HomeMy WebLinkAboutBldg Permit 04-0555
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
Main ~lle
c1-/~-df
I. White File
2. Pink City
3 . Yellow Applicant
I PERMIT NO. Of . 0555
(please type or print and sil!;ll. at bu..u~)
ADDRESS \ <l
\&10?A ',- Jf~ Y~L
ZONING (office use)
,,\
LEGAL DESCR.1J:'uON (office use only)
LOT I PJ BLOCK 2- ADDITION
OWNER
(Name)
~cJ c.,X <~j\-
PIDd;' -:B ~ ....O~ - C I
(Phone)
(Address)
-
~~~R ~II C-,:O \-\~ ' (phone) Q':5Z-. LUtt1, IoQOo
(Contact Name) <tf"f(\lh e hlrl \ r() D t-t>-- (phone) if> 12-- !Pes, 7,ZD1
(Address) :tt1W 1tLUN\\L<.-~\'vz;{1 ltL~lVlILL 0f\YL 6'5lN4-
J
TYPE OF WORK )&t New Construction
OLower Level Finish
o Misc. \ ,(L..Q., ~ ·
o Deck
OPorch
ORe-Roofing
ORe-Siding
o Fireplace OAddition OAlteration OUtility Connection
PROJECT COST/VALUE (exdudingland) $ ~3CCJ,~d.(). ~
I hereby certify that 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 fi 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. m awar~. the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city. Official, a designee may
;ter upon th r eiW to p:( .~ needed inspections. l~ 6A f I~ _ '-
/ Sign~ Contractor's License No. . Date ~
V f 1cture (J
I Permit Valuation ~ ~$(,/)tQIJ I Park Support Fee # $
- I -
I Permit Fee $ Igg-/,SO I SAC # $
I Plan Check Fee $ . IdtJ.-;).",C/ ~ Water Meter Size 5/8"; I"; $
I State Surcharge $ . II q. tJO Pressure Reducer $
I Penalty $ City SAC and WAC # $
r
I Plumbing Permit Fee $ I tJO,o() I Water Tower Fee # $
I Mechanical Permit Fee $ / ro (Jt) I Builder's Deposit $
I ~ewer & Water Permit Fee $ (35: 5"'0 I Other $
I Gas Fireplace Permit Fee $ L{ 0 ' 00 I TOTAL DUE $ ~ s 4- 3. qg
I
Receipt No. LIfo g itJ y'
By ~
(/'>
...
i 35'tJ. 00
asv, oC
L/S"cX)
I d- 00.00 I
. '7~,to I
l!lao, tJO
Building Official
14~
, Date
I Paid fh lj ,i ~ q!.~
I Date L-JL./-DU
. ,
This Application Becomes Your Building Permit When Approved
~~
This is to certify that 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 the City Planner constitutes a l~...>,u,..ry Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~ ~ U~/ar ~ ah ~~~:J
Planning Director Date Special C~;;S,~fany
24 hour notice for all inspections (952) 447-9850, tax (952) 44'74245
16200 Eagle Creek Avenue Prior Lake, MN 55372
/)
-
Main ~'[e
White - Bllilriin9
<-Ganarv - FnaineerliiCb
Pink - Planning
The' C..nl~r nfU,rl..ake("ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
/'
/' .
",/ //1 ..1
-NAME OF APPLICANT (./t)ilu;r ( l:t~t.
. . _.!.. ./-}.
APPLICATION RECEIVED Q -- /d~ oLI L/
" )"
r, I / '.'
A.I/.. )-',.'}>t<. ./" .--'
i\........'. .r, ,.-,....;.~--~
The Building, Engineermg, and.. Planning. Departments have reviewed the building permit
application for con~truction activit~_~.RichjSprop()sedat:
/5 -;;>;} n / ;! ,1 L/.,:, ..
~~- ..-; / ~'-R..A -f.:' /?~ ,""1 I fJ. A -'
. ,~. . / l ~J.' / i~~~r,,'t/\., I C:"--\L.---'
/, ;,-' /
t... ,_/ ..'
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
/'I'fJI;
Date:
S'- ::( S -ol./
Comments: See Reverse Side for Additional Information!
/!7cfl'n f, 'I(
See Attachments: 1) Grading Plan, 2) Erosion Control M:ea~ures
"The 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
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-1 or R-2 Districts
Reviewed by: .~ 7~f- Date: ro/z.~r
Building Permit # PID: Zoning:
Address:/ss'z,,' 1S'3'11) / Sf.J'.r" IS" Jj'S' ~ i"...,.J
18 lq ~;
Legal: L'J)II '2.., I B z.. Subdivision: . (Jo.R ~.
Existing Structure? YE~ Existing Nonconforming Structure? YES@!)
CONFORMS TO ZONING
ORDINANCE
YES
I Yard Setbacks: NA 1 FAILSf(10MPLlE~')
. Front Yard (can be 20' if aV!:I~WIIn 150')
. Side Yards
Standard
25'
10'/
25' if abutting a street
. Sidewall exceeding 50' requires additional side. 2"
setback for every l' over 50' in length
. Rear Yard
. Patio Door: provide for minimum 10' deck or sign
statement indicating no deck will be built in the future
. From 100 year flood elevation of wetland/N U RP
pond
. From OHW (Prior or Spring Lake)
10' setback +
2"/1' over 50'
25'
10' sidel
25' rear
30'
75' or setback average of
adjacent structures, but no
less than 50'
~ Floor Area Ratio: NAI FAILS(!bMP~
.30 Maximum
-
J Yard Encroachments: NAI FAILS)((OMPLI~
Eaves and Gutters no more than 2 feenn width and no
closer than 5 feet to a lot line (Easements),
AlC and other equipment cannot encroach on interior
side yards.
Standard
tIii'
I Tree Preservation{ N/() FAILS 1 COMPLIES
1. Total caliper inches
I. Permit 25% Removal
. Caliper Inches Removed
. Caliper Inches Preserved
I. Replacement
Standard
%:1
L:\TEMPLA TE\BLDGLIST.DOC
NO
Proposed
'3}. 2..'
P.tA Pu [). 20 '6f~
~.
31.0' <<t-~ ~
3),1{' ~
NO ,J e:-
33, '1 i tlIPL.
tJ~
I f!cA fc.c.D ~ ~4e"Q)
Proposed
~ -.J 6"
tJo,J f:'
Proposed
CITY OF PRlOR,UU:PL{JM8ING PERMIT
Date Ree'.
8. 5. 04-
~ tvDe or mint and sip at t . ",.....}
ADDRESS
vt:rrGeS
r'F/SS
/5.329
LEGAL DESCRIl" nON (office use only)
LOT
BLOCK
ADDmON
OWNER
(Name)
(Address)
APPLICANT ;/ / I'
(Name) ol3~1 J<).-. r /c..c.. "'-It? I ":"d-
(Address) ;J-,J. 'f $0 Jk H II- J ;......
(Address)
(Contact Person) H,-I:.~ (J/SJt..IET,^-.
APPLICANT SIGNATURE ~ O/~
I. Blue File
2. Gold City
J. Yellow Appliconl
I PERMIT NO.Of. ()55~
/VfV
ZONING (ollice use)
PID zr. .J"4. ~ rl. .,. 0
(Phone)
(phone) S67~ '-G.S--' dd-~ 1.
L- ~ S ~ t'-~ S'oS-S
(City) 1 _ (Zip Code)
C!,,<..1. ~u 7 - <t'- 9... () '" '"(.
(phone) 6"'07- "'~.. ;l-~ V'"S.
DATE -.S - 6'-oc.f
Quantity
.3
I
~
'-I
'/
I
I
(
3
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
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
I
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Offite Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit # ()+, a55r' flr.
$ ... pIllD O~
;" ./"""'- 50 e V J /.;
p~
Dat~ . 5. O'f'
~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E" Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
H.EA.ill iG/AIR CONDl1 lONING/FIREPLACE PERMIT
Date Rec'd
(Please type or print and sign at bottom)
. ADDRESS
~::' ~:~ I PERMIT NO~ I,~~
3. Yellow Applicant ~
15329 J.t,!'".t']:'~KS PASS
ZONING (office use)
LEGAL DESCRu.l.lON (office use only)
LOT BLOCK ADDffiON
PID
OWNER
(Name AUST CONSTRUCTION
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
(phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVJT .Tp'
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone)
651-633-2561
APPLICANT SIGNATURE
BR~NI)A HUSTON
DATE
10/18/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWann Air Plants 0 Steam
DGravity 0 Hot Water
o Mechanical 0 Radiation
DAir Conditioning 0 Special Devices
DVent. System 0 Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEAT N GLO 6000TRI-IPI X 2
Industrial, Commercial & Multi-Family
FEE S\,.;I1.EDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
rAW WIllI
.5OJJUlLDING
--'~'itdIDir~~L' '
, f~:e UCT 2 2 2004 !~r
~
(Omee Use Only)
This Application Becomes Your Building Permit When Approved
Buildine Omtial
Date
24 hour notice for all inspections (952) 447-98 lJyfax (952t+&7-42~ _ ...
_'''.'l'iI_,..,~..,._..._
.~
CITY OF PRIOR LAKE
UEAlll~G/AlR CONDII10NlNGIFIREPLACE PERMIT
Date Rec'd
~~ ~~ I PERMIT NO. 11_ ~-5~
3. YtIIDw ~ /..1' J
lJ'!!:ue ltPe or ~ aDd 5iltn at bottom)
ADDRESS
_,; S- ~ ). tt 'Ye~ e.r S PIfSS }..J t.....)
ZONING (of;6ce
U5e)
LEGAL DESCRll' llON (oHk.e use only)
LOT BLOCJ<
ADDmON
Pm
OWNER
(Name) # ~ c.u ~ j')
~t:>€(/e-R
(Phone)
(Address) I S- '3 ~ 'j
~ ~ +~~r,j PII-SS
,~
APPLICANT
(Name)-1LP.~ u .s
~J..' .... ~ (e IS fJW.-...I t. 4 -' t . (Phone) 7 (, ~ ~ y ~ ~ - J 722
c:J-
J?~~ L/V A.J u...) CfJO.v ffJPiJ;>S !>.)~J'.J
(Address) (City) (Zip Code)
(Contact Person) .l'e"., n __ ?r ~ ~ r (Pholle) 1 (.- ~ - 'i'" y 'J-/ ') R A
AFPUCANTSlGNATURE 0- ':;:>Lf~:~~ DATE / h :!:>.h !J-
~ ..
APPLICANT PLEASE COMPLETE BELOW' ,
(2JN:Ew CONSnUCTION 0 REPLACEMENT 0 ALTE.RA nONS
PURNACEMAKEANDMODEL ,- 8 ~A- FUEL ...4l.IJ-+.
FLIm SIZE ~ J' "V~ REruRN ur.eJ~GS ~ ~ /'{ xt... INPUT OUJPUT ..tE..., "Of)
TYPE Of SYSTEM HE 4-TING OR POWER PLANT
(Address) 0
. i:l~
OWann Air Plants
OGravity
)21 M~ical.
OAir Conditioning
DVent. System
f.lR.EPLACE MAKE AND MODEL ..
[J Steam
o Hot Water
[I RadiatioJ\
[j Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Unit<;
Cannot :Encroach into
Required Side Yard
Setbacks
Industrial, Commercial & Multi-Pamily
FEE Sl..n.r.DULE
1 % of job COSt Residential, Gas Fireplace
S39.S0 miftimum
$99.50
$64..50
$39.50
R.esidentiaJ. Hearing &: Ale (New Construction)
Residential, Healing Only (New ColUl1'UCti.on)
Residential, Additions &: Alterations
ResidentiaJ, AC Only
$30.50
$39.50
8l14o 1>No w...- _
1NG-;;'11
'l:lIl.frr
Estimated Cost $ BuiJding Pennjt "#_
HEATING PERMJT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE. $
.50
(Ol'lke VIe Oaly)
B.Udb.~ OIf'lCilll
~ rlf-l~ ~ U \,~ I iX
De~ _ ~"'AN ....5 2005
24 hour noti~ for .n iII.pediOlU (952) 447. M50, liax (952) 447....245
By _~~._..
I ~=pt No.
I
~J8Y
-.-J
This ApplicatioD Becomes Y ou.r BuDding Permit Whea Approved
...., <J.. ,'.. . j\. ......... v ~ n.~ 1,1.4'".... j .... 1."';
~!41 VC rn1U~ ~~AC
4IJUU.
Date Ree'd
CITY OF' PRIOR LAKE
SEWER AND WATER PERMIT
(l'kLSC M>C or orint ~ si.tD at bonom)
ADDRESS
J '5 '"?:; (). '1
~hrCU)()
I LEGAL DESCJUP110N (otl\et \IX CXIly)
! LOT (3BLOCK ~ ADDITION
F<eftJ C,~
I OWNER ~ D n r.-h, LL _ _ _
! eN ame) L.V\.Y.-l 'J<. '--"'"'""'\ _ n uy~
(Acldzess) (9 {;AO J...~ B luJ
(Addrenl
! APPLICANT 0 d /:;:-
j (Name) Q Cf ~ e;;< C u.JJ~
! (Address) Z 37~ W l(j~ Sfrfl 0 t
(Add.rm)
(Cont&c:t Pel'on> 3 e--..-....,,~ 1 ~' In~
I APPLICANTSIONATURE ~~. ~~
, , {. ,
~ ~:.. ~i~ I PERMIT N~ 6 ~~r~
l. C<lId lo"clCUll -~
ZONWG (oll'let ue) ...
PlD
(Phone)
~J.(>V( "/1('
(City)
ern -~ 9~95d'
~SZ) 1'7
(Zip Codl)
(Phone) So7 -7-ICf-- 5 0~ 0-
L OY\..s J-~ 6 D GJY;k
(City) (Zip Code)
(phone) '::'u 7 - 7 'y C( -D~ J
DATE ~-/~oy,
APPLICANT PLEASE COMPLETE BELOW
Size of water service -.!:t- inches,
Location of any couplings from structure - feet.
Type of sewer pipe, 0 ABC rarpVC 0 Cast Iron
Estimated length of sewer line ..s-Z:::>feet,
Clean out (if required) located at feet from structure.
FEE SCHEDULE
Residential sewer and water line oOMeotlon S3S.S0 Industrial. Corn 'I & Mvhi.family 1% of job cost with. $39.50 minimwn
Se.....er conneotion only $17.50 Water connection onl)' $17,50
~. .0
: ~O ~~~
$ ~.
~. ~ [; 0 ~.~ ~ ~iptNO, ~
, f'''JUN 1 b 2004 ~ - <::T-'
%4 hOllr notlc, for alllntp,ttion. (95%) 44"~9 ~~ fax (95%) 4~V"'14$ U
. ~ '. ,'"
Estimated Cost $
SEWER AND WATER PERMIT PEE
STATBSURCHARGE
TOTAL PERMIT FEE
tomce l:at Only)
,.
I Tbls Application Become. Your Bulldlni Permit When Apprond
I
I
I
BulldlDlornlll,1
Dale
Building Pennit N.. _.-..
~ ". . ,,~
'.(J\..... .41
I. .
. .
.,.
PRIOR LAKE
INSPECTION RECORD
IS3~9 VefEe.~& p~ss
-Jle.'~ ~
SFlJ
... 0 55 DATJ= ISSUED t . '1. ,4-
cIJ f V PHO~-,*' "-IS' , ~O.
NOTE: THIS IS NOT A PE IT FOR ANvtoF THE INSPECTIONS BELOW
THE ~ERMIT ~V SEPZTE DOCUMENTf) '^ ~ l_
~~ (f!} , INSPECTOR '12.P..JII...J.'PAL ~ \SYtf.W
I FOOTING ~~ ~~~ I I
.
FOUNDATION (Prior to Backfill) I (~(;I.r ~"*
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
. ~ YtA,f'I-$".:>~
,,~ /b../y
~ /t3..y
/~/~kv
" "
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
IIIR
GRADING (Prior to Sodding)
BUILDING -r ~ t tJ <;, - ( C:f()
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
~
--
UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in Inspections
and maintained until all Inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO.
CONTRACTOR
,.
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING u.; "'~ r6 't-tt,
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
"
., . ....
DEPARTMENT OF 1\6o;n pel
BUILDING AND INSPEc+WU 1 e
~ /O-J:l..
t?/$ ;~
L
..~~
~/f
1
fl. ~f. 4J
~
I _
1 '? / z,,/
,
FOR ALL INSPECTIONS (952) 447-9850
,..1'.'.,11,11'...'......,
..;..' ~..{" i;.:tl'.l';;,.;-L~;',::,'...;..~-:..;'.t,-/.~l~I-" a,..d~;:.j~.;.j;l~;i:ii"":':' '::~'l~''-~>''{{ i->,~"-','.~;;i;;-~~~~,;-;:~1\ L'~'&;;':,G..Jl~;h-. ,i,~l~.t;-:',,'..;~'~..;>:.:L.":'..:
~,~-;',;i.l-' ~~~~'~r.j;,~~0a:,::i-.;..~" '.,", i":L'
",..~
ADDRESS
J532'f ~
-J DATE
SCHEDULED , "Z L
~~
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
PHONE NO.
CONTR.
PERMIT NO. l./ - 05~
OWNER
o FOOTING 0 PLUMBING RI 0 EXIGRADlFILLING
o FOUNDATION 0 MECH RJ 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RJ
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL ~LUMBING FINAL ~ G~SJ.INE~ST
o SITE INSPECTION 0 MECH FINAL 0 M~
fllrcOIltllENTS: ,. , : . ;, :-
~1JI~("r.4t;;l..) 1't/ ~ ~2J
1, j'oyl(~-
~,' ... lvlA:b.]' ~J-
~. €;or:- 1\1\_ T{~ 4!:/!J- rm
~I. ~~~ ~.
o WORK SATISFACTORY, PROCEED
X COR:~" II AND PROCEED
o CORT~ R, CALL FOR REINSPECTION BEFORE COVERING
Inspectc r. Owner/Contr:
50 FOR THE NEXT INSPECTION '4 HOUR,S IN A~VA,NCE_
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETYI
INSNOn
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
1~3Atj J~ R,jS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: _
~~/(
Cc.AI~ ~;< - (J) /(.
DATE nUE
BJ<
4J~
Dl/-~!;:f-
~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ WORK SATISFACTORY. PROCEED
v D~RECT 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 & SAFETYI
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 153 '2CC
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
(, Fc'(,oa A
rr~
p
~TE nilE
SCHEDULED \.ct fJC
~ jJ~ Q~ .
CONTR.
PERMIT NO.
l( -i:;)~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
A
(~,./
./I
~~/
( r
4-0
9- [ ...o~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
)\ COR ,C LL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
INSNOTl
, .'......"
Main File
White - Building
~nary - Enaineering
. k . - Plannfri!:>
.. "".r'.
'$'
The renler of the Like Country
""" .
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
/" ....
NAME OF APPLICANT 60 d.cPj ( (I_lice X/O ;
APPLICATION RECEIVED 6 - I d'- Oil
... ,;/
;;,v-r
-
""I!' The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity ~hich is proposed at:
/5 '4i( I ~ ,~/ l_/>"-
. ,-,]"1 . /7-lJ-"k0 (-<'.44--
T ...
Accepted
Accepted With Corrections
/
.it-
Denied
BeviewedBy: ~ ~ Date: GI z,.~y
'-~omments: ~ ~~ -4Y<A~ ~.;).
J1~ ~ ~ ~A!_)~.'~,
, I C/ /I . . ' 17J. ~
e::J~ ~. ~ ~~ ~~ 'H-u:, () eo,~,
, '.,,'
"The 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
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
-
~ain File
<'tVhite - ~uild~
Canary - Engineering
Pink - Planning
The ('tnlrr of 'he tikI Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~d at ~
APPLICATION RECEIVED is - I S- ()Lf (J I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for cO/;~o~ ~iV~1];;:ed;O~
Accepted Accepted With Corrections /'
Denied
r:
~ Date: G/2.~ Y
, .
Comments: ~. aLl ~. /-~,~~)
~ ~ (iJ- 2.1/.n-. ~ ~ :7' f'-- ~
-4n ./~ ~~__7~:-~ ~ ~ ~ ~. I,
f ~~ d
Reviewed By:
\8fl~ ~ ~
"The 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
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."