HomeMy WebLinkAboutBldg Permit 01-1268
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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(please type or print and si2ll at bottom)
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LEGAL DESCR.1.t'uON (office use only)
1. White File
2. Pink City
3 . Yellow Applicant
I PERMIT NO.
LOT I:3BLOCK
ADDITION
~11~
ONING (office use)
RISO
Pill ;)5- )3;;1- OO/-()
~~a ~v I ~~~( /IJ,'c.ie 11
(Address)d(jd1 FA.,'/Z II~/AJ IlJ'lt /(/,
':::~~-I,fff,v {6m21)-cd-,v9 ,We. (1'bone) ?~{'~J'<a-/$
(CQf1tactName) _80 6 i-I-../b tJ' ~ " . €....> ~/:J-7J/,...qff 1'-
(AdJ....~> /4cfJu - y~ Ar/Gd'tfO, ff,'1J11(/vrK$, f?yf/~
11..WWORK
o New Construction
)
\
(PhOne)~;J7l20 .- 5f:l /
o Deck
OPorch
ORe-Roofing
ORe-Siding
OLower Level Finish
o Fireplace OAddition ~teration OUtility Connection
PROJECTCOSTIVALUE (exc1udingland) $ ~q 000 I):J
o Misc.
x
//
e 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
ve-mentione roperty and that all construction will conform to all existing state and local laws and will proceed in accordance with
dOO~~ "" reroke ~;; ;~~-;;;~~;; -- ~t~ ~~"'J:i may
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I hereby certify th I
authorized agen or
submitted pI
enter upon
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
(j,() 1000 a eJ
.
'11~. 1~
't C,3 . q 'f .
3c>.ao .
$
$
$
$
$
$
$
$
40.00
s Your Building Permit When Approved
ID .. 2Y.. of
Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE {JRtIA3{)
#
#
#
#
I ,
11/"/01
,
11Z,4'7.. r,q
, //_"'7-/71 .
" ;-
Paid
Date
$
$
$
$
$
$
$
$
$ /,z.4.7~ /:,9
I
\
Receip),W # ~"r"
By 1'~1_./
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
~bytlreIL=~_cmoc.;~;;:_...-.;;:~=;;;;-~--~
--7:J~ p~~""'~ Date Special Conditions, it-any ~
....... 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Th. e.nl.. of the take Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT Ylla.1T-<M71 (? finlA~~
APPLICATION RECEIVED It) :- d;;}.-eJ )
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity whic~ is proposed at:
SOt?O F~:?cJ
Accepted
Accepted With Corrections /-.-..
Denied I~ /L .
Reviewed ~ ~ -
Date: 10 - 2 t./ -Of
Comments:
(J prh=i l). 8. ~CAU M oJ-cM.~
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~~~
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."
White - Building
Canary - Engineering
Pink - Planning
.. ", ....
. 'Th. {"mI., or Ih. tak. Country
BUILDING PERMIT APP(.ICATION DEPARTMENT CHECKLIST
1
NAME OF APPLICANT ; iii/tit /~ , ... tJ!
APPLICATION RECEIVED I/,:l -':-~/:;. (~J J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which. is proposed at:
.
S:o / .'/,.. 1''/ i /.'{ ____ ..:.i i
.~ I..' (' t ,,/. / -t"l(~l' \. t.......J",;,
Accepted
/
Accepted With Corrections
Denied
Reviewed By: ~tJy~
coml1::s: /^ . ^ _
/,~g. ~
~~
Date:
if IN~
~\e099v cJ<f"' ~ h9v1 ~
~
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be-_~ pel1J1it for, or an approval of, any violation of
any of the provisions of this code or of a"'Y 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 PLUMBING PERMIT
Date Rec'd
/I~UJ~~ /
1. Blue File
2. Gold City
3. Yellow Applicant
}
PERMIT NOtJ1_/ Z {g,(
(Please type or print and si2ll at bottom)
ADDRESS
3050 Fh//cVI6W
ICLJ s vtI
ZONING (office use)
jel.J'D
LOT
LEGAL DESCRIPTION (office use only)
ADDITION
>i:;:'~Ai~/~,e,..::k /4~/ (phone) pJ Js-/ 05"-,,>-
(Address) .;rrdt' ~ h # Vo '~~A S>-Yc;/
eAddress) / (City) (Zip Code)
(Contact Person) ~dck-// ~ h~~1V' (Phone) /' .,.
. APPLICANTSIG~AT~.J"---- DATE Id4.A/
..- ~LICANT PLEASE COMPLETE BELOW" /'
(Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
OWNER
(Name)
(Address)
Quantity
(
/
'"Z-
-z......-
I
BLOCK
I
PID 25 -/32--1I o7-d
(Phone)
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
(Office Use Only)
This APP~i a 'on ~Uilding Permit When APprLoved
LJ::2,O-o
Bui dhifi Official Date
Estimated Cost $
Building Permit #
pII/O elf!....
BV J /,;0
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$ ~
~
P~
'Date
Ud.-o -0 I
~
.;
...,
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR lAKE MC
16200 Eagle Creek Av, S.E. Permit No. J - / ;;-&fI
~~r. Lak~, MN 55372
HEATING A~~idA17c;~~~~RMIT 6\\ \q IS~,K :<:,8~~l':-': .SingliiFarnily
'-:-.:,-'.;:: I'....-~'~ ~- . -'~' -.'
Dat9 \ \ - 6"\0 . 0 \ . PIO " ~ 5 - 13 'J. - () 01"":0_' f:-;,<.:,t Commercial
Sile Address ?J:)bD fa,\-{~~Q.- ~. Fee Schedule
lot
Block
TYPE OF STRUCTURE.
2. O....n -
J. Yellow
Cily
ConlraclOr
-..J""'. .
-.~..:
Two-F~mily
Industrial
~ -; - -:
Addition
Induslrial, -Commercial & Multi-Family
Residential, Heating & AC
Residential, Healing Only
Residential, Gas Fireplace
;4oResidential. Additions & Alterations
Residenlia~ AC Only
Owner'sName ~,,(\"{).,S\L-t iLUr
Address
Heating Contractor
Address
Telephone II
Furnace Make & Model
Model Sizo
Conn. Load
Fuel
Supply Openings
Relurn Openings
fLARE HTG. & Ale. INC.
9303 Plymouth Ave. No.
~oIdelt Valley. MH. 55421
'llo~ - ~)l.r& \ \l..DlP
Public
Multi-Family
OIher
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember to add the Slale Surcharge on Ihe boltom ollhis application.
The price 01 your heating permit Includes one rough-in and one final inspection.
Addilional inspections will be billed at $35.00 each.
House Healing Test Record must be submilled with bl.!.ikIimJ ~ Ill!.IIlbm before build-
ing cerlilicate or occupancy will be issued. .
HEAT CALCULATIO~ BEOUIREo. with number of supply and relum openings tisted per
room with CFM's per opening. New structures or additi9ns send floor plan wilh supply
and return localions shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN ~5372.
City Hall business hours are 8 a.m, - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
~47.4230
Flue Size
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Stoam
Hot Water
Radiation
Special Devices
Input .Oulput
Edr.
Clm.
Allerations
Repair
I hereby apply for a mechanical syslems permit and I acknowledge that Ihe
inlormalion above is complele and accurate; that the work will be in conformance
with Ihe ordinances and codos of the city Bnd with the slate building/mechanical
codes; that this form does not become a permit until signed by Ihe BUILDING
OFFICIAL; that lhe work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
- .
"-:P~~~~\~-,:~\;YlUf
fjU, ,,0, .~ P J Applicant's Signature
l l' ~ 1" \
Building Olficel's Signalure
. ~Iher Devices ..Qui.t- vJr.>J'L
r-:,'(\ ,,~
TYPE OF WORK
~
Repl~~ement
Est. Compo Date
New Construction
Est. Cosl $ _ Building Permit #
HEATING PERMIT FEE $-,~~ :7:;'0
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $ Yo. 00
Receipt if
1,
H:1lo'O I
Date
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P R I 0 R LA KE O-EPARTMENT OF
l BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 3.tJ?!J() ~('rtR-ew R..d..-
NATURE OF WORK ~\, _~~
USE OF BUILDING -.SFf\ .
PERMIT NO. 0l:::..l..Z::.b B '. DATE ISSUED /1)-- Z c.f--c)/
CONTRACTOR .t~.H~ ~ . PHONE-L..L?- ~-are0
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTION ELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I
FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I
,lIe c~
\&lkl ~
.~.
..-t ~ · t?-:r.
FOOTING
INSPECTOR
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
~
I
1214 ~ I
Ii ii/if" I
.1/ /3~!tJJ
112!r~1
COVER NO WORK UNTIL ABOVE HAS--BEEN SIGNED
I I
FINALS
1~~.ll~~
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
--~
't'/~# t..-
I
'1~ 11J'l;
l/ t 2- !z.! t) 'L-
BEEN SIGNED
~.
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections ha'ote 'been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
ADDRESS
$ot/lJ
DATE TIME
SCHEDULED ~ 9,'i'tJ
,,~
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO. ~ I - I;LI. 9
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP /.Ol
J$l PLUMBING FINAL~
~ MECH FINAL ~
~-~.
~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING (p)
o INSULATION
~ FINAL
o SITE INSPECTION
~
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~'::CT ~L FOR REINS:::::FORE COVE~NG
- j
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INS/iOTl