HomeMy WebLinkAboutBldg Permit 05-0303
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. zo. cJ-S"
White File I PERMIT () L::'_
Pink City NO. :;,;- ~ ::;:>"3
Yellow Applicant U J
(Please type or print and sip at bottom)
ADDRESS ZONING (office use)
52'20
~. cA~ f3/fJT 02.
r
LEGAL DESCRIPTION (office use only)
ifMJdd (~
(/
~'::~R Gs~ 11 cH-EY ~E5 llA?)J~
.,.- ,......,
~ddress) ~~.ZO ~_ ()A/~ fO/AJT1"~
~~ ~~JLijd (Phone)-k12-7Z3-~7/S;
~ ~tM SR.1 (J~ (Phone)
CUJ2;n L9 2-/JD ,<:;Z-l{) ~,~#.4A/LS3C:?4--1-
LOT 11 BLOCK
~ADDITION
PID;2~ L/()/~ 037-{J
(Phone)
q, S-Z ~ 2-2..(, ~7{/P,
BUILDER
(Company Name)
(Contact Name)
{l
(Address)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding 2fLower Level Finish
DAddition o Alteration DUtility Connection 0 Misc. , "-
CODE: MI.R.C. DI.B.c.
Type of I~nstruction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
L/tJtJO ,--
I hereby certifY that I have l\.trnished 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 onform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can re~ permit for Jl cause. Further , I hereby agree that the Ctty official or a designee ~ay enter upon the property to perform needed mspections.
X 1 ~ 1/>-/J)~L-1 4-20-th
I Signature ---. Contractor's LicenseNo. I Date --
Permit Valuation L/ooo,-- Park Support Fee # $
Permit Fee $ 8'1,. ~5 SAC # $
Plan Check Fee $ ~...c>o Water Meter Size 5/8"; I"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Llo. - Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
-/
Gas Fireplace Permit Fe~ $ LIt). -- TOTAL DUE $ Ito9/~
. q-K -) t_1 '7
This Application Becomes Your Building Permit When Approved Paid / / a '" 'ry Receipt No. <f ~ I'
-~~~ ~ Date if ,. a-O .- :t) By fn ,
~j,'k'
Building Otlicial D~te
ThIS tS to certifY that the request in the above applical10n and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner conslttutcs a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
'sued
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
Residential Building Permit Checklist
Basement Finish or lmerior _:Uterarion to Single Family Homes
tfJS- 30 '3
BY~~
Date: L/-~-()S-
Building Permit ;:;
Site Address
Pill:
$;<~O
Zoning:
~ CiJc. p f-; l} t'.
Legal: L
B
Subdivision:
E.Iisting Strucrur~r NO
CONFORlvIS TO ZONlliG
o RD ill AJ.'{ CE
Y""E S
NO
"YES
NO
Is tins an expansion of d:e e;,,-i~cllg foo~:-j,;""'t or
building height?
Rete:- ~o Pl:OT'Tlm.g
Does ::h.e alteration include any additional :<itcher:s?
Refe:- co Pl~Tm1T'g
.tic)
JJtJ
rJ()
Is the pI"o-per:j located 7-lithin tile flood plain?
Refe: m Plar..ning
Does the pro-pose:: aite:arion include any outside'
e:ltranc~s othe:- than patio doors?
Refer ~o Pla,.,~mg
1JtJ
Is the pro-posed use of the Bnished. ~ace or
alt~rion for anyching ome: than a nOr-::lal single
farmly non:e (office, g:-au"9 hOGle, day car~,~tc.)'7
Refe: m Plarr6~-:g
fio
THIS cm:CXL1ST:truST BE COMPLETED .-\.J.'fD INCLTJDED IN THE BlTILDfNG PERi'llIT FILE TO
(,!lAlNTA1N A RECORD Of THE REVIEW.
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. Pink
2. Green
3. Yellow
~!:y. I PERMIT NO. C ~ 3 ~ ~
Apphcant ---.) ~
(Please type or print and sip at bottom)
ADDRESS
ZONING (office use)
5220 E. OAK POINT DRIVE S.E.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name B & B CONTRACTING
-CPhone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone)
651-633-2561
APPLICANT SIGNATURE
BRfNDA HUSTON
DATE
4/25/05
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
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Industrial, Commercial & Multi-Family
HEAT N GLO 6000TRI & GASLINE
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
FIREPLACE MAKE AND MODEL
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
(Office Use Only)
~l I~.f~fl) WITH
fJU'lOlNGF'ERM''''
$ .50 I' )J II
$, . ~yf~~i .
This Application Becomes Your Building Permit When Approved \~ i'~~ r~'(jf,- I \ ,j !.'.:. \ \\ReCelpt No.
\ ','r?at, PR' 2 9 2005 \ 'l3yGL
Date ' ! \ R l \ 0 )
24 hour notice for all inspections (952) 447-9~~~: fax (95_~_ 447-4245
t9.L~::-.:::.-':::'-'-
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
Buildinl! Official
. Lll 'i OF PRIOR LAKE
BEA.I.AiiGJAJR COND.I"A.ONJNG/~.I.f4PLACE .'~
Date Ree'd
rPlwet'VDe ar1ldDt IIIl1 si... 8IbaaDlal
ADDRESS
__5 ddO r ~JJu-;- J}-/L/-/__
t."* .... , PERMIT NO.I)'1J~' . 3Q3'
10.. CIIr ....... - .
3.Y.... ~. ',' " . ..'
- ZONINO(oIkle. -
LEGAL DESCRu uON (oIiceue oaly)
LOT BLOCK
ADDmON
pm
~~ ~(f3 t01l/JuChO{/$nh1~:f'/) ~.,.~)/o/2- 7.<~--b/7'S- ,
CAddtess,
=::;g1rt/:4/!!f11~~X7tqt/t)~:,; ,:,'",',
. ~(Ackfms) (~::. (ZipCOCle)
(Contaa Person) , . . 4.14./6, (Phone) .::EJ - -
. APPLICANT S1GN~TUR.:e V~ / OATS' 4Jjl.. ~'r:: .
APPLICANT PLEASE COMPLl!. I. I!. BELOW
(]NEW CONSTIlUCTION 0 ~CEMENT' J{'AL1E1tA!lONS; '.
FURNACE MAKE AND MODEL . . FUEL "
FLUE SIZE RETURN OPENINGS INPUT OUT.Pt1f
TYPE OF 5'\,).1.. HBATJNG OIl rowmt. PLANT
. . WIl1ll Air PIaoIs J:I s.n Pl."-\SI NOTE: .
Mech8Diral . O~= .~~.
__ ~ r Coadidanial Spedall)evjces RIqtiiNcl Side Yd
/----v- 1 . t u. ~
( -~'~~...*--.l.,w <;''''A~\ ~ · .-s.(:'<;l Yf'.11 \, I"~ I ~~" ~ -:--J
'\ ~ \.ft&oUU!lJIJY~/~C~~..~...._/
Ind\lstrial.Com~:": 1I1tl-Family 1% of Job cost Residefttial,GufircplKC.. '" $19.50 ,
$39..50 minimum .... -_.~. , .
Rcsi&ntial. HeaUftg " Ale (New ConMl'UCCioll) $99.50. . Residential, Additions " A1terati~
Residential, Heating Only ('Ncw COnsmaclion) $64.50 . Residential, A<; Onl)' . '_ .
EstimatedCostS ~ .~~ 00 Buildin,Permir #_ \ " )
00 \)\0JV
HEATINOrel\MlTFBB S ,3?, )\
STA'm SURCHARGE' S " .so "^
TOTALPDMIT~.... S 7"~'. .fJC>'JlI\
~:::""'_y_......__....- Pofd~; ~No.
Date C <1/-t;
$39.50
$39.50
. .' "
..... 0IIdeI
BaIt
~.
Q -,
14 lIour notict for.1I illlpectioll (952) 447..f15O. flax (952) 447-4)45
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS .5 ~dJ!J E" ta::J:- PI- Dr
NATURE OF WORK LL. _
USE OF BUILD~G ~F
PERMIT NO. - ~&J:;J DATE ISSUED V-~~-~ ~..
CONTRACTOR -"~MT PHON~- 7;l3....""1 ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I
kfill} I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I'll
~
~
//~
~
~
/tel-
~.
" I'
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
qd-/tJ5
-J4fJj'-
S).~.~CJr
S/2-~~""
s- /~s-
('~~/ ~/~
.s-#s/
,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
. I
~/ Z9KC~
~/~S-
~~ b/C?~---
~~ a,~%~./
OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
;Y~;r
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
DATE TIME
CITY OF PRIOR LAKE / A __ ./
INSPECTION NOTICE SCHEDULED ~Yt1 r
ADDRESS >>;-c> ~J/ CJ~~ /-/ Lh
PHONE NO.
OWNER CONTR.
PERMIT NO. /? \= -, r" ':!
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
.....er'1INAL
o SITE INSPECTION
~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
....efPLUMBING FINAL
~CH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
~PLACE FINAL
o GASLINE AIR TST
o
CQ.MJlENT~ /',-- / I
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_ ((/7~se- ~/e- J
~ORKSATISFACT~"~C~ ~
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F R REINSPECTION BEFORE COVERING
./ Owner/Contr:
.....-
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETY!
INSNOT!