HomeMy WebLinkAboutBuilding Permit 04-0723
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
''31 ~8
LEGAL DESCRIPTION (office use only)
LOT3BLOCK
t -' i-at!
I PERMIT NOt) ~, 0 7.z..3~
ZO~G (office use)
Ie /~ IJ
See Main File~~~~ew
M
.. e f+~c.
OWNER
(N ame)
File
City
Applicant
L
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PID
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FA(l,VV\~r/1 tL'k/ Oev<Joffl1-u",4-
)~ 0 ~t3 C~;J+Or0 (-t.
(Phone)
~5 1- 10 J- ((B:L)
(Address)
(p
111JL
B~DER ~ V I ' ~
(Company Name)f\dM. ~ I 1-,,-, ~,,< OfM~",k- L6 We.
(Contact Name) ;{- (.. f Iv 0+-~ f{)
})1.0 t6 ~ C-t-
(Address)
Date Rec' d
(Phone)
(Phone)
0)1- 'Ic,J- t{82.S-
(, <;'(c ~s: "9CiC(
MtJ 5")"0<"
TYPE OF WORK [l New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc.
CODE: ~I.R.C. DI.B.c.
Type of &'nstmction:
Occupancy Group: A B
Division:
I
E
III IV ~ ~ IBl
HIM l!V'S
2 ~ 4 5
PROJECT COST IV ALUE $
(excluding land)
(jOO I oW
u
)
/
I hereby certifY that I have furnished mformation on this application which is to the best of my knowledge true and correct. I also cerllfY that I am the owner or authonzed agent for the
above-menlloned propcrty and that all construction will conform to all existing state an local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official ~evoke thIS pe. I for cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the propelty to perform necded mspeclloos
x
Signature
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
II
F
I
$
$
$
$
$
$
$
$
Oo.tJ~
OO.[)o
35.5(J
.l/d.(JO
This Application Becomes Your Building Permit When Approved
~ M~ to/ZI/ot/
Building Otllcial ' Date
~C10
b-?.-o'"'L
Date
$
$
$
$
$
$
$
$
$
ssa. 00
Z$"Q.OO
5..110
~ 2eo. ()-o
Oo~oO
Contractor's License No.
Park Support Fee
SAC
#
#
--.........
ThIS IS to certIfY that thc request in the above applicallon and accompany 109 documents is 10 accordance with the City Zoning Ordinance and may proceed as req~ted. ThIS document
:z=""""u;:"" Cm""" of ,"/:m;2;,fW", ,,"m."i"" "SeefOMiiifi'"Fil'e m." oc
Planning Director ~ I Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Water Meter
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
::!l'r~fC) I ~;C:}O
Paid
Date
See Main File
. White - Building
c..., c.;anarv - FngineeriiTg')
Pink - Planning
Thr C"ntrr or Ihr Lake' ('ounl,.,..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
~1 ,_t_.-.
NAME OF APPLlCANT'-/(.:J,,'1/n-!/v".-;;': /i2J''f
APPLICATION RECEIVED 6., -7 -'()i:.::~
/'
"
.. I"S
! (/tl /' /'
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.,' "."" , .
-'.:~:: //; .<. f( -':I'1J' ~/^. .' i r-;- .... "f ",:f..,v. ~:2-N ~ li..._
':-- . - (j "-,J 1/;-L;)-t./(),.-[.c..'C/ V' .-.._~
i'~/
Accepted
x
, ...........
Accepted With Corrections
Denied
Reviewed By:
JrPfb
.
Date:
;- /'1~OLI
Comments:
<~~ f!7t;('~ f;f<-
"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
Pink
The Ct'nll"r nf .he I..ke Counlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ':::J:,~1iN J ~ 0 '
APPLICATION RECEIVED 0 -7 -
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is Rropased at:
~~5t -m~~
/' Accepted With Corrections
Accepted
Denied --n '
Reviewed By: ~~
~
Date:
!o /z-/ /0 L/
I
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."
See Main File
White - Building
Canary - Engineering
~nk - Planning:,
Tht" Ct'nlt"r of Iht" L.kr Counlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
/'..1
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, ,/
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/6 .
NAME OF APPLICANT
,.
APPLICATION RECEIVED
/ '}'"
t....'., -
,-. ' .
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.7.'.' /- ..-~ r' ", ,"t'1 ,,", /;
- , /'.\ . f 11/ ."
- I -) ;/ ;' iLl'.; \;: tC-
I
j'
"': ',l<")(_,v~
Accepted
,/
Accepted With Corrections
,t~
Denied
~
,...
Reviewed By:
~
Date:
folLIIa'!
I (
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."
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
!Z, z%. 04-
1. Pink
2. Green
3. Vellow
~J~icanl I PERMIT NO.tJ+ .. 7)-:> I
AD~RE1S~ / /
-:) 4 '6 JI1/lJ6J77~ uJ.
ZONING (office use)
pJrJ
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
h.r~:"fh"l
f)-ef/e-~ M~"\.-~
t!o.
(Phone)
(Address)
APPLICANT G
(Name) ~ $
,(~~e
p7 it s
(Address) c2.o rf S- .::j:::JCuA." ;;:
(Address)
(Contact Person) If t...cl..
~.
(Phone) qS.<- 'I~9 - ~? .76
-< ~(/ , . S-SOq''f/
(City) (Zip Code)
(Phone) Gf2-C//'I'- V.2.V.:1
DATE 1.l-:l..F--c> 'I'
APPLICANT SIGNATURE
APPL ANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
Vent. System
HEATING OR POWER PLANT
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
;/ed-,v- (;j(;
7s-;, TI?
FEE SCHEDULE
Industrial, Commercial & Multi-Family I % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AIC (New Construction) $99,50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64,50 Residential, AC Only
$39.50
Estimated Cost $ Building Penn it #
$39,50
$39.50
fJi
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blJ1l/
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HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ~
$ ~ .50
$./
.r
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
~
Da ~ ' ?-(, 0
24 hour notice for all Inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
3'lSt A1iL;~(;tic L.A;
tJ
DEPARTMENT cSee Main File
BU;LDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO. SUED
CONTRACTOR PHO~/" 75~. 'If1t(
NOTE: THIS IS NOT A PERMI OR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING {){u/ ~
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING ~uJ L)~
HEATING (if required)
FIREPLACE
GAS LINE AIR TES"F ~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
flArN6/&unl~ I/lJN6 I I
,
FINALS
11-lJ'
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN 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 placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850