HomeMy WebLinkAboutBldg Permit 05-1055
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File
1 White File I PERMIT NO I
2 Pink City . ()S. I () 55"
3 Yellow Applicant
(Please type or print and si2Jl at bottom)
ADDRESS "
l/~ 'QQ.oL~& Or%
LEGAL DESCRIPTION (office use only)
LOT Cf BLOCKg.., ADDITION ~J
OWNER
(Name)
(Address)
I~
(Phone)
ZONING (office use)
PID ZS'.4-z,4f'. ~J3.. 0
. (Phonc6tS()....Q ~5 ./~2>
J _ I'^. (Phone)Q5(;).#<J..'rXo"'4'7[!)Q...
Ct- 4fjOO lfWU 01[, ,,!hl) I;'-'~
TYPE OF WORK ~ew Construction ODeck OPorch ORe-Roofing ORe-Siding
OAddition o Alteration OUtility Connection 0 Misc.
CODE: "hll"I.R.C. DI.B.c.
Type of &struction:
Occupancy Group: A B
Division:
I
E
II
F
I
V
M
4
A
R
5
OLower Level Finish
B
S U
PROJECT COST IV ALUE
(excluding land)
o Fireplace
$lfXt{7~1
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authof1zed agent for the
above- entlOned property and hat <all constr ction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official c rerOhJ;t \ ~ :use h~ee that the City 0~57n the property to perform CJ~7r;;0!5
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
III IV
H I
2 3
~ /..Sfo . OfJO ,.O~
$ led ~9, COO
$ SZS./Y
$ (.g.tJO
$
$
$
$
$
/IJO.()(J
tOO.DO
35. -So
40..00
~
7~
This Application Becomes Your Building Permit When Approved
Building Otllcial
I~ ~S~r
, Date
Park Support Fee
SAC
~ -
Water Meter ( SizeS/8Y1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
"
Paid
Date
/at'1II. / J"
liJ,JI . ~ ,---
#
#
$
$ /?'So .Ot)
$ ,,250,00
$ 50. 00
$ / Soo~Ot!J
$/o()()~()e
$ -
$
$
#
#
Receipt).Jo.
By A'.
I
~-/ {, 81t ffi
I
I
f'lJ17 d
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 conSl1tutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be
i~
Planning Director
10 /(J S~S
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN S5372
~
Special Conditions, if any
See Main File
White - Building
....-r..l'larv - c._",'neerlha:>
Pink - Planning
BlIlL,plfllGP&R"~ ApPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. K
1-1 ()12... TON
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7507 DEEI~;-16C-O De
Accepted
Denied
~
Accepted With Corrections
Reviewed By:
/IIIJJ!>
~ t:: /Yl""',,, h'/ (
Date:
lo-(~-o s-
Comments:
liThe issuance or granting of a permit or approval of plans, specifications and
comPlltiltlonfJ shall not be construed to be a permit for, or an approval of, any violation of
any ofl" provisions of this code or of any other ordinance of the jurisdiction. Permits
presUft'ling to . give . authority to violate or cancel the provisions of this code or other
ordinances of the jul't$diCtion shall not be valid."
t
..
t
..
~
~ PRI~
t;"~
U"-1~
~NNES:V
See Main File
White - Building
Canary - Engineering
c::::.t"mK - t"lannlft9;:>
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/ /
/ /
f i,.....
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I --;' ~~~ / 7~ t I~ / /.:- Ie L Ij ~/ I.-
Accepted
/
Accepted With Corrections
Denied
Reviewed By:
~
#
~
Date:
/0./ ~&-
Comments:
Ser Main File
"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 - l:hJilding ~
Canary - Engineering
Pink - Planning
.BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. ~. H()~I tJN
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7507 Deete-F16W De..
Accepted
~
Accepted With Corrections
Denied
Reviewed By: ~
Comments:
f~
Date: !()/ Sjos
,
See Main File
"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."
10/06/2005 THO 14:53 FAX 952 767 1900 GENZ-RYAN
~ 009/009
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type Of print and siAA at bottom)
I ADDRESS
i If 50'7 'f)Pelf~-j e) C1
I. Blue File I PERMIT NO~'
2. Gold City .
3. Yellow Applicant
'j)' 'r
\ / \ .
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT .Lf BLOCK a ADDITION
D-Pef ~~i fJ (1' I A tb
- I .
PID
&~~R L) P -\fuj/+O(l
(Address) d-O ~(fl () ~ Cn b ~'1 Cl0 f (0 +
, APPLICANT ('; _ 1).
(Name) t::le1.1? - ~iJ{U1
"l <'/ I"l -, \ ^ / j.J.. I 3
(Address) f-t-UU ; Ii. IIV'; [,( '...
(Address) )
(Contact Person) f-e{Aj/\ )
APPLICANT SIGNATURE -LlizVG
..;:..... ~ - ..&......~.._..
$:-{f, Inn
(phone) C15.~ - q Y f-).- 7 f( '1>
Lclkf.V111 fj 5501-1 Lf
Quantity
t
i
I
c;:>
I
[
I
(Phone) Qr.;7_- {[PI - (DDc)
BUtlt1C,V/fle.. MN ~337
(City) (Zip Code)
. (phone) q5t~ -7(ul~ aD
kBi)jJjp DATE JI!i!W{O'5
'''-
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity I
Bath Tub with or without shower I I Rough-ins
I Dishwasher I I I Water Heater
I Floor Drain I \ I Water Softner
Lavatory (Bathroom Sink) I J Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink I I Sewage Ejector
I Shower Stall I I Backflow Assembly
I Sinks I J Backflow Assembly Test
I Bar Sink I I Lawn Sprinkler
~ I Water Closet (Toilet) I I Other
Type of Fixture
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 $
PAID WITH
'~ILD'NG PERMIT
(Office Use Only)
I This Application Becomes Your Building Permit When Approved
Building Official
Date
l~eceipt No.
By
,
24 hour notice for all inspections (952) 447L~850) fax (952) 447-4245
10/06/2005 THU 14:53 FAX 952 767 1900 GENZ-RYAN
~ 008/009
Date Ree'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
(Please tvoe or orint and sil!;O. at bottom)
ADDRESS r,.
/'7.5'Of] ./)-eef/j},idc{ Dv.
~: ~w g; I PERMITNO.~ ~~Jr"
3. Gold AppJiconl ~ ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT..I--f BLOCK <..9- ADDITION
\){tr(ifJc( I~'~
,.../
Pill
OWNER f)'R iJ.-r ,(...\..-r--.'.,r-.
(Name) /""'. I \ I ) \ t LJ I I
<)('(;1 , (" '}p 1\ 'In\ ." cle po n:
(Address) r?'i )f,. (IJ ) '\,I..J I ).' I .IL.. l_;;I.
. (Address) oJ
sh:llD
Q5'1'", 0(,,;:::::. 4()hr~.
(phone) /', d, -. .1'1 X j - I be.. )
L"OJC1.v11 fr. 55uLJ L/
(City) (Zip Code)
. AP(NamPLIeC)ANT 0.,(iVr./I'2.. ._ 12. {' 1/1.11\ fJF)"l 7 //'l1 (f Dr'"
t: I ....c.L1- 'I (.II ' I (phone) . l '7 I- - lf! I - l) )
. . I
(Address) two \rJ. HVVI) I.~ 67AJfJI/S. virr~ tV'vN (7;33-'7
(Contact Person) LFo~SS) . l _ .' (~::~e) OJ 5~ 7(j7 [[rude)
~LICANTSIGNATURE (N21~UILA/t1.JZ; DATE lD/LO!U:;
"---'" ' ~ .
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure,
J:l.Klt SCHEDULE
Residential sewer and water line connection $35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39.50 minimum
Sewer connection only $17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50 PAID WITH
BUILDING PERMIT
(Office Use Only)
I This Application Becomes Your Building Permit When Approved [' -~-gwr.'
"
Receipt No.
Building Official
Date
Date
OCT 2 0 2005
iBy
I
24 hour notice for all inspections (952) 44'~9850, fax (952) 447-4245
J I
I
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or print and sign at b" .."...)
, ADDRESS
17507 DEERFIELD DRIVE SE
~. ~:n ~~:y PERMIT NO.'- I A~'
3. Yellow Applicant W ~
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 F AIRVIEW 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 D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
OUTPUT
DWarm Air Plants
o Gravity
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
FIREPLACE MAKE AND MODEL
HEATN GLO SL-550
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.S0 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.S0
Industrial, Commercial & Multi-Family
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
5(L PAID WITH
. BUILDING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
ii\ ~a~<l:,
ill i..' '
~C 2 0 2005
Receipt No.
Buildin2 Official
By
,
24 hour notice for all inspections (952) 4t~~850, fax (952) 447-4245
:%:~Sd-q
..: .'. h' . ... ... .. CITY OF PRIOR~~:. .. ..
d, :';~~J.;;ING/Am. eONDI l'lONlNGI~'~.PLACE PERlVuT ,:
;
...
':'1'-
...File
. City.
, Applicant
.PERMI.TNO. .......:_.:....,'..
. 6:"1' (J,... .
...../ ..::,~:.:...,....''''' .j,>.:. h!' ,.........
. .
". t. : ~'.: '.:.... :?;:;~:":.~::;;:'~;'}:;,.!.. ":.:,: ,
...~O~~.{~~ci:;~~>,'
; Estim.kted Cost $
Buildmg ~etnlit # .
". ....,...... ",
:,,', '.
(Office Use Only)
This Application Bec~inesYour Building Permit When Approved Paid
HEATING PERMiT FEE
STATE SURCHARGE
..;'..' TOTAL PERMIT FEE
". " . - .
.~ .W^,,- '~~l3blli~:G~~1T
$ .. . '. . ....
Building Official
Date
DaJAN 1 9 2006
By
'. (.
., .24 hour notice for all inspections (952) 447~9850, fax (952) 447-4245
PRIOR LAKE DEPARTM~NTOF
BUILDING AND INSPECTION
~
INSPECTION RECORD
. .
SITE ADDRESS 17~d 7 ./)€E1tF}ao /)1./14' s:E.
NATURE OF WORK}JSIAJ ~~srIfIqT/i;:J (t.JO '.L. ~
USE OF BUILDING 5. ,... A · --
PERMIT NO. 05/CJ55 _ DATE ISSUED Ifj~S
CONTRACTOR .1), f(. /1DfLnfJ l , #J(. PHONE~"- "" 73~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSP!"CTpR DATE,
FOOTING I Y1/Y I / J / J / ~-.-J ,
I FOUNDATION (Prior to BaCkfill),ltY~~/1' /K/ //h~r I //VI 1@~/gJ-
PLACE NO CONCRET~ UNTIL ABOVE 'HAS BEEN SIGNED
ROUGH - INS
/A;A:'"
ryo; /:
l-q;:.~~ ~
/ / - p-.
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING l I (,-. "M? (t.. >o-o(
HEATING (if required) i). (,. JI'v'fJ /J.,.J-lt<<
FIREPLACE _
GAS LINE AIR TEST //~/h f ~ 1<
.
IAtv I
JWt-.
/#'r
/~v/
,
/ &6,('~
/ JJ.J/~
J/lllc~
J////DF'
/ / t. ~. L'S:-
'//I,i/or
I 113 /c6
/ /f~fI
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
.
IJtTfjE maSElUllAfJ I H~~ 1#1IhJ4A
, I .
FINALS
GRADING (Prior to Sodding)
BUILDiNG
ELECT~ICAL
,,~
PLUMBING
HEATING
DO NOT OCCUpy
_ --(_-I
~ee .#k/, /i /~,
/1# g;f~b ~
;:z /2/ ~~
,2/~~~
y/?~
~
UNTIL ABOVE HAS BEEN SIGNED
NOTICE
II(/j.,
-~
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
@erfifitafe nf Q1}ttupantl!
CITY OF PRIOR LAKE
~tptttfmtuf of ~uil~iug Jluspttfiou
~Fina1 Permitted D Conditional e.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 Classification5/lvtEh.E: ,rr/rJ I L V Bldg. Permit No. (j 5:. I ().6::;-
,
Occupancy Type
k'3
L 4-.
Type Construction
V/II
Zoning District
/<;:'2-
Legal Description
CZ-. VEEk'/::/6LV 12TH
Site Address 1756L[)6.C/~/c:.L{) DK-.
Owner of Building
Contractor's Name & Address /..). k.. ~
, / ~ilding Official v
Date: ;7 /9' (::JP::;
~'.
2- ( 8(;, 0 IC-{;NLtc'../ vt!'E ~-;-:I LrI;o:;c.i I L.eE:
City Planner
Date:
CITY OF PRIOR LAKE - L /
INSPECTION NOTICE SCHEDULED -y'9/()6
/7S0;7 ~t:,.Ii// 4-
TIME
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
-5'- - ./ a.Y...r
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~H FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMJ4.F~TS: /'
?-/~,~/
---
hh~/
" /
~>>~~
"
~~
~~eiVe ,
/"
~Aq I ~
~rc<e /
"
~r-
---
~ ./
,r; P14 r
/
0/,--
~
(/ U~, r~ ~/~)
~KSA~OCE~
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FO 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!
1NSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
'7177~~
/75-07 ~~/a/j 4
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
s- -/d?J'J""-
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
~. t'LUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMM.,ENTS:
/ /
~",~~~~
~J,-.. ... ' t1!J A
tf/ ~
1/ / . - . / -"~ /'
/,) /f/~I!d. ~{/ /J"15~//ed
r;;77 ~y~~ (&J s/-Y'7-Yd?"f-'
-r-/~
r'/~~/
- /- /' -J ~A:fI' // ~ /
(' ~~ ~ ~-V' '/ cL~-h:.s. /74+. /
d
/
?C/c
o WORK SATISFACTORY, PROCEED
~RRECT ACTION AND PROCEED
o CORRECT W~~;:~ 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!
lNSItOTl
-
APPLIANCE
PERFORMANCE TEST
Attach to gas line adjacent to regulator
Heating Contractor. A (I: to.. +- H ~c/f
Name of Tester (' .b.. cD
Date tJ....,'~Oh
Job Address 17~") \)tef' r:J.1
Heating Contractor ~ 1I; C4 ~ 1\11 ttll. .
Name of Tester ~ o~.
Date 1. -IS- .'04
Lt><G ,,~
~f/~
~.60te
-S;z.o 6 ;.
Percent 02
Percent CO
Percent C02
Stack Temp
Combustion air is adequately supplied per
UMC Sec. 606 y, S
input WtOtJt\ B'W-