HomeMy WebLinkAboutBldg Permit 04-0643
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5- /rJ-c) '-I
White File I PERMIT N I
~~~I~w ;~I;licanl o. 0 ~; ()(P+ 3
PID1:}5-ltJ/-> Ob5-0
9:;;;, 'II/IJ-Lfh '77)
(Please type or print and siK11 at b , ~.,. .h)
ADDRESS fl
/ b, n~) Nb(~W/J~p' tJ Jl/vJ
I~~ /~
LEGAL DESC~TION~ICe use o~
Id-~ 'r/ PClAf' '~0
LOT BLOCK ~ DITION
OWNER
(N ame)
11t917i.~
!Jtd/J f' I y M ~ ..ielz-h Uld/J
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
ZONING (office use)
If '5])
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
(XAddition OAlteratton~ct~~~
CODE: KlI.R.C. DI.B.C. 1-, ~ ~ PROJECT COST/VALUE $
Type of'co~stmction: I II III IV \.!/ ~QV (excluding land)
Occupancy Group: A B E F HIM aD' S U
Division: I 2 (j5) 4 5
I hereby certifY that I have furnished mformation on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or attlhonzcd agcnt for the
above-mentlOned 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
:clal can: t~A ~mlt for J t cau rthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform 5: /;;C:21 "/
( ,VI Contractor's License No, Date
,
Permit Valuation
Permit Fee
#4A.08()*OrJ
$ , /'lo3. DO
$ L/3o,'S
$ 2.&./, 0 fJ
$
$
$
$
$
~~ fo. u,.. ,04--
Park Support Fee
SAC
#
#
Plan Check Fee
Water Meter
SizeS/8"; I";
Pressure Reducer
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Sewer/Water Connection Fee
Water Tower Fee
#
#
40. 00
L/D,Oil
Builder's Deposit
Other
tf[), 00
TOTAL DUE
$
$
$
$
$
$
$
$
$ 1,7.-3/.9s1
This Application Becomes Your Building Pennit When Approved
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(;.2-9-. (J ~
Receip~o 1-7 z z, '7
By~
I
Paid
Date
ThIS IS to certifY that thc request in the above applicatlOn and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
~~~~endSigned by the Cl :~~n:r: c:n:l1tutcs a temporary Certificate of :0;: :mJ';; ~d 'UOWH"'''!:;:;a Hd;;;;;':'=~;;
- ~llmctoc ~ D.l. 'p<cioJ C_ti~. if "" Sh>""iiiJ.p1U. U
24 hOlu6f2noootiEce fOlf 8CII inskPeActions (952Pri) ~47-9L8ak50. f8MXN(95S2S)347427-4245 -10 (Ll).
ag e ree venue or e,
fhf ('fnlfr or thf I.akf ('ounll1'
~hite - BlJild~
Canary ::-r:i1gineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/lJIGht( e I ~ LL) I'v f3efGiJ UX'-<-v5
3- //?-oy
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
;(,001 ,fi/Ort:AcocoJ ~
/
Accepted With Corrections
Accepted
Denied
-"?_ "-/ , n L
Reviewed By: ~ ~
Comments: ~ ~
~~
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~.~~
Date:
to/ '-I1oe(
I . ,
~ th-~
(2.tJ/CJ. ~ ~
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"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 - Enqineering
r Pink _- Plannin9":)
The ('('n'er of 'he t.kr COUnl'1
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
: J( ( I f
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I
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/
/
, /),..{
<., >.. ()
· / J
{<~-Q/
Accepted
1/
Accepted With Corrections
Denied
Reviewed By:
?r-~
Date:
#Zi'#&/
Comments:
~Q1)(d ~J a ,_ALml5CXcL ~ ~
~ -fo ~o
"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."
Th~ ('("nltr of Ihe t.kf Counlry
~ - Building
fCpl'}arv - Engil"'l"'..rir\g:)
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
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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
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<...-<:,_,. "\," " II ,.,~.."..
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
tYYff1J
Date:
S' -ZS-tJtJ
Comments: -.See. Reverse Side for ArJrJitinnallnformatit"\,,'
See Attachment~! 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."
08/05/2004 10:56 AM
Boleen & Assoc. Inc 952-440--4703 2/2
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
f,5,O 4-
IPleue !vue or orint ilnd siR at bDttoml
ADDRESS
ft, 00/ AI~WO/)J f.lllJAJ f(;'}W (f)b 1ll./1/ )~3])
~:~~: IPERMlTNO.l)lJ_nJ//"?
). Yellow App_ ... 7 Vh~
ZONING (offICe
"",,)
LEGAL DESCRIPTION (offICe use only)
LOT BLOCK
ADDITION
PID ZO. /+/. oes: 0
OWNER '^'^'..I _ _ I'.. Q _.--i-. J
(Name) ~I ~ T ut '~YI wki...5
J<). . 'I..iD- t../Ja!) D
(Phone)
(Address)
~ aW 17 .} abD vt.
. ~~~ANT ~ I~ (PMne)
(Address) ~~ ftv< ~ Tgytbl1
(Address) (City)
{\ (Contact P~rsonJ~ . (phone)
q5).-f(J~->I:>1 ;'( .-;//
~'APPLICANTSIGNATURE' U . ~~~~ DATE
j\ APPLICANT PLEASE COMPLETE 'BELOW
Quantity Type of Fixture Quantity I
..3 Bath Tub with or without shower I Roup-ins
J Dishwasher I Water Heater
..' Floor Drain I Water Softner
4 Lavatory (Bathroom Sink) / Stand Pipe (Washing; Machine)
. / Laundry Tray (lor 2 compartment sink Sewal!e Eiector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
95:J-- C/9; ~;JI;J.1
AtN {"S J~~
(Zip Code)
Type of Fixture
/
~'1
Tbis Application Becomes Your BuUdiDg Permit WbeD Approved
FEE SCHEDULE
Industrial. Commercial &: Multi-family 1% of job cost with a $39.50 minimum Residential, New One &: Two-Family $99.50
Estimated Cost S Building pe::::ntial. ;;~~;;::38 $039.50 t3 Y P
PLUMBING PERMIT FEE $ .-- ill ~
STATE SURCHARGE $ """"'-'50 prl (}Il/OC/
TOTAL PERMIT FEE $ ~ ()
/'
I~
[ DatcZ3 .5. 04-
Bwlmalt Officill'
Oak
:fiiii
COfllcl! Use Only)
24 hOllr notice for an inspections (952) 447-9850, fu (9SZ) 447-4145
16208 Eagle Cl'1!ek Ave., S.E., Prior Lake, MN 55372-1714
~ [E (l8 [Hal!! i,~
CITY OF PRIOR LAKE PLUMBING PERMIl, JUL 2 6 2004 J
1. Blue File
2. Gold City
3. Yellow Applicant
Ry
I PERvlir NQ/)lJ-OJ/L3
(Please type or print and sil!;n at bottom)
. ADDRESS
L~ 00/ AI~UlQJ2) fuw
Pf~ tJY (/JI JC/ .111/1/ S537J
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER ,t
(Name) M Ie hVl f I
~;} -I./VD- t.f~D
'I- JvtL f
~f:r ( .A vtJ ILI~
(Phone)
(Address)
ell W1/' IJ .s
I1~D vL
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
/
3
DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (l or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Quantity
3
J
/
4
'/
I
/
/
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 I % of job cost with a $39,50 minimum
Residential, New One & Two-Family $99,50
Residential, Additions & Alterations $39,50
Estimated Cost $ Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
I Paid
Date
Receipt No,
By
Buildin!! Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
NDV-08-2004 10:25
VIERECK FIREPLACE
861 0456 P.01/01
Date Rec'd
i, ~~:r. ~:,~, I PE&\1IT N 0 ~ J., L~~
'J '(elb..... :"?i'IIr.~l'Ir ; ..., ~ W~
(P1e=se~\::1;l: tlr or.r.c ancl si:m at bt,~ur'lt)
ADDRESS
ZONmG,(omC~ use)
I~DDI NDRTHWODD RQAD NW
LEGAL DESCRlPTfON (office u;~ o<"\!~'l
LOT
BLOCK
ADDrTIO~
.. ..-.....~-- --,....---...._-.."~....._-"....',..,,.
PTD
o '\iV'NE R
(Nam~)
'"i MiKE AND -~ULlf BETCRWA~5
IIiJ 001 NORTJ./WDlJD RDAD row
(PhQt1e:)
952,-4LfO-4l,'JD
(.~..(jcre:;s)
APPLICANT
(N,w,c) VIERfCKFJRfPLlUE 5ALf5./NC.
11015/ MAIN AVE Sf
(Phcme) ~2-lJl/D.5bZ(j
PRIDR LAKE 5531Z
(Zip CoCe)
(Ci_i)
I; (.~rj("."\"-)
! \.-. ... ~ 'J"'~
(Ad..jr:ss)
(O)!1tacc P~rson) STEVE RIVERA /~~.
: APPLic..:..NTSrGNATuR~<~:...nl"""f ) .
"'"--'----- ---:- ~-:--- ---. --.. ".-".
APPLICANT PLEASE COMPLETE BELO\V
ONEW CO~STRUCTION 0 REPLACEMENT 0 AL TERA. Trm-iS
rUR~V,CE MAKE AND MODEL FUEt.
(Phone) ...".?~l-l/lJD-5fo'Z{J
DATE 03 SfPO~
FLUE SIZE
RETUR)"': OPEI-JrNGS
INPUT
OUTPUT
T\"PE OF SYSTEM
HEATING OR POWER. PLANT
OWar:!l1 Air Plf.!:\S
OOI'~vity
o Mc:ch~!1i';;J.J
OAi; Cor.di[ionlr.g
OV~r'lL System
o Stc3.m
o Hot \V~.tcr
o Rnni:ltion
o Spc:ci:lI Dev:c~s _
o Oth.:r D<:viccs
PLEASE NOTE:
Air Condirion<:r Units
Cannot Encroach Int,)
Requiied Sid~ Yard.
Setoacks
FIREPLACE MAKE Al'.'D MODEL ilEAL -fYRE U/ FIREPLACE lTRtJRDIN,/JIR ?LOV-X.L
,...--.- ---.y ,. ..-..-.... . ."..._-_.._,,-_...,',...............,.....~
Inr.1u$tri~!, (t)m:i:~~ci~i & 1-.:uld-F'::lmd;.
FEE SCHF;DULE ,
I ~',; ofjt)Q CllS. RC;:';~liti~~I, G~s FircplJcc
S)9~O mir.imur:I . .
S99.~1) R,)~i.j~t1\!::L Ad Ltions & Alre;~::ons
S6'Jjli R~,;i.:~nc::l.J. AC Only
539.50
Rc:~idc:n.i~:. I.i~;:!i.~:; & A..C ('\':'.... CI>r\;:r:.:ction)
R:;iJc!1li::l. ;":~:J.,;r,g On:;- (0:~w CCI\;;r'~~,icr,)
S)950
$3950
f..):im~:d Co~t S
Bu!ld;~g P!:rTll( ;;.
(()mc~ ls~ OniYI
HEATI?\G PER\lTT FEE
STA'"c SURCH..;,RGE.!
TOTAL PfR~IIr FEn~,
s
s
S
~i2.. 5D
50
LID. DO
"
e"jidin~ allicinl
Dftrt
; P:::.id I Rec~lp' ;";0,
i NO'! (J 9 Z(llJA ,I --' /7)
I D", _..-J;- ~~ -~. 01
This Arfl1i.;:Hion Becomes Your Building Permit \V!1en Approved
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS __ ~()() I ~l r\ uJDDQ ~"C) .
NATURE OF WORK NEW ~.. t It-i,..tJ1UO&' ~O"~nON
USE OF BUILDING S.P:Q. - _ ,
PERMIT NO. .o?-. O~~3 DATE ISSUED ~'f
CONTRACTOR . ~QHONE~-~~O.~'9o
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMI~TS B ~~PARATE DOCUMENT
~ INSPECTOR DATE
t FOOTING ~ ~ H> I CsJ r ~()
FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING 1/1'<;lJfJ vf"
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
l 9cvh<< \ WJ ~~t~
~1\1~\ JNJ /itfh
g"(>
6
9--)
~-?
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I I j
. ff:.dJ~,. 1'e?2- SllKvey FINALS 72J gc "e~V5)'J ;e~~ F;}.,4G 1,.(.&
~. GRADING (Prior to Sodding) AI ~ /lI f) J1 / / _I ~. 0 S
, BUILDING ) fffp jll A57 dS
ELECTRICAL J'
PLUMBING fT"~ /? fr /~ V
HEATING J..-/ j -
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.
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
/Jj~
AJ~~ ~J
TIME
SCHEDULED
ADDRESS I (6 0 0 l
PHONE NO.
CONTR.
PERMIT NO. t/ - (P LIe,
OWNER
"
o FOOTING
o FOUNDATION
o FRAMING
o ~SULA TION
,.::eq:INAL
o 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 GASLlNE AIR TST
o
COMMENTS:
(\ \ J f) ~I
~\~~~.\-l U
D..JVORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORREC~ALL FOR REINSPECTION BEFORE COVERING
Inspector: r ~l ~r Owner/Contr:
CAL~~~8JFQR: THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
l&to I I11f)tf'1wf)()1 fJ.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~r~y at-
DATE
1l::!I ~
oll--(, 'fJ
~~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
4.:!!ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspectoc ~ Qwne,/Conbc
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
1 {'6 (;) (
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED I #
^)~I~~oA ~
CONTR.
PERMIT NO.
Lj
vt/Y
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
<tf15LUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/
~ORK SATISFACTORY, PROCEED
o CORR~ ACTION AND PROCEED
o CORR:C WORK, CALL FOR REINSPECTION BEFORE COVERING
INSNOrl