HomeMy WebLinkAboutBuilding Permit 04-0363
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF Zu. '><i ,6 COMPLIANCE
AND UTILITY Cu.~. \.!.CI10N PERMIT
Date Rec'd
1..SO.0+-
i?!. ~. , I PERMIT NO. 04.0 j' (p3
f!'Ie-tfJ.C..---..-
I ADDRESS \31 ~ I WI L.1) ~ ORSE. PA55 I :tu' ......;,..., (oftk<...) I
POI()I2 I AIl'4-M.1J ,~I2.. ,....
LEGAL DIlSClUP110N (_ use only)
LOT 18 BLOCK -4 ADDmON W/(A'./..J J (/t/771
PIDz..5. 382... ,2..s. 0
iN~~) ~'" <lj.- ALLE. fJ\\.5HuR.
(Address)~7:l\~\ WilD U~g"o~ PA,()~
BUILDER. 'D C
(CompallyNamecl. ~VA.~\.tf.((I.n
(COlllact Name) _LE. IbU P ITT012 F
(Address) 01 L:> laTH A\J~. f.J1.J .
(phone) Q5'2 -_-4~-"~.n
OQ\DR \,p.\I-f,)'A.~ 55312
/
TYPE OF WORK 0 New COIltlruCtion ODeclt OPon:h OItJ!.Roofinl ORo-Sidilla IaI -_ Level Fim~irqllaCC
OAddition OA1t<ratioll OUlility Con_ 0 MiIe.)I'4.~ 60
CODE: DLII,.c. Du.c. PB.OJECTCOST/VALUE $ /11 ~()() -
TypcofCOllltnlCtioa: I n m IV v A B (exdwlin,land)~'
0.."."".. Oroup: A B E F HIM R. S U
~: 1%345
(Phone) ~I\}OI-333-~19B ,_
(Phone) l' ()12 501- LI o-tffi() (t ::LL)
I- (.lQI6f:ku:r, Mt-J ."\"\021
I bmby certify lbat I haft' I\u1aisbed information OAtbis '. ,. ..." .', wbidI is to thebcstofmytnowlcd8ctnX' Iftdconm, I AIiocertift Chat I am the ownCf!)r ",In' .,-,.. qc:m aiftr
I:.. '-. _._.~,,_:._ '".' ',I and lhatrfff{- wI!Ic:onform toaH nlmDtlfMCandJoaJ Ja,"udwiDJQCC'Cdin ...:" -. wilb RlbmittedptanJ, Jim IWlredWrbebuiJdinl
offici&! em ~ ptrmk ror' , P",.. .", ,. . '., I heRby qrft ttwtbcacy offtdalor I. delipcc mayCl'lter upon tbt'property to perform needed msprcbons.
X ,,'''AiiT _\1xr~ RC- 2.0'1151;,3B -1-30 -()-4
,:"....". t..--.) Coalnclor'.LiccueNo. Do..'
PermitVa\uation 3- 000.00 I PartSupportF"" II I $ I
PermitF"" $ I '? t/. '7r SAC II I $ I
Plan Check F." $ IWater~ SizeS/S";l"; $ I
State SurchatBe S /. .ro I PmaUR R.eduoer $ I
Penalty S I SewerlWall!r Connection F.., II S I
I'\urnbing Permit Fee t!O,.a7t . S 4--0. 0 0 I Water Tower F." II S I
I Mechanical Permit Fee S I Builder'. Deposit S I
I Sewer.t Water Permit Fee S I Olher $
I GuFitep1acePermitF'IJ.,,<I7;V, S -fO. 00 I TOfALDUE S /.5(,.?5 I
Thk/"..", -.Vour_.._W1ooIIAppIomI I Paid /~t; U I ReceBVfE' . U .?/LI" 'Ill-
~ ~t- -I;3d,4ij I Date ' 4-S0.04-' AJ/l
Build... officiai Dale
nus iscocmify dtattbe-f'C!'CIIIdt iIllbr~ ,.,....... .'. aad ..,.......'"'. 'aa__mmts is in "u'." '0. wicb rbtCity ZonibaOrdiRancr and may proceed ill reqMl'Slcd. 1'hisdllCUmeoI
whtn sienrd by dwCity P\anna' o.,,,.,..~,..,. ,. ..,. '''. CertiftcateofZcllina~ aad aUows ...,.. ".:. to.." BeforeUC'alpancy, I. Ccrti~ of... 0.'" o. mustbt
isIutd
_00-.
DaCe SpactaI P----.. d' lIlY
Z4ltowr 8000 for .lIlupcd:1ou (951) ....,.M. f.s ~) 447-4145
16200 EasJe Creek Avenue Prior LaJa:. MN 55372
.
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY: ~' ~
.
Date: '/;30 fa 'f
Building Permit #
Site Address .3 I Y I
Legal: L / 'I B
Pill: Zoning:
wlM ~~
if Subdivision: t-d~ ~
Existing Structure: ~r NO
CONFOR1\tlS TO ZONING
ORDINA1~CE
YES
NO
Is this an expansion of the e.--tisring footprint or
building height?
YES
Refer to Planning
NO
I Is the property located within the flood plain?
I Does the alteration include any additional kitchens?
Does the proposed alteration include any outside
entra:nces other than patio doors?
Refer to Plamring
rJv
rJtJ
p)tJ
Refer to Plamring
Refer to Plamring
;Jo
Is the proposed use of the finished space or
alte:-ation for anything other thlm a normal single
family home (office, group home, day care, etc.)?
Refer to Plamring
';0
THIS CHECXLlST :l<IUST BE COMPLETED AND INCLUDED IN THE Bti1LDrNG PERl'vlIT mE TO
MAlNTA.lN A RECORD OF THE REVIEW.
.
LlTE"CPLA. TE\AL TCHC<.DOC
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
5. to. 04--
I. Blue File I PERMIT NO I
2 Gold C;'y . 0 '1-" 03 "'-3
J. Yellow Applicant
(Please ~e or orint and sim at bottom)
ADDRESS
318/ W/t,O Hli/t.J6 ,o/1JJ
ZONING (office use)
,.er
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 25'. J8"Z-. iZ-3.0
OWNER
(Name)
(Phone)
(Address)
APPLICANr,) d..,/1 (). // J' /
(Name) /_11:; IflV~. IlM<A./Ut" . ~(Phone) ,~o7
(Address) ~() S- (!)ttLn--d' ill () ( )t7'>;;/;!, ~
n (ltddr;ss) , - (f/1ty)
(Contact Person) I 1/";:' ~ ~ (Phone)
APPLICANT SIGNATURE <( I ~
C/(
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Qualltity I
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
Floor Drain I Water Softner
Lavatory (Balhroom Sink) I Sland Pipe (Washing Machine)
I Laundry Tray (1 or 2 compartment sink I Sewage Ejector
I Shower Stall I Backtlow Assembly
I Sinks I Backtlow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
t </') <(2 f't
~tJS-?
(Zip Code)
DATE
/JIlA j, _ ;7 eM c/
(/
Quantity
f
Type of Fixture
I
I
FEE SCHEDULE
Industrial, Commercial & Multi-family J% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$ ~
$ ./'
./-
(J ~. I:.?fo 1 tJYdL-
PfrtO Of:,'
()1I11/
~
.50
Estimated Cost $
Building Permit #
(Office Use Only)
Building Official
rPa~
I Date5.lr. 04-
Date
24 hour notice for an inspections (952) 447-9850,' (952) 447-4245~
,.
16200 Eagle Creek Ave., S.E., Prior Lake, MN ~,;jn-J7TlI
This Application Becomes Your Building Permit When Approved
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS .3 /8/ W/l--k) f/tJrU' c: PHfJ'
NATURE OF WORK I-f)WGlL- tA3/6'l----
USE OF BUILDING 11'~ ~/C..-;
PERMIT NO. O,f. . O.s(PJ DATE ISSUED 4.30,04-
CONTRACTOR DEV/1..rHeteA~. PHONE 507. 3:JJ. 57'1B
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
OATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
\JC-
(-I1J <'
f":!;
(9j
. I
~
bur
#,p
(j'j)
~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINAL,S
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT 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.
((/)) B -t-%
I
Ii7
HAS BEEN SIGNED
FOR ALL INSPECTIONS (952) 447-9850
DATE nilE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
8-1f:>
ADDRESS
~~l
lJ~l:Q
lfa--~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
(f-)0
o FOOTING
o FOUNDATION
o FRAMING
~ULA~ t'-
~ ~!~AL r.
o SITE IN CTI N '-\.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
~FIREPLACE FINAL
J;K;ASLINE AIR TST
o
COMMENTS:
I?~
~7
r I h ('1/
C{oC;e }lA.~, LV'
/ WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORREC . CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
7 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
r
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
""NOn