HomeMy WebLinkAboutBldg Permit 04-1045
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
q - ;)i'-() 1
I White File I PERMI + r'
2 Pink City T NO. 04- \ I d '.::;J
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ~
300$5 ~obca.+ 1~4i1
ZONING (office use)
1</
LEGAL DESCRIPTION (office use only)
LOT~ q BLOCK J
ADDITION
j~lullJ'~ S'O~+h
PID<l5 -&2- ()2tiO
~~~R Scotl:. S-t r2 y ns~j
(Address) IoLJ II? (J -H I \lJfS1 ) a rt.. ~ I ... fo\o 11
BUILDER \) . l......'\ f'r \ L , .~'" .- 4114 % q
(CompanyName'T'Ov,,,,qtt T1()\'YlQS.. ~. qf>,->' (Phone) 62.. 86 -5CJSQ
(ContactNameL2.Ql~y,~q+1\a.f.{ Lct&Q.JA..- -1~~\ (Phone) '52- C)f6''I170
(Addressk;'ILJg 3 Gr.e~ktvl\.)e v Sol'~ \20 ) a},w; J/QJ rn ~ f55DLJLj
(Phone)
Pro i r;e,.
95.1- Lj;.;. .6?7/
.
TYPE OF WORK b(New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
LJAddition DAlteration DUtility Connection D Misc.
CODE: ~I.R.C. DI.B.c.
Type of t~nstroction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $ 355 J DO (), op
(excluding land)
I hereby certifY that I have fhmished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or authonzed agent for the
above-mentIOned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
:r~mit for Just cause. Furth~Xb~~t the City official or ~s07~aZ3D7e property to perform needq:2~~dI
f)~ Con.,,",,', Li=re No. D." .
I Permit Valuation 3SS.O:X:> .C>C') I Park Support Fee # $ 800. XJ
Permit Fee $ , I SAC # $ /. .1"50 .od
'2; 'Sa"? Q)
Plan Check Fee $ I Water Meter Size 5/8'(j); $ ., -
I. c...". ze 30D . 06
I State Surcharge $ , Pressure Reducer $ 70 . (j6
/77. 50
I Penalty $ Sewer/Water Connection Fee # $ I . 2.0 I) . CJ6
I Plumbing Permit Fee $ J 00 . 00 I Water Tower Fee # $ .
la../). 06-
I Mechanical Permit Fee $ J()O .00 I Builder's Deposit $ I. c:;oo .60
I Sewer & Water Permit Fee $ 35".5"0 I Other $ I
I Gas Fireplace Permit Fee $ 't 0 I c:x> I TOTAL DUE ~ tb~11.0f- $/0. (,~5. 7A
,
/'rJ I ~~- 7[;/ -<-
ecomes Your Building Permit When Approved Paid b -~ ,. ReceiPt No. LI r / l--(-f-1'J
acf. 5. 2La if Date / tJ r / <i!:' ~ t-( By r:
()--
I'l"ate
ThiS tS to certifY that the request in the above applicalton and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. Thts document
~:'~~d'~ ;fC~" ",,'" w","'''" · "mpo"~ C,,'ill,," ';~;z; "d .110", w",~,", w wmm=, ,er,,, oco,,.o~, . C,",,,,,,, <" O=""~ m,,""
Planning Director I / Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
White . BulldinQ
~alli:arv . cnqineern~
pInk . Planl(ling
lh. e.nl., of Ih. "ok. Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHt:CKLlSI
NAME OF APPLICANT
APPLICATION RECEIVED
F::, f-n- z: L l-\ F F
'':\1 -., t; 0 11
I.. . l- t./ . ......
1-- (. fvlC::'=
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-2) 0 () S t;; c e{!/-'i! I 1~~4~ Ii--
Accepted
/')(
........
Accepted With Corrections
Denied
Reviewed By:
!YJHZ,
........
Date: ~ - 12 -0 '(
Comments: See Reverse Side for Additionallnformationl
Driveway Must Have A r.nncreteApprn;:!rh
See Attachments: 1 ~ Grading Plan, 2) Erosion Control Measures
"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."
CtWtWe - Buildi~
Canary - Engineering
Pink - Planning
The eenl.. 01 the Like Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
f2ATz: '-A FF
q. z.e. 04-
HOH 55
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
30o~
BOBl!A I
Tf2,A I L-
Accepted
Accepted With Corrections ~
Denied
Reviewed B
Date: 1 D ...t.f- 200. c/
Comments:
I. eeoJL cJJ ~
'2. ~
a~W ~~
Wh1Cp ,'-\.\.spri.\'tM ~,
b~,...e..
Cov.u c'~
"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."
Tht ('t"ln of Ihe Like Counlr)'
White - Building
Canary - ~!19in~ering
c:::~!< _ - t"'.annm9:)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1- i Z: L/--\ F F-
i --; ,', C.' /;-
;.:,.-c. -~
/--/ (I E~=
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-? (' / ~"' 1-\ I r\ ! L--
Accepted ><
Accepted With Corrections
Denied
Reviewed By: (?~ ~
, 1/
Comments:
Date: f 0 -5 - oc.!
"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,"
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
(Please !rY,e or orint and S1fm at bottom)
ADDRESS I
r3c:o~ Jbhr.of 7m/(
i: ~ ~~ i PERMIT NO. /J_ j~1l""
J. Yellow Applitl\'" -" , ~~. ,
ZONING (ofl!ce use)
l.EGAL DESCRl.t" .L.lON (office use only)
LOT BLOCK
ADDITION
PID
&=~f-~f!- ~
(phone) q~~,.. ~q 5q
(Address)
APPLICANT . L ,/ (1
(Name) r J".h ,r~ etlV 11 t t"
(Adc1ress)r-J/0)I("l Qn' Rue ~+-AJ.
(AddresS) I
(phone) fA:)
P?M) ..
(City)
~~a
s'~@ L./
(Zip CoCle)
(Contact Person)
APPLICANT SIGNATURE
(Phone)
DATE .c_-D -~fA -0 L.f
.- APP1.ICANT PLEASE COMPLETE BELOW
. ~w CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL' ~ ')to 7l1K /00 FUEL A lA-I-
FLUE SIZE ~ 1/ WL.- RETI.rRN'OPF.NINGS " tNPUT /a1 (m OUTP~T .-!Ja?ooo
r. ( '
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants 0 Steam.'
. D~ity 0 Hot Water
.A:rMechanical 0 Radiation
~ ~ Conditioning 0 Speoial Devices
( a ~enL Systctn 0 Other Devices
CE MAKE AND MODEL tIt:o/- .I..J Cln ~ - 7~
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Ylltd
Setbacks
FEE S'-'tt.l!.DCLE
Industria-I. Commercial & Multi-Family 1% of job cost Residential, Gas FircpliICt
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50 Residential. Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
$39.50
$39.50
$39.:50
Estimated Cost 3; Building ~ermit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
I' .
~..' 4~,-f"}.
~'..~. "f...
....";!~..~. ~..;.... .,
"'\.,~.,..> ..1:' ~;~.
. ",'
. 01'
II" '....
Jt: ':l ~
, ~'.?""#~
(OUiee Use Only)
This Application Become.s Your Building Permit When Approved r~ @-t~ U \D II~CeiPt No.
>>..."", om"" .... .:lnteOCT 2 8 2004~' f)
24 houuotice for a1linspections (952) 447-9~.r,-l~ (9:l.SZ) 447-4..245 '()
16200 Eagle Creek Avenue, Prior La~ 55~?~__ . _'~______ \
~IV a3110MLNOJ 9L6909tTS9 XVd CT:CT 3111 tOO~/9~/OT
.- ~ j
TOO III
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
I. Green File PERMIT NO '-I $'
2. Yellow City . (I'} ./ to Ii
3. Gold Applicant J"'"
(Please type or print and sign at bottom)
ADDRESS
3 oog '6e>(3CI?T TrL
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER .IJ
(Name) I~,q;- ~ L C) ,c ~
(Phone)
(Address)
(Address)
(City)
(Zip Code)
APPLIC~T. r
(Name) V<<-~!'H Elf. t ><-c.. ,
) ~. [( g TDft.;:~ IN f/-y
(Address)
L3 l.1. ; C I'"
APPLICANT SIGNATURE ~ \J~
(Address)
(Phone)
LA~~J ~l-l. E..
(City)
q..r;L -~ ') ;) - ~ q 0 (P
SSD,-/l{
(Zip Code)
(Contact Person)
(Phone)
DATE JO)J 7 J~'I
APPLICANT PLEASE COMPLETE BELOW
Size of water service J" inches.
Location of any couplings from structure -
Type of sewer pipe. 0 ABC ~ PVC
Estimated length of sewer line .3 0 feet.
Clean out (if required) located at - feet from structure.
feet.
o Cast Iron
Estimated Cost $
$35.50
$17.50
tJ
ClDD. I'
FEE SCHEDULE
Industrial, Com'l & Multi-family
Water connection only
I % of job cost with a $39.50 minimum
$17.50
Residential sewer and water line connection
Sewer connection only
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
'}\ ~y
pai~ ;\-
- '\
Date
Receipt No,
Building Official
Date
By cr/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS :?ool3 1>o1oc;p..~ ~.
NATURE OF WORK ~
USE OF BUILDING SFD
PERMIT NO. 04-,.10 ~S DATE ISSUED /0 - 5'- 2ooc.f
CONTRACTOR ~Cl~_ +'''-' ~..Q~ PHONE <152. 'IE .. 51.5f
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
FOUNDATION (Prior to Backfill) f' b // -y I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - IJ{S
SEWER I WATER I SEPTIC ~ .....c.-.c
FRAMING
INSULATION IW )'
ELECTRICAL
PLUMBING
HEATING (if required)
.... '
FIREPLACE (~) .f.:1P I~~C:I
GAS LINE AIR TEST /'I" ~F~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
; ISlu- L.\I-. /1-I01l1!o1 ""<' ~ · I /: II
;4lib tJtJ()~ /lk~d-' FINALS. A~t'/ ~G-e I v/1.f;t;is~
GRADING (Prior to Sodding) If..AI D .11/ f" df . 6 S
BUILDING ~~J1. C(J",//ttY a/~ d!hy-Jr- If 1.1 J ~
ELECTRICAL I . _f~/~S.&-
PLUMBING €.-C ./ ~ .......
HEATING /I1'J'
FOOTING
/1-- ~f-'t.A-f
~
~<;#?
.
J
. I
-.? //~ ~.s-
;.. ,
~/ /1DO /NOT pCCUPYYNT~L ABOVE HAS BEEN SIGNED
If/tJ 1/eUc-,l~'~/e 7h#tS iP~ICE
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.
FOR ALL INSPECTIONS (952) 447-9850
....... ...
...
-. .....
~-
._~~~ .lM,,"-.'~~'~
~-,
:JO
ADDRESS _ ~ '")(10 ">
OCCUPANT _
HEAT LOSS
SOLD BY
EI.ctrical Work By
TYPE OF HEAT GA
APT. _FLOOR
OWNE'
If, ilj
CITY L-.4k~SUBURB
~Io ~4;+ J./
HOUSE H EA TING TEST RECORD
DATE HTG. INST.
FA }{ HW
,
MAKE.
Model
Serio I
INPUT
-r; GAS DESIGN
J'V.i .......uI
fa ~/.2D ~9&'b W. ~
'-1::2. '3 It... Y r;~
/~h IV~J
- I
CONTROLS
THERMOSTAT ---'i:.JA ) Heat PI",
Valve
Limit
limit Sa"ing
Fan Satting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing
L. W. Cut Off _
...t:?, ~
Pr..aur.
Input CFH.
Stack Temp. --LLO 0
Form 235
lq/)L:J
Li.n:t n#l.€j)
HtS I
Petcent CO2
Percent O2
Percent CO
&.3
log
_STEAM
INSTALLED BY CONTROLLED AIR
Ga. Lln. By CONTROLLED AIR
,SPACE HTR. UNIT HTR. OTHER
CONVERSION
MAKE OF BURNER
Model.
Mo.. BTU Ratl", .
MAKE OF FURNACE
Mod.l_
..3))
_ Vent Size _
_ KIND OF LINER SIZF
_ Draft Hood R.gularor
_ Flit.... Slz. ':;.5;' /r:J .c..- Number
_ Ollmney Location In.ide
_ Ollmney Construction p tJ c....
.NONF
_ Out.id.
_ Smok. Bomb
_ Droft
0- Pr.ssur.
_ Wiring _
T..t Tag
, Lighting Inst. .
;;}./ ,g/Q5
CONTR'OLLED AIR
~
_ Dote T..t'"
_ Company T..ting
_ Na_ af T.st.,
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS -JCX> 8
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
COMMENTS:
/7/""--tk - .olL
C.V Ib
DATE TIME
SCHEDULED
J/.:U~
&bl"~ f- T/ J
CONTR. A.,-lzj~{I H 0"'-<1-
PERMIT NO. 04- Jbl./ S-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
)(~ILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
(,) //
l'N'J/-.- /) '-
S+ r j.. (l'if-
u&-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 & SAFETY!
/NSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~ y,ot.:,cJ-
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
7FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~lJU -J!?~
;'~y
DATE TIME
n(z-dar-
1-1,..')['''--- /o~
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORR~ CALL FOR REINSPECTION BEFORE COVERING
Inspector t ILlI) Owner/Contr.
J-V
CAIiL 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
V
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~
ADDRESS JQOp, f;,kJ- 11>
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q-/6~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
~. 0 WATER HOOKUP
'7----0 SEWER HOOKUP
..>I!:C PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
,. Daf ~)(lo \LA..
1.., ~~ Rc:.:t ~~
3. GI{Jp, (\!.D~~
'" Uc.ok t,v> ~~~ ~
Dt---...
.
o WORK SATISFACTORY, PROCEED
~ORRECT TI AND PROCEED
o CO. RRE WQ LL FOR REINSPECTION BEFORE COVERING
Inspect;tr: Owner/Contr:
CAL 44',:-. 50 Ij R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
---
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNon
-!p'~hJ
r ?a?~ ~~~ I 1/1
,E)'MM.ENJ"S:, ___ ~. I
CUcPJC~ / .kJz.~, I ~
~) ~.. /" ~
(;Z /ir~~t:e- /7~~6- 9lL/
t4// Vut..'u ~ ~H" ~rp / ,./
//kc4~ h:..,.. ( .A 6Jt~ ,
A~lJ'vJ I/rsC?r _~J-r-
<, I / /J J .(
(f/. /Y-e_u~V4'<sur/iU.-e 1JnL.e. L.c..-..,.Y"
-I J~c.)~ ( r~~p' / /.
'_ C:;;P'" ' 'h:n!/4r~dL c~/)~XN~I
- //'~~ c:hdr. 7/"~ 1 / / "
A/..e ed l ~ 7~ 7/ttJ15 L Ci- P'# ~ ?A
~~.r.? . ~ (.JH -Ii 7' , r~ ;:'.5-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
..,I!HmAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~H FINAL
OA TE TIME
c9f - /0;\-
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
....e-FIREPLACE FINAL
o GASLlNE AIR TST
o
, /'
Jp/ /q~ -
. -'
~ORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
o . CORRECT WORK, CALL FO REINSPECTION BEFORE COVERING
Inspector: /" Owner/Contr:
V
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOT/
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!