HomeMy WebLinkAboutBuilding Permit 05-0013
ADDRESS
-- S.CHEDULEO.--.- - '-j11-
/{'Z5"1 (.I\.\Js l1y
CONTR.
- itmPECiibNNC)TICE~ - .--
OWNER
S-uOl)
PHONE NO.
D FOOTING
o FOUNDATION
o FRAMING
D INSULATION
o FINAL
o SITE INSPECTION
PERMIT NO.
D PLUMBING RI
o MECH RI
o WATER HOOKUP
D SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
D EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
D FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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N.Ac(
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC K, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
White
Pink
Yellow
I PERMIT NO. (/IS- cJC;/j
File
City
Applicant
ZONING (office use)
/5-(35/ -
LEGAL DESCRIPTION (office use only)
BLOCK /
IlJd
LOT
ADDITION
PIDo?5--
d-3-'O/~ 0
OWNER
(Name)
...~- )-...., \ /'"",
'i~V)h-,,, --^- :,,<\('j"')~-Y,(, ,-'
(Address)
(Phone) Cl f, 2 _ \.1 ~V( - \2. "'LQ..
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
Lower Level Finish 0 Fireplace
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding
OAddition OAlteration OUtiJity Connection 0 Misc.
CODE: tKri.R.C. DI.B.C.
Type of &nstmction:
Occupancy Group: A B
Division:
II
F
I
III IV V A
HIM R
2 3 4 5
I
E
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have hlrmshed 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
Jbove-mentlOned property and that all constrUCl1on will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can revoke thIS permit for Just calise Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propel1y to perform needed mspecl10ns
X ".i-" 'C:',x,U:.,J (. it\..::..a~ 0.<. '.:>
Signature
Permit Valuation '100tJ, () 0
Permit Fee $ J'7r zs
Plan Check Fee $ -
State Surcharge $ ~,OO
I Penalty $
Plumbing Permit Fee 0 IlJ j1) ey' $ 40.00
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee tmJ-- f $ '10,-
This Application Becomes Your Building Pennit When Approved
~~~
l3uildlll!! Oftlclal
1/3 ,{~e.r
\-~-(,5-
Date
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other e/ec $ J.. 00
TOTAL DUE $ //70-';;5'
Paid
Date
-
/70 d5 _
- 3 '"'0 '5
I ~;cej:Lj~Ol(9
ThIS tS to certIfy that the requcst m the above applicatIon and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issucd
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Residential Building Permit Checklist
Baseme!l.t Finish or Interior AJteration to Single Family Homes
BY:~~
Dare:
/'-
..-
:';? __ /' ) L-..
'- .' L-/.J
Building Permit #
Site Address
Pill:
Zoning:
Legal: L lOB
/
(
/j-d-51 i~~/d;J /?(('fA.J,1
Subdivision: t#~ c:9-dJ ~
EIisting structure@or NO
CONFORL"YIS TO ZONlliG Y-:[S NO
ORDmAJ.~CE
YES
NO
Is this a."1 ex:pansion of the e:-,.i:::illlg footpnnt or Refe: to Plar.uJ.hJ.g
building heighr? ;JO
Is ,he properry located wiw.in me flood plain? I Refer to Planrill1g I rJ6
Does ,b.e alteration incluc.e any additional :<.itcnens? I Refe:- ,0 Planning I rJO
Does t..~e :proposed alteration include any outside Refer LO PlaTh-ring ;JCJ
eTIt:r3J."1ces othe:- man patio doors?
Is cb.e oroDosed use of the fi.mshed SCJace or Refer co Pla.-mmg
, . .
alte:-:J.tion for anythi"1g oeb.e:' l~an a l10rsal single NO I
.., ( ~- " )"
L:::.r.lilY nome OITlce, group aome, day care,e:c. :
THIS CHECKLiST ,:vmST BE COMPLETED .1...'fD Ii'KUJUED IN T3E BL1LDfNG PER1'lfIT FILE TO
.Y L-Vi'iT.-\.E'f A R.E CORD 0 F' THE RE VTDV.
.. .---::-7,'i--:r ..:.. --::' ;. - -..-.,~...~(~/.. ~(-c
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
; ~ ~:~ I PERMIT NO.
3. YeUow Applicant
ZONING (office
use)
\52.5 1 V, \d.~ vor>\c:..
N~
LEGAL DESCRIPTION (office use only)
LOT '8 BLOCK I ADDITION
nO
pm
OWNER
(Name) K~~ C:,-\~rn~
(phone) qS'Z - ~\..q. \218
(Address) \525\
NvI
APPLICANT
(Name) KdJcu-\. G\~~~~
(Phone) q5~- '-l'4,. \'Z18
(Address)
APPUCANTSIGNATURE DATE \~-~\ c'""
PLICANT PLEASE COMPLETE BELO
DNEW CONSTRUCTION D REPLACEMENT AL TERA nONS
FURNACE MAKE AND MODEL &2'3)( v"Z.'3 -lH "Ir=(.,-l FUEL (b.a~
FLUE SIZE 191. RETURN OPENINGS 4 INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
?~ \..~\.o
(City)
(phone)
55 31 Z.
(Zip Code)
\SZ5' "^,, \d~ ~\U~'\~ N...J
(Address) 0
(Contact Person)
~~-'
OWarm Air Plants
DGravity
o Mechanical
OAir Conditioning
~ent. System
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
FIREPLACE MAKE AND MODEL
~L - "3
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
$39.50
--1-\ .50
iJ $3 0
~6- 'i
liJI&Q~'
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
I ::ociPINO
Buildil12 Official
Date
I Pwd
Date
24 hour notiee for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
.
SITE ADDRESS I WI IIIt1A t'
NATURE OF WORK ~
USE OF BUILDING
PERMIT NO. · '" DATE ISSUED ,
CONTRACTOR PHON J8
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
IL ABOVE HAS BJEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if re uired)
FIREPLACE
GAS LINE AIR TEST F:~. '" & '7
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
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 shaH be placed near main entrance.
FOR ALL INSPEC710NS (952) 447-9850