HomeMy WebLinkAboutBldg Permit 05-1018
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
10./3. oS
1. White
2 Pink
3 Yellow
File
Cily
Applicant
PERMIT NO. OS: /0 taJ
(Please type or print and si21l at b" ..,. ..J
ADDRESS 5/6f/ EcJaL /b//?T~J:/S.E
P/-/c>'r /Rre .,?/A/ 55B;/.:2-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT /L.JLOCK ;2...e..DDITION
,
D~~J2
~=R ~C~/7~/ ff ff~
f()-c;L
PIDz.5.+OI. Og+.O
\.../
(Phone)
~3:z -4~-//o/y
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing ORe-Siding
DAddition OAlteration OUtility Connection
~ower Level Finish
3 ItJ#IS .
o Fireplace
CODE: ~.R.C. OLB.C.
Type of &stroction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
1
III IV
H I
2 3
V
M
4
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have lllrnished Information on this application which is to the best of my knowledge true and COlTect. I also certify that I am the owner or authOrized agent for the
above-mentIOned properry and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
;"~);; 7~i;~re"..= ",,"" "" """" ~. ''''eo'' =, '0," "'= ", ~","" m""o= 0""':;,?;~5
Signature Contractor's License No. Date
Permit Valuation 3, ()oo. 00 Park Support Fee # $
Permit Fee $ 74'.76 SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ /.Sl) Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ 4d .00 Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 1I{p .d~
../ _ J"I
This Application Becomes Your Building Permit When Approved Paid 1{~"dJ / Receipt Ne.......F)~.Y/}g-?
~ .~ /0/13/oS Date 10 ... J :3 '" 5 By if
Building Ollicial 'Date
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 constlllltes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
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
..
Residential Building Pel.w.it Che~kIist
Basement Finish or Interior Alteration to Single Family Homes
-
BY:
~
,
~
Date:
/t)j/3/0S
Building Permit # Pill:
Site Address
Zoning:
Legal: L B
Subdivision:
Emting Structure:<SES~ NO
CONFOR1VIS TO ZO~ThG
ORDlli.AL'{ CE
YES
NO
Is this an .....:-c:w...Sion or the e.'Cist:ing rOO"tJ.L~t or
building beight?
YES
Refer to pl'-'lT'lT'l-MJg
NO
Is the ,lJ.L vtJert}' located within the flood plain?
Refer to Planning
;Ja
r1~
;la
)(}
pO
Does the alte:"ation include any additional kitchens?
Rerer to Plamring
Does the ,lJ.LvtJosed alteration include any outside
entrances other than patio doors?
Refer to PI~g
Is the proposed use or the finished space or
alte:ation for anything other than a normal s...ngle
family home (office, group horne, day C3.I'e, e!c.)?
Reter to Plamring
THIS cm:CKL1ST :'vIUST BE COLVIPLETED .~'1'D INCLUDED IN THE BL'1LDING PER;\ilIT FILE TO
~LUNTA1N A RECORD OF THE REVIEW.
.
.
T .\~T . 'l"'t:". \ T "T".'""T:~.r T'\('\r
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File PERMIT NO ~ ~
2. Gold City .J'. ...... I/) I .
3. Yellow Applicant tI.!. IV Il
(Please type or print and si2D at bottom)
ADDRESS
5/!aC/ E- ~;:?;l ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
V OWNER
~ (Name)
(Phone)
. (Address)
"APPLICANTO {\ \ p \' 1
'\ (Name) \ (,Q+-4'.~"(icC v>"'\.b:")' "'(",. (phone) e1Cl.- "'1L-\l- s-lb I
V (Address) '?,"Kl(() U I \\cvJv..J<:cc>J 5r svJ Pc; (;.-- L.._k._ N\J.,J S-S- .~l d-
'\ (Address) (City) (Zip Code)
V (Contact Person) () ~'" C \" ~ ~ (phone) <.., t. - L.I 0 - <;;l. '-I "1
"\APPLICANTSIGNATURE ~~~/-/ DATE 1\-- ,-oS-
- . A;dANT P~SE ~OMPLETE 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)
Quantity
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 1% 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
TOTAL PERMIT FEE
$
$
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
1050 0 6l~
0", ff\ Reeeipt Noo
p--' By
Date
Building 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
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS _ 5/&4- t:;ri>T Ot1-i::- p()/ tVT
NATURE OF WORK L () WC;/'L ~
USE OF BUILDING /2{3J' ~/ft-
PERMIT NO. 0.5. /018 ' DATE ISSUED /0.1.3. OS
CONTRACTOR K All.$) PHONE ~O. .t/--OB
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BE(OW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
...... I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
.~
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FIN A L S ...c,
BuiLDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
. I J
'II Lflo.b
.~;;2/1 ~b
'/ / l/ /0(,
'I / ~ /tJb
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
f1t/I'
jfVf-
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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
SCHEDULED
ADDRESS
5/~ </ ~q ~ I t!:Je;;f
Jf ~
P/v~~j'l
//kc~:
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~I TION
INAL
o SITE INSPECTION
CQ.PtJMENT~
71 -eC r~,'c6L I
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
,..er~LUMBING FINAL
)!r"MECH FINAL
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TIME
~- ,/O/r
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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2.// /t;{,
CJk
0'//
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h /e.- ./
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/.-./'
t CI tJS~
~RK SATISFA
/ Ii CORRECT ACTION AND PRDCEED
o CORRECT WOR~).J.?R REINSPECTION BEFORE COVERING
Inspector: f/~ f.--/ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &. SAFETY/