HomeMy WebLinkAboutBuilding Permit 05-0167
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTMCATE OF ZONING COMPLIANCE
AND UTILITY CONNECI'ION PERMIT
Date Rec'd
.3 2.. O~
.
~. -:.:. ~~ I PERMIT NO. 05". 0 I " 7
) Yellow AppIlc:ara ·
~M~_:-:
AD:RES~ OM eve Ave.
N E. "Pyf (),/ l,Qj(e . \--t N. 0S 37 ;;t
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LEGAL DESCRIPTION (office use only) .~
LOThLOCK / AoomON ~fiJ /fr
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PID ZC I fr. OO~. 0
OWNE1l~
(Name) eatvlev
(Address) 404 (p
ueCl14.5I1'~V1
BUD.J)EJl
(Company Name)
(Contact Name)
(Address)
(Phone)
(phone)
TYPE OF won 0 New Construction ODec:k OPorch ORe.Roofing ORe-Siding OLower Level FiRlth 0 Fireplace
OAddition OAlteration OUti1ityConnection JltMisc. M/lNc, 6 OF ()Sl5
. CODE: OJ.R.C. [jiJ(B.C. 4' PROmCfCOST/VALUE S
Type of COIIStJ'Uetion: I @ m IV V A (excludinCland)
Ocaapaacy Group: A B E P H ()) ~ R U
DiYisioa: 1 2 3 A'Y 5
I bmby C!eI'tilY tbatl bave furnished iIIfonnation on dlis application whidl is to !he best of my bIOwled&e _ and correct. I also mtify !ball am tM OWIIer .w authon%rd ... for tM
~...~.......>>........ _....... '-'..................._... - - 1- _....___
l) I . m . I heftby llIIft !ballhe city officiaJ 01 a drs~ may enter I1pDII dlr proprny to pcrfonn nreded msprctions.
Conlractor's License No, Dale
Permit Valuation
Pennit Fee
500.0
s 2b.O 0
s zS
s .SO
s
s
s
s
s
,
#
#I
Park Support Pee
SAC
WaterMeter SizeS/S"; lIt;
Pressure Reduc:er
Sewer/Water Connection Pee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
#
#
Plan Check Pee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Pee
Sewer&. Water Pennit Pee
I P 'd
O~te
~.~~
z..,#
I ~o. :!8U
s
s
s
S
$
S
$
S
S
1'lus is to C!eI'tilY dlat die: request in die: a~ appliclllion and aa:ompIIlIyina doaamenlJ i$ in acconImt:e witll the City Zooin. Ordinan~ and Ift&y proceeG as requested. This document
whm silJlCd by tht: City PIannrr constitutes a te1llpOrary Catific:ace of Zonina co~ and allows constrIIClion to commence. kfore lXCIIpancy. a Q:rtilicace of Occupancy must be
issued
JlIauins Director
Date
24 ho.r notlu lor alllnspectlou (951) 447-9858, fax (~) 447-4245
16200 Eagle Creek AYeI1Ue Prior Lake, MN 55372
ou,
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
;v; ~ (!fi {/ 5"71 ~ /fE;rf7JfEJC..
,
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ If gO {!o fVI fYl6 r?~ /iV6.
Accepted
t/'
Accepted With Corrections
Denied
fiJtl
.
Reviewed By:
Comments: I ~
"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."
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/I/P("'
, -
. I. (. .. 1 .
/. /11 I:. /f (' f-
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, i i .
/1 ~ C.. .
Accepted
Accepted With Corrections
Denied
Reviewed By:
Date:
Comments:
'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."
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---
PEB. 28. 2005
8:47AM
651 223 5958
NO. 247 P
.1/3
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INTERAGENCY REQUEST for INSPECTION
!! [l~ ~ \~
I~ MAR - 4 2005 Wi
lay .... .~.... -=-~J
To:
o State Fire Marshal
o Local Fire Inspector
tyLocal Building Inspector
o State Health Inspector
o Local Health Inspector
Date: February 17, 2005
From: Judy L. Brekke, (Licensor)
Phone number: 651-297-4117
Prior to issuing a license, verification is required that a facility is in compliance with appropriate
state or local codes for health, building, and fire, Please complete the applicable section and
return to the Department of Human Services, Division of Licensing with any orders attached, A
copy of the orders should also be provided to the program,
Name of Facility:
Proposed use: Child Care
Name of Program: Kids Count Daycare and Learning Center, Inc.
Address: 14180 Commerce Avenue North
Street
Prior Lake, MN
City
55372
Zip Code
Program contact person: Heather or John McCaustlin Phone: 651-308-3310_
Area to be used:
Basement ( )
First floor (,>q
Second ()
Other ()
Specify:
Numbers/Aae Ranaes of Particioants:
6 weeks to 16 months: 12
16 months to 33 mos,: 14
33 mos, to kindergarten:40
kindergarten to 12 years:30
Total: 96
Facility olans
to serve
handicaooed:
Yes ( )
No ( )
Health Request: ( ) Licensed () Not Licensed () Application left or mailed
( ) No orders necessary at time of inspection () Major orders issued
( ) Minor orders issued ( ) Major revisions needed before license can be issued
Signature of Health Inspector:
, Phone #
Agency Name:
, Date:
Building Code Request: ( ) Not appli
Date referendum yote removing cod
Signature and Title of Local Official:
An inspection is required for all proposed facilities located in a code area which involves new
construction, major renovation or change in occupancy, (i.e, any facility not currently used for the
proposed usage), .
\.. Continued on next page.....
Page 2
Building Code Request (continued)
()<.) Facility meets requirements building code requirements
) Facility does not meet requirements and cannot be occupied until orders are met
) Facility does not meet requirements, b may temporarily be occupied until
(dat , g pletion of orders,
I Phone # 'f~-"f./7-"~51
Date: 1/2(;,,/()~
I'
Signature of Building Inspecto~
Certificate Number: 1't h . I t.j &()
Fire Code Request: A fire inspection under the Minnesota Uniform Fire Code is
required for all proposed facilities, The facility must be inspected within 12 months before initial
licensure, The Commissioner of DHS must not grant a license until written approval of
compliance with the MN Uniform Fire Code has been received from the fire marshal with
jurisdiction,
( ~cility meets requirements of the fire code
) Facility does not meet requirements of the fire code and cannot be occupied
until orders are met
) Facility does not me t requirements, but may temporarily be occupied until
(d e, pe ing completion of orders,
, Phone #
q52.J-9"f7-~
Signature of Fire I~p.ector:
Agency Name: a/
, Date:
Comments:
When the inspection is completed. mail or fax this form to:
Minnesota Department of Human Services
Division of Licensing
444 Lafayette Road
St. Paul, MN 55155-3842
Fax number: (651) 297-1490
Updated: 2-26-04
I~J~. @[f,'n ill ~ I~
~U MAR - 4 2005 W
INTERAGENCY REQUEST for INSPECTION
To:
By
o State Fire Marshal
o Local Fire Inspector
tyLocal Building Inspector
o State Health Inspector
o Local Health Inspector
Date: February 17, 2005
From: Judy L. Brekke, (Licensor)
Phone number: 651-297-4117
Prior to issuing a license, verification is required that a facility is in compliance with appropriate
state or local codes for health, building, and fire, Please complete the applicable section and
return to the Department of Human Services, Division of Licensing with any orders attached, A
copy of the orders should also be provided to the program,
Name of Facility:
Proposed use: Child Care
Name of Program: Kids Count Daycare and Learning Center, Inc.
Address: 14180 Commerce Avenue North
Street
Prior Lake, MN
City
55372
Zip Code
Program contact person: Heather or John McCaustlin Phone: 651-308-3310_
Area to be used:
Basement ( )
First floor (.>-q
Second ()
Other ()
Specify:
Numbers/Aae Ranaes of Particioants:
6 weeks to 16 months: 12
16 months to 33 mos,: 14
33 mos. to kindergarten:40
kindergarten to 12 years:30
Total: 96
Facility olans
to serve
handicaooed:
Yes ( )
No ( )
Health Request: ( ) Licensed () Not Licensed () Application left or mailed
( ) No orders necessary at time of inspection () Major orders issued
( ) Minor orders issued ( ) Major revisions needed before license can be issued
Signature of Health Inspector:
, Phone #
Agency Name:
, Date:
Building Code Request: ( ) Not appli
Date referendum vote removing cod
Signature and Title of Local Official:
An inspection is required for all proposed facilities located in a code area which involves new
construction, major renovation or change in occupancy, (Le, any facility not currently used for the
proposed usage), .
l... Continued on next page.....
MAR. 8.2005 8:50AM
651 223 5958
NO. 422
P.2/2
March 7, 2005
City of Prior Lake
Attn: Bob Hutchins
16200 Eagle Creek Ave. SE
Prior~ce,~ 55372
Dear Bob; I
This letter is written in regards to the business property we have ~eased to open a daycare
facility. The facility will be located at 14180 Commerce Ave. . , Prior Lake, MN
55372.
The item in question is the stove hood which is cunently locat at the facility. Because
we are unaw~e of the exact venting method of the hood, we wil not use it for any frying
of foods. If, at a later date, we choose to have the hood tested, t ensure its capabilities,
we will do so at our own e~pense, by a licensed company.
Please feel free to contact me if you have any questions.
~. 1'J{()16-
Heather Me austlin
Kids Count Daycare and Learning Center, Inc.
651-308~3310
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DATE TIME
_G!nt-OF PRIOR LAKE . /. J
INSPECTION NOTICE SCHEDULED ,/Zi()'j'
ADDRESS 1!lJ 8? 0 ~rN\P~ /JV'I?
OWNER CONTR.
PHONE NO. PERMIT NO. j~ l~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
X SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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COMMENTS: J-
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Owner/Contr:
1 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
/NSJIOTJ
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KIDSCOUNTDAYCARE
.JrE 612-474-5243
FAX+ PHOIE NO. : 9524747543
952 226 1143
A?r. 08 2005 08:58AM 'r'~P. 02
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To: 1M CaaI1rlIcI:k\Q
171001 ~W&l65
A- HIm LUl, MN ~,~
-
U: ANNtJAL ARE SPR.IN:Ja.SR INSPECTION
SIlL'~ are two ~ of 1be muual fire ~1d~ ~ reports
(for YOIJl'. IDd. for your f.nI\nnce c:o.mpui1). Caples Will be .. by
... to 1bt 1ft ~ for fbI city m ~ Yom' balktina ~ kcatrl4.
Tb;. iavtIict fat tbea lDspeaioas is attiche4.
Sb.cd4 you haw any questb\t or COJXaJJI iu ~ to this impoctilx~
pleaao fetl be to call (952.835'-3810) CJ; write.
51ta:e1y,
GJL3E1T MBCHANlCAL CON'.raACI'OltS, INC.
Don~
Pn Protecti.oA StMre. :hIt''''r
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~v5 10:54AM GILBE,T ~ECHA~lCAL
I nspection Report
GILBERT MECHANICAL CONTRACTORS, INC.
~I W. _ St. ~ ~ldIIeIpOlis. MN' 5.u:U
omae pbClDl 9S2-m$-3810 fa '32-U5-476
952 226 1143
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952 226 1143
NO, 1,10
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GILBERT MECHANICAL CONTRACTORS, INC.
.451 W. 1151h St. .. l4imupoua.)IN 15435
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EOINALARM
INCORPORATED
Residential/Commercial Security and Fire Protection
6440 City West Parkway · Eden Prairie, MN 55344
(852) 842-5276 · Fax (852) 842-5808
FIRE SERVICE REPORT
eO Y1
SUBSCRIBER .
NAME
ADDRESS
CITY
TROUBLE
REPORTED BY
':S4. WATERFLOW 0 VALVE SUPERVISION
o AUTOMATIC 0 LOW TEMPERATURE
')(MANUAL?u...(I~ b 0 F.T. & R of R
)ilSMOKE DETECTORS'"" 0 FIRE PUMP-ELECTRIC
o HIGH/LOW AIR.PRES. 0 FIRE PUMP-DIESEL
TROUBLE REPORTED
OR WORK REQUESTED
fJ e w XV\ s fed I
Key {Or ~eft -tOr {:fe-
TEST RESULTS OR II
DESCRIPTION OF WORK DONE It S +to be
lA fA,( .s.
YEAR
05
(VJOJ((
~NTRAL STATION
o POLICE/FIRE
o LOCAL
o OTHER
o
cJ.. ~ ,'f-
TIME DISPATCHED
EDINALARM REPRESENTATIVE
SUBSCRIBER
SIGNATURE X
AM TIME COMPLETED
PM I~
1l1~
, TITLE OR
I.D.NO.
EXTRA WORK AUTHORIZATION
AM
PM
UNIT TOTAL BILL
NAME HOUR~ MATERIAL NO. COST COST COST
TOTAL HOURS TOTAL MATERIAL COST
HOUR RATE TOTAL LABOR COST
I HEREBY REQUEST THE ABOVE WORK TO BE DONE TOTAL COST
AND AGREE TO PAY FOR SAME WHEN BILLED.
SUBSCRIBER
SIGNATURE X
DATE
TITLE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS J Co.ll fu
~ <:FWt ~ -'
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o jllISULA TION
J:J FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
r;i~
TIME
5""-D/ ~ 7
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
() i~.ftv. (? ~
~RK SATISFACTORY, PROCEED
o CORRECT A 10 AND PROCEED
o CORRECT 0 CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CAL
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
~ CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
"$/~/c5
ADDRESS E:JJa? O~MP~ /hrP
OWNER
CONTR.
Sib~ l~
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
X SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: ..J--
~~~ ~t'r-WC
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1J;~p~ 0 ~ US'L
)c~u.u-~ t.po~ ~~ .
3. ~~-~'S~~~ ):~ ~
Owner/Contr:
50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
INSNOTl
CITY OF PRIOR LAKE 'I ;';o/'~-
INSPECTION NOTICE SCHEDULED
ADDRESS J4/86 (1-O~ ~ ~
.
OWNER CONTR.
PHONE NO. PERMIT NO. ~- e;{~7
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
-.LJ2.~ ,^J \.l'~ ~SjSk ~~
Z, AJ6l"~ S:JS~r~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INS/IDTI