,f/1l. --
- Bllildl'll.!!.Otlil,,;wl
~~hS-
Date
Park Support Fee # $ I
SAC # $ I
Water Meter Size 5/8"; 1"; $ I
Pressure Reducer $ I
Sewer/Water Connection Fee # $ I
Water Tower Fee # $ I
Builder's Deposit $ I
Other $ I
TOTAL DVE tfAt.-t..{;b e./I. oS" I $ /& 9. Z5 I
/7 quI" 7
Paid /~ 1- 25' 17"
Date <;-/J:,r
ThIS IS 10 certity that the request in the above application and accompanying documents is in accordance with the City loning Ordinance and milY proceed as requcstcd ThiS document
when signed by the City Planner constitutes a temporary Certificate of loning compliance and allows construction to commence Before occupancy, a Certificatc of Occupancy must be
issued
Planning Director
Date
24 hOllr 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 Permit Checklist
Baseme:lI Finish or lmerior .>Jtcration to .sin.,.le Family Homes
" .
BY:#~
Building Permit ;;
Site Address
Pill:
~f5o
LegCll: L
B
EIisting .sCnIcrure~ NO
COL'fFORLyIS TO ZONING
ORDINAJ.'1CE
Is this an ~xpar:sion or d:e e:ci~....ng rooq:r.nc or
building height?
I Is cho proper:y located mchin che flood piain?
I Does ~':e alre:-ation Lnc:ude my additional lcrche::s?
Does the pro-posed altera-c.cn inch.:.de any outSide-
e::=c,s oche: than patio doors?
Is the proposed. l.lSe or;:he 5::isned. spac~ or
alte::lr:o'C, for anyd:ing Q(b.~ man 1 no-w:al single
F'~ .""'\ 1 .. ( ,..~ ... 1 -- .. -1~~ c'1"''' ~"c \,'
I ~':J-.::nlf Coon:", o c...C... , group ucc,,,,,,~.r __,._.j
<6-f~~
m bC~-+Zo;J~
Dale:
.subdivision:
):""E S
NO
YES
NO
Refer ~o Plan:r.~~g
v---
Refer co Plar.ning
v
V
Refu tQ Plar.ning
Refe: m Pl~~""~g
v
Re:~e::o Pla....,.....;~g
~
TE1S CBICKUST ~lUST BE COMl'LETED Aim INC1.UDED IN TBI B81LDIT'iG PSRlyl1T FlLE TO
MAlNT..lJN A RECORD 01' THE REv1'EW,
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1""".l:::llrl:::Jl
CITY OF PRIOR LAKE
HEA TING/AIR CONDmONING/FIREPLACE PERMIT
Date Rec'd
(!'l=e rvr>e 0< ori1lL and siJm otbolll>al)
ADDRESS
-
;: iI...... ~~~ I PERMIT NO.c,. _ ...., L... /i
3. YeDlP'M AllllJAfinl ""-"', vW
"d.8S0
DC) b C-Q.T /r-u.; (
ZONING (ollia: tUc)
LEGAL DESCRIPTION (otlle. Ulle oaly)
LOT
BLOCK
ADDITION
I
PID
OWNER
(Name) .
(AddIes.)
-:r? X
-
(Phone)
i
.
I
APPUC~ If) I Q
(Name) (...,'HI",r-,,> "lJ:lcic:.0 ut)~f:>k\
(AddteSS) t.,? 4 0 ~ Ib-""tt\ ,4 {.)C"n () ~
1'-. ~ /'"0" I (Addro,,)
(Contact Person) U" / ,
APPLICANT SlGNATURE ~",.....,~
(phone)
(phone)
P 1'1 f11()J-I-""
(etty) (Zip Code)
7b3-bYC/-<fl/"3
~/dS/6 s"
s-,Sf<f I
/'t.A..-l1'I.
, /
: APPLICANT PLEASE COMPLETE BELOW
~NEW COl':lSTRUCTION Q REPLACEMENT 0 AI.:tERATIONS
FUIlNACEw.;f(l<DMODEL I (P~1../ D V p~ FUEL /.Ject
FLUE SIZE 7 RETURN OPENINGS rnPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWannAIrP!anlS 0 Steam
OGnovity 0 Hot W=
o Mechanl~l 0 Radialion
DAir Conditioning 0 Special !Xvi...
OVen!. SYStem 0 Other Oovlces
DATE
FLEASE NOTE;
Air Conditioner Units
Cannot Encroach intO
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Residentilll, Heating & Ale (New Comtruetion)
Residential. Heatipg Onl)' (New Con!tru.ctioo)
FEESClIEDULE
1% of Job cost R..iclonlia~ Gas Fireplace
539.50 mioimum
599.'0 R..ideotial, Acldifions & Altet'8l.ion.
564.50 Resldellllal, AC Only
539.50
Jndusrrlel, Cnmm<rciaI & Mnlti-Family
53950
$39.50
Estimated Cost S / D(') f') ",'/9
Bulldlllg Permit /I
REA TINO P'ERl\IfiT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.5~AID WITH
t:SUILuING PERMIT
(Office Us< Ooly)
Buildiog om~1
I Palcl
I Date
DOl<
24 "our nolie_ Cor aU iDspec:tioos (952) 447-9850, fax (952) 4474245
f..c"",^1i'.._,.. .....__.,. .~, -. - - - -- -.
I RJoooipt No.
I By
err
TOTRL P.01
Tbi! Appllcation Be.ome, Your llullding Pormit Wbo.. Approved
1001fJ
li.1ddl1S S1I3a1Iila Sll:MJ1~
L880CSSC9L XVd Sl:80 SO/S./80
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
APPLICANT Ll rJ ,-,-,,;,,{
(Name) ;r-t'ci14< r'/b~', , (Phone) 'I'J.-7.- - 7 <J '2._ - go'?1
(Address) 15CJ3S- c;.t:€f"'- 4....-i ~v/'b~...lf. Ai,u. (,)cn... I
(Address)1 '(City)/ (Zip Code)
(Contact Person) 1< tLi/-tc' Go.er:'y;/ S<'>-h, (Phone) S-O/-73Y-7;J/O
1/) #' /? . / -- ,/
APPLICANT SIGNATURE. K ?.....Lf:..d~-z-.. -" -' =-, DATE @//r;/O,
0/
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
q?lease tvpe or'Drint and siRn at bottom)
ADDRESS
;;.... B ~-c)
Be b c 4(~-I-
Tj,....
,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
Quantity
I
I
I
;:: ~:~ I PERMIT NO. ~.t:;"'- /]~ / I
3_ Yellow Appllcanl ri {I Co
ZONING (ollice use)
PID
(Phone)
Type of Fixture
Rough"ins
Water Heater
Water Softner
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 $
Building Permit #
$
~/) A ~~~J
I~!)~~ P Receipt No.
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(omc. Use Only)
This Application Becomes Y onr Building Permit When Approved
Banding Official
Date
I Daie
By
24 hour notice for all Inspections (952) 447-9850, fax (952) 447-4245
16200 Eagl. Creek Ave., S,E., Prior Lake, MN 55372-1714
PRIOR LAKE
INSPECTIO
DEPARTMENT OF
BUILDING AND INSPECTION
RECORD
SITEAOORESS ~o .L';.u~~"" -1-,.,..
NATURE OF WORK ~ ~
USE OF BUILOIN~. .
PERM. IT NO. - -,,~ O~TF ISSUEO......,...s- -
CONTRACTOR r ~.". PHON
NOTE: THIS IS NOT A PERMITFOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
_CTOR
DATE
I
. I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FR MING
INSliJLATION
ELECTRICAL
PLUMBING V I-S ~
H~ING (If required) .
FIRipLACE (VIJ ~ -7'1
GA~ LINE AIR TEST f() Ilh 6- V
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
. .
lib
8~JJ-6<
tJiJ>
v
1
I
I
o
IIJA'6
/'
BUI DING
ELECTRICAL
PLUMBING
H~NG
DO NOT
OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
'This card must be poatecI near an electrical aervice cabinet priDl' to rough-in inspections
and lIUIintllined until all inapections have been approvecl. On buildings and adclltions
where no '.'. J. cabinet Is _liable, canhhall be placed near lIUIin . '.'.
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED I D/*
ADDRESS
2BS/) ~n.l-
OWNER CONTR.
PHONE NO. PERMIT NO. c;- - 7 (..I.p
o FOOTING o PLUMElING RI o EXIGRADIFILLING
D FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~NSULATION o SEWER HOOKUP o FIREPLACE FINAL
FINAL o PLUMElING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: LL -+;"",\:1.-.
ut
+"
r.l~ ~~'/~~
~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORREC OR CALL FOR REINSPECTION ElEFORE COVERING
Inspector: .
Owner/Contr:
CA
R THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
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