HomeMy WebLinkAboutBldg Permit 05-1053
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(Please type or print and si~ at bottom)
ADDRESS
See Main Fi~e~
White File
Pink City
Yellow Applicant
I PERMIT NO. Os: 1053
[}S)
&.SG
ZONING (office use)
/?2.
LEGAL DESCRIPTION (office use only)
LOT~LOCK ~ ADDITION G-Qo * d& 18-~
OWNER
(N ame)
PID 20.. 4'Z+. 0' I. ()
(Phone)
(Address)
~~~:Name)f)~t1&!i'~~6 (Phone)4.9..q6-7~-;
(Contact Name) 1Y'ub LVr*1nfJLv..Yz.A. (Phone'fJ.!53....9/(j..(c;.Lf'7 6~
(AddreSS),c)o~ 1/ . J\& l"jJ~ ~/Cb LaJuuUL ,thYl EJ=CiP-f
_ ~~, ~A-rrj ~ I .
TYPE OF WORK ~ew Construction ODeck OPorch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace
~ddition o Alteration DUtility Connection 0 Misc.
CODE: !XJI.R.C. DI.B.c.
Type of 1onstmction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
PROJECT COST IV ALUE
(excluding land)
sC}(J f get[
I hereby certity that I have htmished information on this application which is to the best of my knowledge true and correcl. I also certity that I am the owner or authonzed agent for the
above-me wned property an~ thlt 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
official can voke t~ ~ermit "Dr Jst caus Furthermore, I hereby agree that the City offici or a designee may enter upon the property to perform neede Inspections.
X lli'~ ~~_() _ . ~. ~ p- ~
Signatu e Contractor's License No. Date
Permit Valuation ';i3~.()oo. DO Park Support Fee # $ . ~
Permit Fee $ I ;l/tJ9. 5"0 SAC # $ /1./50.00
Plan Check Fee $~ZS". IF Water MeterC:Siie5/~"; $ ZSO. l)o
-
State Surcharge $ "g-. c=J 0 Pressure Reducer $, 'so,. 0 C)
Penalty $ Sewer/Water Connection Fee # $ I!JbO.O 0
Plumbing Permit Fee $ /00. 0 ~ Water Tower Fee # $ /000,. D 0
Mechanical Permit Fee $/ca.oo Builder's Deposit $
Sewer & Water Permit Fee $ 35'..5""'0 Other $
Gas Fireplace Permit Fee $ 10.00 TOTAL DUE $ t,~ (, 813_ la
() ,
./
This Application Becomes Your Building Permit When Approved Paid {,tb,l',{ ./d Receidt}.1o, flJ7 f (/
~ ~I!- lo/~:s- Date /"~~~ ,,--- By Y,
;;
Building Ollicinl , Date
ThIS IS to certity 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
~ P~'''''P'''''' C",",,," Of;;;; ~d "'~ 00""""0"" oom~"re Il<f~, <~P"'''' ,.cm".." <"O=p~" m,,' '"
Planning Director ' Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
"]
See Main File
White . ~ull~lng
r Cal')frv . t:nq.n....r-qp
PInk . Planning
p,JIMII,Jl,,.Q PJ..,..T~~PPLlCATlON DEP4RTMENT CHECKLIST
, j.. ." "
.j,'L'~~:~i "
.D. K. H OIL-T7J IJ
, :APPLlCANT _
'j "."
! ':'W~ArION'RECEIVED
"fhe Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which. is proposed at:
/7503 DE€/L-FIE1-D OfL
Accepted
Denied
x
Accepted With Corrections
Reviewed By:
Comments:
.&11:6
Sf..c- A1,,:r. Fr'II'_
Date:
10" J~~05
~/:. L'.
r,,(
liThe 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 shaD not be valid. II
See Main File
~ - Buildini::>
Canary - t:nglneiring
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. e.. H ()IC{1:) JJ
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/750:!, Dee/2.,f=/a-D Olt-
Accepted
v
Accepted With Corrections
Denied
Reviewed By:
Comments:
~~v
Date: I~/s~:r
See Main FDe
"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."
See Main File
White - Building
c:::i::ary - Enaineering
. -PlaRn1rig::)
BUILDING peRMIT APPLICATION DEPARTMENT CHECKLIST
~I~
NAME OF APPLICANT
APPLICATION RECEIVED
/..
l '
i. / /
,
! .
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1,1 I'Y I ( (! r / L L /j .J 1<...-
Accepted
/'
Accepted With Corrections
Denied
Reviewed By:
Comments:
~~
Date: I~ I S-/o~
See Main-FiIe
:-,p';
'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 CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink
2. Green
3. Yellow
~:~y I PERMITNO'''ID'~'
Apphcant 'f1iI . ,.,.,.,
(Please type or print and sip at bottom)
ADDRESS
17503 DEERFIELD DRIVE SE
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name CENTEX HOME
(Phone)
(Address)
APPLICANT
(Name)HEARTH AND HOME TECHNOLOGIES DBA FIRESIDE HEARTH & HOME (Phone)
2561
651-633-
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone)
651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
12/20/05
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
D Steam
D Hot Water
D Radiation
D Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
HEAT N GLO SL-550
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99,50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
REA rING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50 PAID WITH
BUILDING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Buildine Official
Date
~c 2 0 2005
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
~pbd.q
'Date Rec'd
,\: . t"
PERMIT NO:: .....d.. ~~
.' , ,. ...'~I(J~,
," y. ..:';.~:' . ...~_....,:...,.:@: . '
':"': ~.: ~".:::1d(:7;;:.:~;'".'.!r:.:",,~ .:~' ,
itesid~hti~i. Additions & Alt6raiioM.:..' :
ResidiihiiaI;'AC Only . ,
Buildmg p'ennit # .
.. . . HEA'TING PERMiT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$W\\... '~~e.,-: :PAIP'W1TH"
: ." .50 BUILDING PERMIT.'
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid
Building Official
Date
DJAN 1 9 2.006
Receipt NrfJ
By ;/
C-
. ,
. .
. '. 24 hour notice for all inspections (952) 447-9~50, fax (952) 447-4245
10/06/2005 THU 14:52 FAX 952 767 1900 GENZ-RYAN
~ 004/009
Date Ree'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
(Please tYPe or 'Orint and siRIl at bottom)
ADDRESS D ,...
f 06V3 'f. .eerPrt/CI Dv:
f
i: ~;~~ ~~ I PERMIT NO. II!'- IA _...
3. Gold ApPUtinl .., .,.,....",
ZONING (olfic~ us~)
LEGAL DESCRIPTION (office use only) l").p r
LOTO\ BLOCK d- ADDITION L/ l. e.V 'I i eloJ
OWNER [')''l . L . _
(Name) j' k \-rDtf to)l)
(Address) ,,9()X-( O() ~-<(Yl \0V\Ck),c &"
. (Address) J
;-Ifh
OZ -'
Pill
Sh:iLD
(Phone) C15J,.- YX-5 -t({tJj
l)lJCiVi'f IG' esoLJ L/
(City) (Zip Code)
, APPLICANT fl. 12'
(Name) l:1{1~1_- -fA a fll
. I I
(Address) 1,liJO Vv. {-hAIUr I,~
(Address)
(Contact Person) --et)Jr") ..-...
~LICANT SIGNATURE ( J4tv~ 41/J /J.iP f V
~....L ,""'"'-,
_ (phone) '102 - 7 LI/7- (000
BJA ~/1 S' Vi f r~ ~fvH {3~33-7
(City) (Zip Code)
(Phone) en a ~7(pJ- (C~D
DATE .,fJ (((; 105
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. 0 ABC 0 PYC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
FEE SCHEDULE
Residential sewer and water line connection $35.50 Industrial, Com'J & Multi-family 1% of job cost with a $39.50 minimum
Sewer connection only $J7.50 Water connection only $17.50
Estimated Cost $
Building Pennit #
SEWER AND WATER PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50 PAID WITH
9YlLDING PERMIT
(Office Use Only)
I This Application Becomes Your Building Permit When Approved iPaidl
Receipt No.
Building Official
Dat~
, ba~Ci ~ &-zooj By
I
24 hour notice for all inspections (952) 4471~o,Jax (952~447~~~_
10/06/2005 THU 14:52 FAX 952 767 1900 GENZ-RYAN
[4J 005/009
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blu. Fil.
2. Gold Ciry
). Ydlo.. AppliWlI
I PERMIT NOS: ItJ53
(Please type or print and sign at bottom)
ADDRESS " r-. )
\ ry~~ \,~-ee(t;eJ()\. ('.
ZONING (office use)
LEGAL DESCRIPTION (office use only)
'\"\ (, I
LOT ~').. BLOCK d ADDITION \J-lX-1' {--It 0\
l'd.t
PID
OWNER D t'') .Ll-,.,... /1...1''' A
(Name) l. '\, r I VI' "1 U{ I
(Address) CAO E( pD K CV'I i~ Vl ct 0 [: e*. >-.-fc. I nD
APPLICANT /l_ n
(Name) CJe,j11..~ ~ilavl
(Address) 211)0 \N. I-h'\J [) /...3
(Address) )
(Contact Person) L- e OJ\.
APPLICANT SIGNATURE (~ r-'<JJ )1)lJ ()p
(phone) 05) -- q vt=).- (K7f)
LO..ktVr I [ -t-- 550 '-I L!
(Phone) QC51:-,lfi1 ' (DOc)
F)~{t2.VI~if /' {I~, fv\ N S5337
(City) (Zip Code)
(-}t=" '"'\ ~ /;7 (("\1-,-,
(phone) '''''rJc)( - I..U. - \....J\..A...)
DATE 1 @J /(0 (u~S
!2
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower I Rough-ins
Dishwasher I I Water Heater
Floor Drain I I Water Softner
Lavatory (Bathroom Sink) ! I Stand Pipe (Washing Machine)
i I Laundry Tray (1 or 2 compartment sink Sewage Ejector
) I Shower Stall Backflow Assembly
I I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
Type of Fixture
Quantity
I
I
I
,;(
FEE SCHEDULE
[ndustrial, 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 Pennit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
FWD WITH
IiJllDING Pt:t\MIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved _... -Ea,i,l
Ii \
!' Ii.
~I ill) !)ate
Date J ,f, OCT 2 {) 200~
24 hour notice for all inspections (952) 44~S50. fax (952) 447-4245
!
i
------::t.,Receipt No.
I' !"',n:
Ii .l3y
'I
i
Building Official
;....,.(
,
.1
->.----~--_.---_.---~ ^
PRIOR LAKE
INSPECTION RECORD
. .
SITE ADDRESS 1?503 Dc:,.JtF/ELO ~ S~E.
NATUREOFWORK ~ ~C'rAw'\ (NO ".1..)
USE OF BUILDING S.F: A. _
PERMIT NO. ().5. /053 DATE ISSUED lO/~{O S'
CONTRACTOR >>. ti. H.tCI'IN PHONE-'.S&. 22". '1?Il.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
See Main ~11e
DEPARTMENT OF
BUILDING AND INSPECTION
J
INSPECT~R .DATE,
FOOTING I 1M I 1/ /1/ as
"., t . ,.
I FOUNDATION (Prior to Backfill)d/9IIF~~/ .~ //hkrl I#J I~S~11
PLACE NO CONCRErt UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER/WATER/SEPTIC M- l/j/~/~$
FRAMING ~ t//i:lof
INSULATION ;jaf 1.,li;rltJt,
ELECTRICAL )//~6
PLUMBING l),c::. #I I!Lf!tJ€:' 1Jf~ I fIJl/oc'
HEATING (if required) C/,~, II/f~~, ;rl-- / ///~h
FIREPLACE r~. / //?/~
GAS LINE AIR TEST ~Fj.,... f-r,/jd ~ / ft/"t&
COVER NO WORK UNTIL A~OVE HAS ~E~N SIGNED
I LATHE ~~ Iff/;;v: 1#/J-1./J9ft~
FINALS
GRADING (Prior to Sodding)
BUILDING
.
ELECTRICAL
PLUMBING
HEATING
DO NOT
J
~ee~k k/f' ~
/IU? ..r/2~/d~
-2Mf'A"
YI'P/- ,2/7,7/09
~ -.?P~h
,
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
QT~rfifitaf~ of Q1}ttuflaUt\!
CITY OF PRIOR LAKE
~tpatfttttnf nf 2iuilbing Jlnspttfinn
~ina1 Permitted D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 110 of the 0 Residential / 0 International
Building Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City of Prior Lake regulating building construction or use. For the following:
Use Classification :SINGe.. 6 ,t.-:rI/'1/L.-V . Bldg. Permit No. 05. /{;53
,
Occupancy Type
k3
Type Construction
v't/
OE e I6F / (;. L-..O I Z 7H
_ Zoning District
~Z-
Legal Description
L Z I 8Z,
Owner of Building
Site Address / 7503 .uEE.~/t;L-.o Dre...
208 GO /~ IV C k.. /0 CGC C!..- T , LF-I;t:C; v'; U~
Contractor's Name & Address [), K:. . H t k--7t/ I'j~~
,#/ ft-
B~u9'fi Offi' 1-- 'r~C"
f~</;&2 cia
;/ "
_ City Planner.
Date:
Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/7S-OJ
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NSPECTION
COMJIIENlS:. ,
~C~'C~(
TillE
SCHEDULED ~~~
/~rI211 /d-
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~H FINAL
--- ;
/'7h~ I
,
~/:L~ Fi~~ / ~
4ec", ~ 0-;'.L CYJ-<~r
~ /
hh9/
/
Uf,
O-/dPs;<>
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
,.e-F1REPLACE FINAL
o GASLlNE AIR TST
o
- ./'
.2./ ..L<;/~ C.
"
c9fc_
~J'~
...-
.-------.'--... --'--- -=----
--- -.. --.......
/ /? /"r/ ")
( CL'o-S-e rt'e ./
'-- ------
~ORK SATISFAC,; I OR'I, t'K~cE:D
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CAL OR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
<!ALL, 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSIIOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/7,SoJ
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED ~.?~
/ . ,.
a~-y4/J dr
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
--'=' r"LI:.IMBING FINAL
o MECH FINAL
COMMENTS:
4/ /
/" /v/t'76~~~
/
~()~~
~ /
/-7~L
-
~/
/-7 k.-rt
\. \- /&)C ?
o EXIGRADlFllLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/
~ / /"
/-e' J,r qc,.
~/
~?C
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORt] .-'~ .;?EINSPjCTION BEFORE COVERING
Inspector: /.P"-' ~ner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSItOTl
IIIIF
..
APPLIANCE
PERFORMANCE TEST
Attach to gas line adjacent to regulator
Heating Contractor
Name of Tester
Date
Job Address
Heating Contractor
Name of Tester
Date
Percent 02
Percent CO
Percent C02
Stack Temp
~~
().'LJ
0/'7 jDt.
i7S0.l ~C'~
~l MaL
-GhJ
QJI7/~'
~~
fE-I'/n,
t;,,/GZ
~t'JF
Combustion air is adequately supplied per
UMC Sec. 606 '1'*".1-,
input ,,; eAJ ~\n,.