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Home My WebLink AboutPermits 04-0316,0317,0345,0340 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec' d 4, 1,0 ~ (Please '!ype or vrint and si2Il at bottom) ADDRESS t. White File 2. Pink City 3. Yellow Applicant I PERMIT NO. 04-. 03/~ 4-(, 70 PlflUc ~/&Jl/~T riVe. ZONING (office use) e..4- LEGAL DESCRIPTION (office use only) LOT I BLOCK I ADDITION p~ IV''''''~ PID -z.,!~ J>'Tj 060 I. 0 OWNER (Name) (Address) BUILDER (Name) z:Tm (Contact Name) t!Nv'J7t:!4N.P~.',1 &<'IAd /f~~i'E-f:7.- (Phone) ~~,. (Phone) 7W'~ (Phone) 5 J' ~ '1GMJ (Address) .s'YSJ"' ;f76f-/1o./+1 /61 /'t7/?'t'lfth 11,'/'/ S3~f'L DLower Level Finish o Misc /.~,r. .t -:ur--f2, DDeck DPorch ORe. Roofing o Fireplace OAddition JtfAlteration PROJECTCOST/VALUE (excluding land) $ tr. /)00 DUtility Connection TYPE OF WORK 0 New Construction DRe.Siding I hereby certify that I have furnis d 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 abov enti property and that all construction will conform to all existing state and loca11aws and will proceed in accordance with submitted plan~m aw a uUding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may ;'er u~~, _ needed inspections. ",irA y Signature Contractor's License No. Date Permit Valuation Permit Fee I Plan Check Pee I State Surcharge I Penalty I Plumbing Permit Fee Mechanical Permit Fee 11 f...:, 7 COO, 001 / '&/0.00 I 52~So I 33.5'"0 I I Sewer & Water Permit Fee Gas Fireplace Permit Fee $ $ $ $ $ $ $ $ This Application Becomes Your Building Permit When Approved ~~~ ~2~r Date Building Official I Park Support Pee # $ I SAC # $ I Water Meter Size 5/8"; 1"; $ I Pressure Reducer $ I City SAC and WAC # $ I Water Tower Fee # $ I I Builder's Deposit $ I I Other $ I I TOTAL DUE ~ 4-,~2-.0a.. $1.370. OV I I Paid I Date I Receipt No. ~u~'.f BV/y_ U j, 770,00 , 4. Z.>.ClL This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document :-vhen signed by the City Planner ~titutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be ~Plan~~fl .~0<( Au~on~ 24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245 16200 Eagle Creek Avenue Prior Lake. MN 55372 MAR-23-2004 12: 55 CITY OF PRIOR LAKE 9524i?"~A'ccc..g.02_._._.._.._ i-- "-", :':' ,,-~,: ,n~_) ;", I .' c.. Date ReC.'d i: Ie)' ; .' -- i! ! [:'! MAR 2 6 2004 ~ I '-<W .~ CITY OF PRIOR LAKE PLUMBING PERMIT (r!9l!~ or _ 0Illl oi&n.. bottDlIIl ADD1U!SS Ltloln VC\ (\Z 1,1\CL I le-1- A-,rt SE ;::. ~ I PERMI'I*h. ol 03/"" I 3.Vdlcrw A.PJIIi_1 " -/ WNING (oIlXc""'l I LEGAL DBSCRIPTION (olli",.se onIJ) LOT BLOCK ADDITION PID 2.-5', 3q / , ()()(. 0 OWNER (Name" \7N lV\ L. (Phone) (Adcbess) ~~;~~A.NT('l R \'v~LhD-f\i ('.if ,\ hJ G (Phone) 11i?> 4d.$?- Qu1 ~ (Address) \::3L\-n\ \rOr\I.\~c1 ( \ -rL\t'7*-' i) '~.vF"~ (Addless) (City) J (Contact Penon) I Ct f'<'\ rn ~' I I ( hone) APPLlCANTSIO~~~> ~\:-3 ~ L ~LDATE}fz-:>-, lot./- -. "r---- AP~(.IC Type or rilllln'f' Bath Tub with or without shower Dishwasher Floor Drain I Lavatory (Bathroom Sink) I Laundry Tray (J or 2 compartment sink I Shower Stall I Sinks I Bar Sink I Water Closet (Toilet) c; c; ~/Y (Zip Code) Quantity PLEASE COMPLETE BELOW Quantity type of Fixture .J., ROUlh.ins Water Healer I Water Softner ~taDdPipe (Washing MlICbine) Sew ale E;jec:tor fJacktlow Assembly I riackflow Assembly Test I Lawn Sprinkler I oiher FEE ~ni\....JLE InduSlr;ol. C_ ...... __:.1" Mulli-r.mily 1% .rjub COS! wilh. SJ9.S0 minimum Residenti.l, New One" Two-Family S99.5O RcsidCluial. Addition. " Allerations $39.$0 Estimated Cost S d.?.J=:rF PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMlT FEE $ Building Pennil # 04 . 0.317 ?fl. oV .SO ')",'1 . <::::I,:) 10_ U.. O.IJ) Tllis Applk:alion Beco..es Your BvildiDg Permit W..,. Approved ~ ~ ~/~z--/o t./ 10114l1ll: omcioi D'" I Paid 3 C/. 5V I D~ ZZ-. 04- Rc<:eIpI N~~ ~~ h BY;l/L 18 hour a"lce r... altlaspeed_ (951) 447-tHO, ru (951) 447-41.5 151DO hilt Cro.k A.e. $.1., Prior L..... MN 55372.171. TOTAL P. 02 10:52 CITY OF PRIOR LRKE 9524474245 P,01/01 CITY OF PRIOR LAKE Date Ree'd HEATING/AIR CONDITIvL Ii. IGIFIREPLACE PERMIT 104--:l1 Lt CJ'f . ~t.fo, 00 A(..,G/ IV ()t1.03Ih ~~ ~ I PERMIT NO. 04- C>~Ad 1. YIRDw .\IIIllo-lt . ~ r:.J I I (Pleas< IVI>e or Print ODd.ion ar boIlDm) ADDRESS 4010 PARk Nt COLLET ZONING (.ni,.....) AVE- $c LEGAL DESCRIPTION (.mc:e UK unly) LOT BLOCK ADDmON PIDZS', s9l~ OOl. 0 OWNBR (Name)' PA 1<.1< N [ (D Ll BT i+1; A L:rn ~ vi ces (Addzess) S A1'Yl f:- (Phone) APPLICANT, (Name) '{ A--LE rvteutA N l CAc- (Addzess) g bl.N G Wilt 12-0 Me S (Addt..,) 'fourJ6 ~L ~Jwy-yJ (Phone) CJ5'2 - 88 4-( (:;,b I 13 LCON I N C; n:>rJ S5Lf3 I (City) . (Zip Code) (phone) S /11Y\e DATE Lt-d-d-.-OY (Contact Person) rn f2-t 5 APPLICANT SIGNATURE APPLICANT PLEASE COMPLETE BELOW ONEW CONSTRUCTION 0 REPLACEMENT !B'ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RE11JRN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT OWII'IIl Air Plants DGravity o Mechanical DAir Conditioning Ovent. System fIREPLACE MAKE AND MODEL o Steam o HotWator o Radiation o ~ecial Devioe. [B'OIhcr Devices geLD U\'rr- fi\'lsntJ~ D (JOPl.lS€12.$ PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks FEE SCHEDULE Industrial, Commercial &. Multi-Family 1% of job cost Residential, Gas Fitcplacc $39.50 minimum Residential, Heating &. Ale (New ConstnJClion) $99.50 Residential, Additions &. Alterations RtI$idcntial, Heating Only (New Construotion) $64.50 Residential, AC Only $39.50 $39.50 $39,50 EstimatedCost$ .?.10CO.CO BuildingPennit # 64-.034f /iff;. (;- HEATING PERMIT FEE $ 3Q.5t) r&d~~ ~ STATE SURCHARGE S .sO ~ ~ \ TOTAL PERMIT FEE S Lj{).OO.J - 0 :.J.-..J.-'1 ~, (om.. Use Only) .~ -"~r'.fkA.u Tbls ApiJllcation BecomeJ,Yonr Building Permit Wben Approved I pai~ ' 0 0 Receipt N~O . e 2- I ~ ~ 4(;J-gjd~ I Date". ..,k"rJ." . By /r/l I BUl1dioC Qt1IdlIl Dalt q rv. .,.--- /1 /i Vl...... 1.4 h~.. M'." tnr .lIlno_lIons (951\ 447-9850. faX (951) 447-4145 ;-- / TOTAL P.01 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT (fllU frAec--f;o,,) p{'Jj-tL niLo IL. I- Ltc", ~G Part- ni &I~}~ s:CZ-> (Please ~ or print and silm at bottom) ADDRESS '-I 07 () LEGAL DESCRIPTION (office use only) LOT / BLOCK / ADDITION ,,) " r:JAk' Date Rec'd 1f,27.01-- I. White 2. Pink ), Yellow File City Applicant F/[.;e vv'I 04,. 031b I PERMIT NO. 04-. 0.340 I 'J ~', .;-'.- '''',- PID 253q /. 00 I. 0 OWNER (Name) PCLlrJl.. N; rn 11.+ ), <f.Ef\ 9l:1Y'tJ\ \ ( b \ lo.-\- RJ\1 ~ (Phone) ~+- ~l A.;, -:PtJJ\~ (Address) } BUILDER :::'~-COn~iZ- . (Name) Se..rv;a F,'ru PVll*-.L.-f:.(\"", (Contact Name) -ldl'y-er, (Address) dJ I b; /J..r..-. Lm s: I ./ TYPE OF WORK I ZONING (officeu"l I (Phone) (Phone) q5/- 51/.--Q;)(JO rn ,'n 1'Iq, -ho... y IA.. fYl AJ .5"5'3, 0 <" D New Construction DDeck DPorch DRe.Roofing ORe-Siding . DLower Level Finish D Fireplace DAddition DAlteration DUtility Connection ~iSC J:;/U 5Pr-;I"'lIC~ PROJECTCOST/VALUE (exc1udfgland) $ /650. 00 , . ~!flt'>/>-I-P _< ""- .""V, '"' IL ~ FJ-P.-r dLr I hereby certify that I have furnished information on this application w~ich is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the above-mentioned 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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may ;tetupon~:~ C(l;Z/ LJ-.?S-oJ ~ Signali'ire 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 '1I'j</(Jt}, Of) I $ . SLf. z.s:- I $ 35.?-f... I $ ,70 I $ I $ I $ I $ I $ I This Application Becomes Your Building Permit When Approved ~ ~ ~/Z-7~~ Building Official Date Park Support Fee SAC # # $ $ $ $ $ $ $ $ $ 7'0, 2../ I Water Meter Size 5/8"; I"; I Pressure Reducer I City SAC and WAC I Water Tower Fee j Builder's Deposit lather I TOTAL DUE # # ~ 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 constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. Plmming Director I Receip By ~~7~eeB. I Paid I Date qo.. Zc.( 4-.Yl M- 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 ~~ White - Building ~rv - Enaineering . l>lannin~ Th.. ('..nil" nr Ih..l.8kf Counlry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED I~ , -/ / I (! .- / Ie. 4. 7. (4- The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: Q(70 /';-/k/L Iv//L.lceEI rilE. Accepted / Accepted With Corrections Denied Reviewed By: ~ ~ Date: ~/z z.fttf 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." &~~ r-'Nhite . tsuildiniil -Uanary - Engineering Pink - Planning Th~ C-~nl~t of lh~ I..kf C"ounlry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI~T NAME OF APPLICANT APPLICATION RECEIVED ,e:J 11 ~o/VsTe-. 4. 7. 04- The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 4(P70 / ~/1 telL tV I C-O u....e-. I /lv6, Accepted Accepted With Corrections Denied Reviewed By: ~~ ~~.f)f- ~~ad Date: L-//2z/o'i Comments: or ~l.~ (I "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." (jIl~ ~ MINNESOTA DEPARTMENT OF HEALTH Division of Environmental Health REPORT ON PLANS ~\L, lJ\r Plans and specifications on plumbing: Park Nicollet Prior Lake Clinic Remodel, 4670 Park Nicollet Avenue SE, Prior Lake, Scott County, Minnesota, Plan No, 043290 OWNERSHIP: SUBMITTER(S): G R Mechanica], Plumbing & Heating Contractor, ]2401 ironwood Circle, Suite 500, Rogers, Minnesota 55374 Plans Dated: Date Received: April 22, 2004 Date Reviewed: May 3, 2004 SCOPE: This review is limited to the design of this particular project only insofar as the provisions of the Minnesota Plumbing Code, as amended, apply, and does not cover the water supply or sewerage system to which this plumbing system is connected. The review is based upon the supposition that the data OQ which the design is based are correct, and that necessary legal authority has been obtained to construct the project. The responsibility for the design of structural features and the efficiency of equipment must be taken by the project designer, Approval is contingent upon satisfactory disposition of any requirements included in this report. Special care should be taken to insure that the material and installation of the plumbing system are in accordance with the provisions of the Minnesota Plumbing Code. A copy of the approved pIans and specifications should be retained at the project Iocation for future reference. A set of the identified plans and specifications is being returned to G R Mechanical. Enclosed is a copy of the report and transmittal letter to be forwarded to the project owner. ' INSPECTIONS: All plumbing instal]ations must be tested and inspected in accordance with the requirements of the Minnesota Plumbing Code, As specified in Minnesota Rilles, part 47I5.2830, no plumbing work may be covered prior to completing the required tests and inspections, Provisions must be made for applying anair test at the time of the roughing-in inspection as outlined in Minnesota Ru]es, part 4715.2820, subpart 2, of the code. A manometer test, as specified in Minnesota Rules, part 4715.2820, subpart 3, is required at the time of the finished plumbing inspection, It is the responsibility of the contractor/installer to notify the Minnesota Department of Health when an installation for a state contract job, licensed facility, or project in an area where there is no local administrative authority is ready for an inspection and test, To schedule inspections, contactthe state plumbing standards representative for your region, or call the metro office inspection hotline at 1-800-926- 6216 (7:30 a.m. to 9 a.m.), or 65112]5-0836 (8 a,m, to 9 a.m,) on Monday, Wednesday or Friday. REQUlREMENT(S): L It is recommended that a c1eanout be provided where new waste and vent piping connects with existing plumbing to facilitate required testing of the new installation, 2. The submitted plans indicate that the new fixtures will be served by existing waste and vent piping, Verify that the existing pipes are sized to accommodate the added fixtures (see Minnesota Ru]es, part 4715.2310 and part 47I5.2520). 3, The submitted plans indicate that the new fixtures will be served by existing water distribution piping, Verify that the existing pipes are sized to accommodate the added fixtures (see Minnesota Ru]es, part 4715.3800). PRIOR LAKE INSPECTION RECORD Lf1tL'7() fJJ JJ(~/I~'I- JfuG: 'tF'N, 1/ lit r UJ,.} DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS NATURE OF WORK USE OF BUILDING PERMIT NO. 4, ().3J~ DATE iSSUED ~/.. ~." CONTRACTOR ~h1 C,lAJ~, Jf~~a/~ PH6NE~40 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE I I I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS !lIvf t:vL{~{J~ , )//f 1/ ~m J/ v'r// s - ')-1JI-\ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS ILDING ELECTRICAL PLUMBING HEATING DO NOT vvY vWI rp OCCUPY UNTIL ABOVE 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. .5 . 2-5 - l-! 5'dE.-Lf HAS BEEN SIGNED FOR ALL INSPECTIONS (952) 447-9850 CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULISD ADDRESS L{C'io &/~ c J~ r<d/~ r OWNER CONTR, PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING ~NSULATION FINAL o SITE INSPECTION o PLUMBING RI o MECH Rl o WATER HOOKUP o )lEWER HOOKUP ,jif j'LUMBING FINAL ~MECH FINAL COMMENTS: DATE TIME ~/J.r~/ t.( r sab o EXlGRADIFILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o ...----- /"" ./' // / ,"'\ --- - ( / ll/~ ( ....A' \ '--- -- ---- ~ --........... ) ./ / " ,/ { ("*! ------ o WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT W~R~lJ-L FOR REINSPECTION BEFORE COVERING Inspector: _..J!2LI'" OWner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNO" CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! CITY OF PRIOR LAKE INSPECTION NOTICE ADDRES~ (p 70 OWNER PHONE NO, o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION COMMENTS: SCHEDULED DATE TIMe 5'-2-7-0'/ , ~,)~ y\J Ir CONTR. PERMIT NO. 4 -"3IIA o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL ~ECH FINAL o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o -------~ U<SND" . CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS ~ OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION COMMENTS: A:r .\.~L DATE SCHEDULED l{:1{) P~~ILr TIME CONTR. PERMIT NO. .B'"'"PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL ~-<,n o EXlGRADIFILUNG o COMPLAINT o FIREPLACE RJ o FIREPLACE FINAL o GASLINE AIR TST o () !,,- /' ~ORK SATISFACTORY, PROCEED o CORREC TION AND PROCEED K, CALL FOR REINSPECTION BEFORE COVERING 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. Owner/Contr: CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY! """"" CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED DATE TIME s- 3";/' ( ADDRESS 4G7o Arie t1jLo/f'...--r OWNER CONTR. PHONE NO. PERMIT NO. {~~ 3/G o FOOTING o FOUNDATION P'!'RAMlNG o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRADIFILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o COMMENTS: (r--u.,""""f PiU-'1b,,,,, //'1' v1 ,.y-- o WORK SATISFACTORY, PROCEED If CORRECT ACTION AND PROCEED o CORRECT WJ~ALL FOR REINSPECTlON BEFORE COVERING Inspector: ( r 1 Owner/Contr: CALL 0147-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE, CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH ,{ SAFETY! "",,<<m