HomeMy WebLinkAboutBldg Permit 01-1406
(Please type or print and siRll at bottom)
ADDRESS
14 '"Lfo '7
l .'Y OF PRIOR LAKE BUILDING F.MIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3. Yellow Applicant
Jj r() () /t:.M~ b I UtP '
LEGAL DESCRIPTION (office use only)
LOT l BLOCK L ADDITION
OWNER
(Name)
c~
J2tftJ/J
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
/vleJDW View.
f/z; /VI e,S
IAJhi ~~ })r. I
/
~p
AtA-1/ I) '/j-J ","td
5~~
.
~New Construction
OLower Level Finish
Date Rec' d
I ( . ~r...O I
PERMIT NO. n.' /4{J (0
ZONING (office use)
I!!. 2--
PID 1,S' - 38tf... tJ'5,,()
(Phone) "IS l-7 3' - ~~.J3
5~ -k /~. Jl}:AVldt;"k~ I'1AJ} .5~3~ ~
/ /,
5~~
9IZ-3~9-J~? 3
(Phone)
(Phone)
o Deck
o Porch
ORe-Roofing
(
ORe-Siding
~ireplace OAddition OAlteration OUtility Connection
PROJECTCOST/VALUE (excluding land) $ Iz r. t/OO
- ,
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
authorized agent for the above-mentioned property 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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;ter upon the prope to perform needed inspections. ~ ,., /:1? 3 / / / / 2" ~ /
Contractor's License No. I D;de
. o Misc.
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
(~S ,Ot:JO .dO
$ ~ ~
, 1 I ~~ . ..,~
$ ".?(, . e;~.
$ ey.5'D
$
$
$
$ -
$
16o.QO
toO. (;:) 0
1.[0 . 0 ()
f%ryj_....y=...;:;:;A~
~~cial Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid r;;o':1~ VI
I Date /-Z/,IJ/OI'
# $ R~,OC
# $ 1./ ~.c)C;>
$ . ,
---
$
# $ 1.200.0(J'
# $ . . ~ .00
$ -
$
$~OI3.f!/-
Receipt No. "1-11 oa I
Bv LL)t.J. I
, 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
=,~~fu'Ci~P~:"~::-C_;;;;~lim~mdill~?:ID~D'c:lRT;.::
V ~_, -.""" S"do C",,'moo, ;f~y -
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
White . Building
Canary - Engineering
Pink - Planning
Th. ('.nl., of 'h. I.... eGnnl1')
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
C ~b fVi"B}( H 0 fJI E5
11- Z9;-O I
. .
The Building, Engineering, and Plan~ing Departments have reviewed the building permit
application for construction activity which is proposed at:
) ~l{()S SeoolcMErGE BLVD.
X
Accepted
'-...
Accepted With Corrections
Denied
Reviewed By:
M4f(.
-
~ Cf MA/,^: bk
Date: /'2. -'10 -tJ J
Comments:
'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."
"
The eenl.. of the tlke Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t~~'16)( HL~IE~
f{-Zy.,-QJ
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J 4- Z (c 7 t~;~'(-C c~~'IE t<-E BL \/ D.
. ,
Accepted V
Accepted With Corrections
Denied
Reviewed By: ~~i1:----.-"---~ Dale: I :?-fltl/Bl'
Q -:c.I ~~;<' --\ ~ "-t fN, \ ('~~
, _ 'V:1 ~ r ...L9", /J, +- ~% ~ "\ Jut
~') ~_) S,9b&J/JiJ<h~ 4b
'''i,
"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."
\
D~te Rec'd
CITY OF PRIOR LAKE PLUNIBING PERl\IIT
~. ~~~ ~!~ I PE&\nT NO'Of -I AO '-
J. Yellow Applicant ~ (]
(Please type or print and slim at bottom)
ADDRESS
/{/af 1
0I'df}ht~/{J
8ft;}
I ZONING roffic~ use)
f' r:"'- ,'" .-.. "":,,.,-T"" T"""'-"T""""'", r ,...-
LOT
....._._.. ~_ _ ___-_..__ ......'-'~, \J'~"""_''''''''''' ~'~..',
PID
BLOCK
ADDITION
: OW"NER /I t .
! (Na~e) I _~~1 ~ I.
(Address)
(Phone)
~~;;;,~~ANVa/ J, JlI~l.
(Address) ~O ~.<<ab/' l/i/<t
(Address)
(Phon,? <? 5cZ- t/~ 01, ;;! J ~
'\,~/tlai1 / 10-5:1/
(Cicy) (Zip Code)
(Contact Person) ./
APPLICANT SIGNATURE (UAA-A
Quantity
:p
/
/
1
I
I
.J'
I
MMAAJ
(Phone)
A
11)// t!.-r t /
DATE
APPLICANT PLEASE COMPLETE BELOyV'
Type of Fixture
Bath Tub with or without shower
I Dishwasher
, Floor Drain
Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Quantity
,1 .
i
Rou~h-ins
Water Heater
i Water Softner
I Stand Pipe (Washing Machine)
I Sewa~e E)ector -
I Backflow Assembly
I Backtlow Assembly Test
I Lawn Sprinkler .
I Other .
;.
"
FEE SCHEDULE
Industrial. Commercial & Multi-family I % of job cost with a $39.50 minimum
Residential. New One & Two-Family S99.50
Residential. Additions & Alterations 539.50
Estimated Cost $
Building Permit #
PLUMBfNG PERMIT FEE $
STATESURCR~RGE $
TOTAL PERMIT FEE $
'0 '.J' I \\'r-\
pP..\ '"fpE.RMH
.t\)\\'p\NG
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Date
By
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16:33 651 633 8884 FIRESIDE CORNER #1521 p.0021006
'-'....1. ... '-'A. A ................' ...............~
REA TlNGI AIR CONDITIONINGI ludPLACE PE~111
t~ ~,_I PERMIT NO'OI-/t./-00 \
(Pltue tvDe or Tn'i!1t rmd. slm at bcmoml
ADDRESS ZONING (oftke lUll)
/CI~("7 ~"L. ~~ AJt.J
LEGAL DESClUPTlON (gfl'jl;c Uft: Q7Jly)
I LOT BLOCK
ADDITION
PID
OWNER
(Name) .
[1p.r:~ )Jw-5
, (Phone)
(Address)
APPLICANT
(Name) lILLIED FIRESID~ DBA FIRESIDE CORNER
(Address} 2700 N. FAIRVIEW AVENU~
(Address)
BRENDA aUS~T
(COD.tad: Person)
APPLICANT SIGNATURE . ~
. (phone) ~51"'633-2 'm1
I
4L,-~~
mSEVTLT,F. 10'11\1
(eil:)')
. (phone) 651-633-2561
DATE )tu/2L
"'~l"
(Zip Code)
APPLICANT PLEASE COMPLETE BELOW
~w CONSTRUCTJ.~N 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETIJRN OPENINGS INPUT OUTPUT
TYPE Of SYSTEM HEATING OR POWER PLAN'!'
Bwarm. Air Phmts
Grllvlty
o Mech8lliclll
DAir Conditioning
OVcnt. Syfltem
FIREPLACE MAI<E AND MODEL .....~
o Steam
o Hat WDk.r
o Radiation
o Specl.al Oevlces
o Other Dovll:es
A1 (D~ S<. -.Du
PLEASE NOTE:
Air Conditioner Units
CanD.ot Encroach mtCl
Required Side Yard
SetbKks
Residential. Hesting &. Ale (New CClnsuu.ction)
R~idcntiaJ.. Heeling Ol'lly (New ConlP1JUction)
FEE SCHEDULE
l~ ofjeb GOJt Residential. 015 Pltr;place
$39.S0 minimum
$99.50 Resld.",tilll, Additions &: AltcnWonl!l
564. SO Resld.",tjf).~ AC Only
539.50
539.50
539.50
Industrial. Commercial &: Mutti.FllIl1iJy
MEA TlNG PERMIT fEE $
sr ATE SURCHARGE S
TOTAL PERMIT FEE S
() /- / t./CJ&
r PA'D WITl \
.50 BUILDING P Z::
~.
Estimated Cost $ B1.IildiZlg pennit #
(omce VII: On'1)
Thill Application. Becomes "lour Balldlng Permit When Approved
.~
ORB l 0 20lU
~cetP..ttNN~O..
-----;/;jJ/
BYr
BlIlIdtDJ omchlll
D.,e
14 hour notice 'or Rlllnlpec1fo". (!J52) '-.7.9850, r.J: (952) 44'1-4145
ell. , OF PRIOR LAKE
REA TING/AIR CONnI. ~ .I0NlNG/,tIudPLACE PEDu J.
Date Rec~d
.~ t /
, .ti
~:::. ~_ PEDI.lI.L'~v. /.. -/h/) / J .
3. V..- AlPI~ ,l../ ~
(Pkllll ~ 01 'DriDc IDIS sip acbu1mml
ADDRESS
/~ 2-G. R 11 rtlfJ/f- I)'\.(~
ZONlNG (01&1 1M)
LEGAL DESCR.a.r uON (otIIet UK only)
LOT BLOCK
ADDmON
PID
OWNER .
(Name):.c P.11 f-f...,v
(Add.ress)
. APPUCANT
(Name' :II~Q f,' ""~
j-Ial'Vl'-fJ
. (phone)
? (0'7/;'1\.4
,
"r, .A.<I' n
(phone)
7&3 - 't/29<1c' i1
(Adchus). I" 9 S-~,.,
< :"i"L ,,, ~.., R J 8"1 /'H~J ,/~ Go rqA S r ~ 6 r
(AddmI) (CRy) (Zip Code)
----
(ContaCt Person) I ., r""~ C en (e- (phone) ~, 2- ~ G. 3 . S-S-/4 7
APPLI~SIGNATUIl1t ~ ~./- DATE ....s--/s.--~
APPLICANT PLEASE COMPLETE BELOW
(QNEW CONSTR.UcnON 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL ./3t:.:{ar. t -;'Y 303<.00 7t:J FUEL G.. 5
fi '~
FLUE SIZE J( RE1'l1RN OPENINGS ~ INPUT Ij' () 1 0 00 OUTPUT ~ 0.':) i)
TYPB OP SYSTBM HEATING OR. POWER PLANT
. ~arm Air f'lants 0 Steam
OI'avlty 0 Hat Water
Mechanical . B Radi.t1an
~lr COlldhJon1ns Special Devices
Q'V.nt. System 0 Othlr Devices
PLEASE N...' Alii.: .
Air Conditioner Unlu
C&DDot EIIcroaoh lcto
R.equired Side Yard
Setblclcl
FIREPLACE MAKE AND MODEL
I"dustrill. Conunc:rclal ,& Multl-Pamily
Residential, Heatlnl" Ale (New ConstrUction)
ResidenUal. Hetzinl OtIly (New COQINction)
FEE SCHEDULE
1% of job cost Reaidentlll. Ciu Flnlplacc
$39.50 miDimum
S99.5O Residential. Additions ,& Altaatlons
$64.50 Residential, AC Only
539.50
539.50
$39.50
Estim.ed Cost S
Building Pemit #
.1
PAID "
r),~, , ''',
""', '1~8
HEA TINO PERMIT FEE
STATESURCtlAkG~
TOTAL PERMIT RE
$
S
S
.50
Bui1l1i.. OOlcial
D... .
.DIre l t .\ \/
I ..... , ~ '
--
'."~.
Jleceipt. No. .
~
I
(om" UN 0lI1y)
nil AppU~.tioD Become. Yoar I.tldlll Permit Whea Approved
Paid
2.t hour aodce for allla.peed... (952) "'-9150. fa (952) .w'7~U5
te"d
ZS9:52:8Z....:52:9L
OM~ ~NI'008 ~ ~NI~~3H W~ ZS:Le ze-st-^~W
10/07/2002 12:00 5
__.01121/0:! TIII.i 1'::l T..l6I IUU7UU
CITY OP "101 UK!
PAGE 02
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! eN-) K &. R Contracting, Inc. (I'bOM)
I 3245 1..ake Avenue
.. (A.d4RII) . New Prague, MN 56071 (CMr) (Zif0*)
I 252.758.62i7 q'c '7 ~"-12. /..., "'L7
I (C:an'"tP~) l:t(~k.4 (pJaou) ;;/, - r,::} 1-";-:7_
I APPtJcurrSlQ>l"~~~f'~-~ .. DAn _II) 17/';;
APPLICAA"T 'LEAH COMPJ..I.TE BELOW
s. at.....1CII'Yicc -LJL isbII. "
L--'OP of &.1 coupliap froal J1I'QI::E\IN JeO .....
Tn- ~... pi,.. 0 ABC Q!PVc 0 C_11U
Irlo/l:t. ~..J~of_llM ~O fWt.
a... out (ifnq1lind) IoatIId at d,.. flare ~
ra 1C'IIED\1U
~i...ti&l.w.. ..1.............. tJ,.so J.....riil. c.-'.. MWd~""Dy \" oIj.... _.tl!t 1139.50.......
!i.wer ~..... CIIl~ 117.50 Vi- CSlI1Udlal -11 111.50
Lt.~ PT _ COlt S aulWiaI P_iUI
SEWD. AND \V" 1"21 P!IU4)T lie $
ITA U'S'U'lC1W.GE S .
.... . Al.I'DMIT .nz S
J2
(~. UIt o.tl
ny 4".II..UOft ...co.. yo.... ..UI-. ,...It --.. AP"",- ......
u.
".... Plo.
........ Of..... -
...
P..!~Il'~ -
U .'11' ....lIrtr .111......... (JI2) ",....... fa. (fI1J ..,...a~ U lLD IN" G
PERMIl'
PRIOR LAKE DEPARTMENT OF
- BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS ~ ~ v.-\V'-€- ,. .$'~
NATURE OF WORK -fj).e., J
USE OF BUILDING SFICr
PERMIT NO. 11/- /4-0& DATE ISSUED
1:-
CONTRACTOR Q.e,,,,,\.cx PHONE cPl2- 5~ i -3t, !_<:
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING Vv1Q~ I
I FOUNDATION (Prior to Backfill) ~ql~ I . I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
vlAa '"
~~
~
r~ ~ .CY~'-\
'%b
'tQ~
~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
~
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
:RJ{)Ml/
~,. l~) oot
~ '(4\ oa
3. h 01-
~\i~~
II
l\.
5JOl.er ~~
l II
\
~ ~~ 0\ .~J ,Ocl-
~ 5"Ot.~~
\. I.
OCCUPY UNTIL ABOVE HAS EEN 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 piaced near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/LI2' :(
(JrrK/t jI1IU ~
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
DATE TIME
i - 2 J-'O(./
tP i.I r!
/ -14 d)G,
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE R1
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
s;, J 4- T~r: ~
~
/' ~f
~ L) f)~
--- ----
~
r/~
I-/~ )
/
~~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~. ~A~OR REINSPECTION BEFORE COVERING
Inspector: //vr . Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
t/<SNOn
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~ . z.e -02- /:l .-r:
ADDRESS
/+ZCP 7
~AU.f:}~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0/- /c.fo fp
o FOOTING
o FOUNDATION
o FRAMING
~NSULATION
, INAL
- 0 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
D./LUMBING FINAL
~ MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: Fl'}
~l?OlOOl
~rY'lA. - l I I
!""-,,ryo,\, vpe.s.
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO , CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
HE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INS/'IOTI
~ 'Ct(,...()~ '3.~t)()
..
14;).(,S ~G>\:~iY
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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
f\ P PLUMBING FINAL
o MECH FINAL
COMMENTS:
lM.dV\.OV\t\e--tec 0\<:'
'lATE " TIME
1- t40~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK CALL FOR 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!
INSNOTl