HomeMy WebLinkAboutBldg Permit 05-0384
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
See Main File. ~::y
J Y.llow Applicant
LI~OtJ-O::
I PERMIT NO. OS. 03841
(Please type or print and sip at bottom)
ADDRESS
/L!l?~ ~~/t-})~
~rY
.
LEGAL DESCRIPTION (office use only)
LOTI? BLOCK ~ ADDITION Wb.JVS""-"NrJ
OWNER
(Name)
(Address)
~r/r
(
PID~S:- 0j??J1'l-1J
. .
. (Phone)
BUILDER
(Company Name)-!t J~,u<; /A/OrJ~
(Contact Name) -3v z. ~
ii/'
(Address) /77~- ?4/~/A
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TYPE OF WORK.~ew Construction ODeck OPorch ORe-Roofing ORe-Siding
OAddition OAlteration OUtility Connection 0 Misc.
CODE: DI.R.C. I21T.B.C.
Type of Construction: I
Occupancy Group: A B E
Division:
I~~
!/4-
II
F
I
IIIIV(0A(ji
H 1-.... '-ti' (b s U
2 {3Y 4 Y
ZONING (office use)
I /eLj
/
(Phone) ~O-L/t:J~- f f~C/
(Phone)~/ZrZZ-/- /~ Z6'
A.A/~ <""~JB..;2.
~.A"l ~~
OLower Level Finish
o Fireplace
S /A~/~OV
PROJECT COST /V ALUE / ?
(excluding land)
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.menl1oned 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
;cial can reVo~it f: just cause. Furthermore. I hereby agree that the city officia/~.c~i~fer upon the property to perform needrZ;~
C-/' Signature ' 'Contractor's License No. Date
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
"
1ft / OJ Ot) (), (J()
$ /1 j ~, ~d
$ 7Z'3. 7Y
$ 55.. dO
$
$ 10d .00
$ IDC), (JD
I $ .1S, ~a
I $ ~{/. (J~
~B<<~"-'~;;;;'"
Building Ollicial Oate
I Park Support Fee
I SAC
I Water Meter( Si:!e 5/8))1";
Pressure Reducer
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
Other
#
#
#
#
$
$ 1~5a. Do
$ 2500 00
$ Sa,oo
$ I St:1d, ()t)
$ laCleJ. Od
$--
"
$
$fD.4--/ 7. lfJ I
Paid
Date
t ~/-J. If
7. 1 () r'
Receipt Np. ~ Ii; 7 otI--
By A.
u
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
=~:~-2;J/;M>C"'~:;:;~"";'~"'M-'"'5ee 1fiiiir~~eoc,m'.~
Planning Director . Date Special Conditioll&.. if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
TOTAL DUE
'"
g@e ~ain ~i~e
White . Building
Canary . Enqlneering
<. PlnL . P1aiiiilna>
~
BUILDING PERMIT APPLlCAnON DEeARTMENT CHECKLIST
.
NAME OF APPLICANT
APPLICATION RECEIVED
!2/jcV..J
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/;
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
l!
. L . . ..., 1--
/ / / -:;;...:J -
1
~// /,/
/
Accepted
/
Accepted With Corrections
...
4.
Denied
Reviewed By: ~
.
~
Date: S / e.( /os
,
" '..
Comments:
"
'"
, .
'1'0"...
"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."
I
I
I
I
,I
See Main File
White - Buildina
c:1-...,.rv - Enqineerin)p
Pink - Planning
BUILDING PERMIT APPLlCAnON DEPARTMENT CHECKLlSI
NAME OF APPLICANT
I ./
/j I.)' .
i~/ ,-,'.....< . ~./k>! {~./:L/.H__.J
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L) ~ (~:)~l
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/L/i2C. i /!....,;
I / I .J--'/~l- C (A<;./
J
Accepted
Denied
x
Accepted With Corrections
Reviewed By:
Comments:
~
~<e (Y/c,/~ (, II(
Date: s: 3-cs-
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 shall not be valid."
08/16/2005 TUE 10:43 FAX 952 767 1900 GENZ-RYAN
~ 002/031
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
Date Rec'd
lplease ~e OfPri.nt and siRD at b.~._)
, ADDRESS
\\.\ \ 35 L\JI. cl S PCt:lh
I, 0._ fij. I PERMIT NO a.A
1 Yellow Cily . OS {)3~'
3. Ovid Applicant .
ZONING (olIice use)
LEGAL DESCRIPTION (ollice use only)
LOT BLOCK
ADDmON
PID
. ~=R (1 )FY\~ \'YV\fW) i-ton 'ItS
(Address) I ~C( fj P I O~ \) ( . ,S tc. ,'Jet)
(Address)
(phone)
.EMCln rViN
(Cityr
( OF) 1-- q (f)- :-n Clj
r- -'J
_.:1.:.) r v'.).
(Zip Code)
. ~:;~~ G,{f~r.- [1(,{ a fl) (phone) f7t?'2 - 71P1- (ODD
(Address) 12f)[) \IV. I +flAf! 1 {.3 BUJlIIS V/f[-e." MN rY}337
/ (A~ ~ . (City) (Zip Code)
(Contact Person) "-tIn 1-\_tT\\ld\~ . (Phone) lfSd.-76?1- (&.vI
"LICANTSIGNATURE~1lY1 l:..s::p~ DATE .R j I(O/OS-
. L/ j - ~ ''''''.
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.
FEE SCHEDULE
Residential sewer and water line connection $35.50 Industrial, Com '1 & Multi-family 1% of job cost with a $39.50 minimum
Sewer connection only $17.50 Water connection only $17.50
Estimated Cost $
Building Pennit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL.r Jl,.l'\MIT FEE
$
$
$
(Office U,e Only)
I This Applieation Becomes Your Building Permit When Approved
'iiA,D WITH
BUILDING PERMIT
1~ l[ta@ ~ U \iJ [2 rT', Receipt No.
1 IJtffr; 2 4 2005 l / By
_L
Building Offidal
Date
24 hour notice for all inspections (952) ""7-9. 850, fax (952) 441-4245
,By_
08/16/2005 TOE 10:44 FAX 952 767 1900 GENZ-RYAN
~ 003/031
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
~=R I,UfVlS VYVl Jln Hnrv1cS
(Address) I Kq0 ~)\ G\7i\~ Dv. );+c :JCi)
APPLICANT (1_ 1)
(Name) tJe.J11.:- - t~.-il aVl
(Address) 21/)0 \N. 11\.'\1 f., 1.,3
/ (AddreSh J
(Contact Person) _ :.><\.~\ tD_F<C0. ~ i n~ _
APPLICANTSIGNAT' ~j)jifJ
. . -
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity
~ Bath Tub with or without shower .
I I Dishwasher I I
I I Floor Drain I \
4 I Lavatory (Bathroom Sink) I \
I I Laundry Tray (1 or 2 compartment sink I
2. I Shower Stall I
I I Sinks I
.e I Bar Sink I
_ ~ I Water Closet (Toilet) I
(please type or llrint and sign at botlom)
ADDRESS
\ Y \?f5 LU i 1 05 Pettit)
LEGAL DESCR..u-.l J.ON (office use only)
LOT BLOCK
ADDmON
~:: ~~ I PERMIT NO. OS: 0.3 8+-
3 Yellow "",icont ,
ZONING (of'&ceuse)
PID
(phone) f /nl-CrJ'5- 37eA
FD C1(1VI rV\N '~f5/;)~
J .
(Phone) 0(c:i1.-/lff1 - {DDO
F)lilttt1~V I flf.- M N S'J~~37
. - . (City) . ... (Zip Code)
(Phone) ~-I(01- L~~ I
DATE X/JliJ/rD
j -
Type of Fixture
Rough-ins
I Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage ~jector
I Backflow' Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEES~.t:IJ!,DULE
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
$
$
$
(Office Use Only)
Tbis Application Becomes Your Building Permit When Approved . D1 \!,Bi~ r~ D \TI I.t ('\\1 I Receipt No.
1\ "i Dl~G 2 4 2005 U lay
l j L-
24 hour notice for IlIlnspec:tions (951) 44', -9850, fax (952) 447-4245
\.BY "-
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Official
Dale
Building Pennit #
PAID WITH
aDlLDING PERMIT
08/16/2005 TUE 10:44 FAX 952 767 1900 GENZ-RYAN
~ 004/031
CITY OF PRIOR LAKE
REA TING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Ree'd
(Please tvl'e or f)rint and sip at bottom)
ADDRESS
i LU 35 GlJI \ cls P t1.th
~'~?:w S~cam I PERMIT NO. 05: 038~.
ZONING (offk:e
use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
~~~ \J la.'\SXYVi Jlil\ ~-\on''(S
(Address) I gq5 ()ICllOv fA"'. Sk. ?()O
(phone) Ct51- cqU-S- 370S
1~'=-LtC1 aXI [\/1 f\(
.- ''/.'.
[551,:(}
APPLICANT r Q
(Name) c:rCVY2> <-i j (11"1 (Phone) (jt){A -:7 if'? - 1000
(Address)Q'I((, I 1\, i. 1.11 ;1 '~I' I'?.., B 'I c:::rn.? -7
v'dV.j vv n VVV ../ ... llYl'15Vi if .JJ:) )
./ . ~dre5S) (City), (Zip Code)
(Contact Person) '.""\ll'Yl .I~I . 'rll \ .e / (Phone)C!:ik fWr \ &.c I
~ (lJ])J)Jl.J DATE X' / I&J /as
. .
.. APPLIC T f'LEASE COMPLETE BELOW
. ~ COl'!STRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL if 1/ltiO'X GL1 QU\1-oVl- G~O , ," FUEL ~"Y1"1.: 4)at>
FLUE SIZE RETURN OPENINGS .t..{ INPUT tJ;(; a;o _ OUTPU~ (fi;;}fJ 1 )
TYPE OF SYSTEM HEATING OR POWER PLANT
~ann Air Plants 0 Steam
OGravity 0 Hot Water
o Mechanical 0 Radiation
a8lAir Conditioning 0 Special Devices
OVent. System 0 Other Devices
APPLICANT SIGNATURE
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial lit. Multi-Family 1% of job cost Residential, Gas Fireplace
$39,50 minimum
Residential, Heating &: AlC (New Construction) $99,50 Residential, Additions &. Alterations
Residential, Heating Only (New Construction) $64,50 Residential, AC Only
$39.50
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
PAID WITH
BUILDING PERMIT
.50
~~~ ~
This Appll'''''. B....... Vo.r Buildln. .....It Wh.. App...... D) ~.~ rc; D \flli: !lllroceipt No
BulldinlOlTlCilll Date \ -) DA\1G 2 4 ZOO~ ~/fY
L ~ \
24 hour notice for all inspections (952) ~~50, rax ('-~~474245 ___ !
DEPART~ENT OF See Main File
BUILDIOO AND INSPECTION
PRIOR LAKE
INSPECTION RECORD
.
SITE ADDRESS . I'II-'S W/~S I'A7?1' . f
NATURE OF WORK NE'bJ ~S"~e1'/~ <1IJ1l.. L. Fi~~.$NL
USE OF BUILDING S fJ:: A, '.
PERMIT NO. .r.%""- DATE ISSUED 5"/V/(JS
CONTRACTOR W~"'~N ~ PHONE'/2.-2~/-1"2I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
FOOTING I
~ FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I
q /~/DfP
1 r
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
tu4TNr ,. H~~"'A" I I
FINALS
.IJ~,
{If?
lib .?/~4I'~?
~/f(/J" , ,
r ,
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
We
PI>
ffJ
Ilt.~J,ft
, .
11~I/tJ.#)
; ;
,
fb ///</66
f?~ / ;::f:'~ ~
I "
/)0
, (f/r?
GR~DING (Prior to Sodding)
BUILDING
~
ELECTRICAL
PLUMBING
HEATING
DO NOT
. J
t..f /21 I at-
o f
I
q!l2lJ~
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
< .;''''. ,,"'J,;\.: ..~, , ;
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""""~',", ,,; .,,'....
IiIiliiiM "
...........
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
I LJ(';SS Ld,'\~ ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
[] FOUNDATION
[] FRAMING
[] INSULATION
o FINAL
[] SITE INSPECTION
o PLUMBING RI
[] MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
.~PLUMBING FINAL
o MECH FINAL
COMMENTS: f.) . 1
/. ~~ ~,~ (~
2. ~ Ar \u~()
DATE TIME
31+-
~ - ~~e.r
o EXIGRADlFILLING
[] COMPLAINT
[] FIREPLACE Rl
[] FIREPLACE FINAL
o GASLlNE AIR TST
[]
o WORK SATISFACTORY, PROCEED
It CORRE~rfj!.AND ROCEED
o CORRE~~ 7/' FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALJ447~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
"'~":::'.';~~"'. <}_~U, "" >j,f>.\. :.:..:::";jih ,~. ....- ;.~ ;"'~'"
;.\.\(..;:...'
SCHEDULED
D.\T~
izr/~t;
,..e
III I '3 t::::; ,~ ) ; \(\ ';, Glv-L
CONTR.
,P'~C)NE NC).
PERMIT NO.
l:)-i58Lf
. ...,.. x ,
o FOOTING
o FOUNDATION
O-fRAMtNG .
.' .IJ INS\JI.ATION.
)$-FINAL
o Sf1'EINSPECTION
'.-:.. .. . -.,
O. PtUMBlNGRI
o MECHR(
o WATE~ HOOKUP
o . SEWER HOOKUP
. 0 PLUMBING FINAL
o MECH FINAL
b EXIGRA[)IFILLlNG
o . COMPLAINT
o FIREPLACERI
o FIREPLACE FI~L
o GASLlNEAtR TST
[J
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C!..oJtki'" L fp.A""d
o
1/(" cd c'*-- \ h \~~,,,,, CJ M&..r
(J \o~?~~' ~-'- lp
d WpRKSAT1SFACTORY.PROCEED .
...tJ:. CORRECT ACTION ANDPROcEEt>.
. ::l{fCAU.1l>R""I~::FOIll!~-
i 1/
CALL. U7..9850.<FOR' 'IltE NEXT IN~PECnON24HOURS1N AOVANCE.
CODE.RE(lUlREMENTSAU.FORl'OVR I'ERSONM.HEAL'fHd:.sAFETYI
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