HomeMy WebLinkAboutBldg Permit 05-1249
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3 Yellow Applicant
PERMIT NO.;?"... /-;I Lje:;
(Please type or print and sip at bottom)
ADDRESS
3tJ/6 1Jd,~.{ il2L)tJtJ
/1z, O/l. lit Ice 1">1 IV
ZONING (office use)
S'S"J? 2
LEGAL DESCRIPTION (office use only)
LOT '3(\LOCK I ADDITION t1J~bJ ~~
PID3~-03t)-()
OWNER I.
(Name)--:TA InJrr r Y AI rJ
(Address)
(Phone)
9.5'2- 21:1- 3lJ/ 1
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck DPorch ORe-Roofing
DAddition DAlteration OUtility Connection
ORe-Siding
~we3ev~D6irePlace
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
1
III IV V
HIM
234
A
R
5
B
S U
PROJECT COST /V ALUE $
(excluding land)
I hereby certify that I have filmished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
above-mentIOned y.vy,..j and that all construction will conform to all existing slate and local laws and will proceed in accordance wilh submitted plans. I am aware that the building
:Clal can revoke IhIS'=JI;us.e;!:Jher~ore, I hereby agree that the CIty official or a deSignee may enter upon the property to perform need; ;~e;~,.... ar-
t r Signatu"Y Contractor's License No. Date
~
I Permit Valuation '300(; I 00 Park Support Fee
I Permit Fee $ 14/15 SAC
I Plan Check Fee $ Water Meter Size 5/8"; I";
I State Surcharge $ /6(} Pressure Reducer
I Penalty $ Sewer/Water Connection Fee
I Plumbing Permit Fee(ln/J.J-r, $ 'If).. DD Water Tower Fee
I Mechanical Permit Fee $ Builder's Deposit
I Sewer & Water Permit Fee $ Other
I Gas Fireplace Permit Fee $ 4o,oe TOTAL DUE
#
#
$
$
$
$
$
#
#
$~
$ "
I
$ (
$
/:5"0.-d..5
60640
8--
T1U. ilit~ B~. y- BuilWng Ponni~ ;;:;'"
B",'&' Do"
Paid
Date
i!:i (;,. do .~.-
',::1- ~r'l ;. b'!:J
Receipt No.
By
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 constllutes a lemporary Certificale of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
/l,.c. d
~ I~ I /).r.,d 0t..Jf-.
Special Conditions. if any
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
BY:
Residential Building Permit Checklist
;ij ~t F~h or Interior ~::rati~; :~~~;om~ .
Building Permit # ..
Site Address
Pill:
30/~
Zoning:
t>>bCft-i'f;}JLU
Legal: L
B
Subdivision:
E.:risting Structure: @ NO
CONFOR1.'rlS TO ZONThG
o RD IN".AL'f CE
~~
NO
YES
NO
Is this an expansion of me existing foo,:-,,;"'t or
building height?
Refe: to PI::rnTlmg
------
Is the property located within the flood plain?
Refe: to Planning
~
Does the alteration inciude any additional kitchens?
Refe: to Planning
.r--
Does the proposed. alteration incLude any outside.
ena-anc~ othe:' than patio doors?
Refe: to PI ':I"""";'" g
~
Is the proposed. use of the finished space or
alteration for anything othe: than a no-r:nal single
family home (offic::, grau~ hOwe, day c:n-e. e"c.)"
Refe: to Planning
~-
THIS CHECKL1ST MUST BE CO~[PLETED .-\J.'fD INCLUDED IN THE BU1LDlNG ?ER.J.'fllT mE TO
MAlNTA1N A RECORD OF TRE REVIEW.
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CITV OJ;' PRIOR LAKE
HEATING/AIR CONDrnONING/flREPLACE f>>tJtMn'
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: LOT Bl.OCK ADDrrlON
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i ~.PPLICANT ofVN.f-5J b:~ \ t 'I: ,l \ '. . . . ' 1\(.' . ;.
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(Address) (ClfY) (/'11 '.\!I.lt:1
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(C unt,,, Pc<son) ...... ". ~~.. -". . "T""';;" "-n.......;......__.,.......... .. - (I' ,'''"C) !. ' .. ,
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APPI...1CANl PLEASE COMPLETE BELOW
1...--.......... .... -... ...........u.... ,~_.,....."...."._.._._____.._ ............. ....................._..........._u.u.. .......... ........ ..... ..'''' ....................'........
. D!'-IEW CONSTRUCTION :J REPL.-\(TMENC flAL HRt\'fIC/t-.J';
FURN^C1: MAKE' AND MO[)[L. ...........w.....................,.,..........u.'......... ':I,if:(
FLUE SIZt,
RETURN OP[NINc;~i
IN hiT
uurPlrr
TYPE OF SYSTEM
HEATING OR POW[I\ I'L""r-.J1
[JWarm Air f'lam:' [] $\~anl
CJ(;lll\I\> [J lilt! W,,,,,( (,i, (\,/1(1111011>::1 L.IIIll:.
[J Mecha.llical 0 R~dla\i\lll C"nrwll:n,"<)al:ll ll,ll)
DAlr Comllli(Jllln~: (J ~p()ci~1 DCVl';C' kti..1uircd ~,id.: Yani
,/ OVt'lIl :'} SIell1 \ .. D, 01l1C( Dc\i,~I;:" ,...P...... I'" i I ~:rh"t;k~,
~.IlEPI;:~(:I'!IA.~E A N!.'.~.~)I)~.L_,,,,,,,~,,~;;;;,;=_\~~,~,:~:. .,,-_.~;;!;,,=,,~;,;fL. +J 'i::I(._i~':~~:~'~~-:~
IEl: SClU::Ol!LL ~""" .1" \, I ". '
Pl.EASE NOn.:
Industrial. Cornrnej"i;I~1 &: Mullj'.rilt1lil,y
1% "I".i')(' ,;,)~I
~.:~9. ~,O fil i/l'll 111.11 \I
:bIN.5'.l
$6~.51J
1\~)ldco:lJll. c.~... I'l!q'ld(~
.~.d:'li
)l.c:;i(l~l1l1al. Hea.lIng &. !\ie' I i-J.:II' COIl:';II'W;'lQI.j
RC:';ld~IHla.1, lica.tin~ Only i~~~w C'-"I,lI'u,(IIJnj
f{~".kn~l;li (l.dJill','IIS &. i\ll.;;r:\lI<q,;
ji.~""klll\al. il.\. 1 ;11'>
}.:,Ii :,(1
S.:1\'. ;;'.)
EstimaIcd COSl $
Building PCIIIlil ,I
Hf-:A TING PERMIT FEE
S TA TF StlRCH ,\J{GF
TOT At. PERMIT "..:~:
$........................................ .
$._...... ............ .... :~g
s.. ...............___................
--.. PAID WITH
aUILDING PERMIT
((llliee ll,< Only)
This Apl11ic~tion Become" \'uur Building I'crmil Wlltn Appruved
I~;~M~R~'~'~O~ "~"'".~
,..._.~...B-;;ildini: om.;;l---------n .....-n-Ii~~;u_m---.---._n
_..",~'............,-.._.."'_.....'~..'_.."',.........___ __..."~..........'..__._..._.............,_.,..".,w....,.',~,"...~. I'" .'. .......-....................-....................-.......--.;::..J
24 hvur nolict for all impt'l'\IlJII.; (952) .1").'tI~..,-l'a:t ('S~I .u7.-1:!.-lS
162<lO ElIglt (:r~~k o\nlluc. PrIlll' Lal ~~IN==;n~___
10 3SI\;;1d
S I S3t'B9
9ESC::Lt:>t:>C::!;5
Et:>:91 900C::/!; 1 IC::0
LI.. i OF PRIOR LAKE
HEA.tJliG/AIR COND.tJ.J.ONINGIFIREPLACE PEDu.l
Date Ree'd
lfte!8e type .. print aad sip at r , ,..,,)
ADDRESS
30 llP 2dcx'cu- -rn
~ =- ;'.' PERMIT NO.fJ8.12JfII(
ZONING (o&lce
1IIe)
LEGAL DESCRu .. .ON (offJa! use only)
Lor BLOCK
AUUUION
PID
OWNER \
(Name):.j \ '(V\ ~ ~ IN\' \'rD. LJa Y\ n
(Phone)
(Address)
APPLI~ \ -
(Name)~Y't"'\~,\\-r. ~\~\QCe.. ~ ~f\
(Phone)(g~ )7!flO.1:;J.4{p
(Address) 3\ Cf6 W~t t-k.w \6 l&AYnSVlU~ bS2>DI
(Ad';:, ~J',J~ (Ci.!Y) (Zip Code)
(Contact Person) JI)\~' '~-\~ (Phone)~8qO-124U
APPLICANrSIGNATURE _ DATE 9-11 lo<p
APPLICANT PLEASE COMPLETE BELOW
[]NEw CONSTRucnON 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND Mvun.... FUEL
FLUE SIZE LI- 'f...l 0 RETURN OPENINGS INPUT awro OUTPUT
TYPEOFSYo.m\'I HEATING OR POWER PLANT
OWann Air Plants 0 Steam
DGravity 0 Hot Water
o Mechanical 0 Radiation
[]Air Conditioning 0 Special Devices
[]vent. System 0 Other D...I :~-
FlREPLACEMAKEANDMODEL _\J'\V'"V'lQfy'un ZO\J~~ N-
.~' FEE SL,.d.I!.&.I,.JLE
Industrial. Commercial & Multi.Family 1% of job cost Residential, Gas Fireplace
$39.50 niinimum
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations $39.50
Residential, H..cC,,,,Only(NewConstruc:tion) .$ S64.SO _ Residential,ACOniy $39.50
Estimated Cost $ 'A \ $(X). Building P.. " :, # I 6.17IfI! e~
HEATING PERMIT l'~~ S p,.'PI) I) .
STATE SURCHARGE S .50 rw ....
TOTAL.. ld.~.MIT DE S 44-) on V
--
&.:i~ 'M-
By
PLEASE No AAl,:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
(0ftIce u. o.Iy)
TIlls AppUcatioD Becomes Y 081' BIIildiaC PerDlit Whea Approved
-Paid
~
BdlIiIIc 0IIIdaI
Date
~. 9.",
24 hour DOtiee fer aU illapectiou (951) 447-9858, fax (951) 44'7-424S
PRIOR LAKE
INSPECTION RECORD
.gD/' ~ r,L
. .. 1,..
"
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDI G
PERMIT NO. .. a"', J DATE ISSUED I.. ~O..~ 1\ntI
CONTRACTOR ~~ PHONE--Ol.5j. 3." I
NOTE: THIS IS N A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I I
. .", . .-. .' ..'. I) I I
-f" . ...... . "'.._--
'---'PLACENO CONC~~ETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
'R"MNG
INSULATION
ELECTRICAL I J
PLUMBING f1I 7t/ ~
I r ..
HEATING (if required) .
FIREPLACE w L- veS Zfit{cCP
GAS LINE AIR TEST it ~? ~.j/01A'
COVER NO WORK UNTIL ABOVE HAS BEEN SIGN'ED
rJj
t,
I I
l/ 171~~
~
I
FINALS
......
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
I
......,.
OCCUpy UNTIL ABOVE HAS BEEN
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.
l/y!
I
o
~./I( ~
I
I
~
SI~ED
FOR ALL INSPECTIONS (952) 4.17.QB50
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
x/; !JCt
ADDRESS
?&C rZ0Ut ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~ ~-: 1)t;1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION I /
~NAL /..-fe-I
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
---
~
/'
/
(
"'--
----
/
( -' I ()S--(
'" -
--...........
---
q./ "
rclt 1
/
---------
---
l2f WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PR D
o CORRECT WO 0 EINSPECTION BEFORE COVERING
Owner/Contr:
Inspector:
CALI..: 7.~850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl