HomeMy WebLinkAboutBldg Permit 05-0191
\..11 oj OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERu.llICATE OF ZONING COMPLIANCE.
AND UTILITY CONNE'--l ION PERMIT
Date Rec' d
I. Whit. File I PERMIT NO '
2. Pink City . ()5.- /q /
) Yellow AppIiclI..
(Please tne or JRiDt and si... at bottom)
A......'.....aESS
~5S9 r-\ ~ yY\ rD ~ "J bl( d Tr \
LEGAL DESCRu: uON (office use only)
LOT 1. BLOCK 1.. ADDmON KNo"B H.i Ll ~~
NE
)r\O( ldVf' .
ZONING (oma, 1IIe)
~I
.
PID Ol.~- '3"l-q - OO~-O
~=~ud\<"\t a:rcl Su1-<1n~S-htA\t2 (phone) qS~-'~--o\3D
'i~ddress) ~me- a.~ <).. 'bD'<~
"'" "".'\- .~
BUILbER ~ -i"'.~ C C Pfe' l.9XO:i-~uJJ~"'. Cl 1;:
(Company Name~ n LV K\t c :'\0:h\ l \1"2.. m\ LAm (phone) ~~ -;.:).;, ;- I~
(Contact Name) LA 'rO.l( ~ (phone) Cha-. -~'2:>~-O\ ~D
(Address) c....o.... VY\~
....
TYPE OF WORK 0 New Construction ODeck OPorch ORe.Roofing ORe-Sidina I!:(Lower Level Fimsh 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc. ~ ''Bcd-h ~ 2 & d yeo M.~
PR.OJECT COST IV ALUE s.::1.1 So 0
(excluding lancl) ,
CODE: ~.R..C. OI.B.C.
Type of &stn.mon: I
Occupancy Group: A B E
Division:
n
F
1
m IV V A B
HI MR.SU
2 3 4 5
I hereby certify that I have furnished information on this application whidl is to the best of my knowJedac true and ..,..... I also certify that I am the owner Ilr authorized lIlICnt for the .
above.mentloned r"r ...; and that aU ~~..~....aion will..,,'!, "" to aU e:xistilJl state and local laws and will r' ....j in actardanc:c: with submitted plans. 1 am aware: that the building
offICial can revoke: this permit for just calise:. Furthmnore. I hereby agree that the: city ofticia.l or a designee may enter upon the r', ..,.,,' 10 perform needed mspcc:tions.
X ~N O. 0 (' ]....0. Or.P ....ID%5~() ~\=..Q5
~ ~~~ Contractor's License No. )ate
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
~ Plumbing Permit Fee(1"ItJt-r
'J Mechanical Permit Fee
Sewer &. Water Permit Fee
Gas Fireplace Permit Fee luo
'I"
Jj 8000 t () C
S 74,75
s
s
S
$
S
S
S
. Park Support Fee
SAC
Water Meter Size 5/8"; I";
I Pressure Reducer
I SewerlWater Connection Fee
Water Tower Fee
Builder's Deposit
Other ()/.I }Jtl(' /"
TOTAL DUE
/,50
4"0,,-
This Application B .. " .' ,,' .5 Your Builelq Permit When A 1 .1 . . . eel
~ Mf- 3/2//05
Buildinll Officiai Date .
I Paid
I Date
//r;, (I- C; -'
~ -,~ 1- () ~
#- . $
#- S
S
S
#- $
## S
$
S l- OD
s 1/'7 'c}O
I Rece, iPt No. yl 9u1 b
Bv /'
r
nlls is to certify that thr reque:st in the above application and a.........anyin. documents is in ac:cordance with the City Zonin. Ordinance and may r.'....J as reqUl.'Sted. This document
when sianed by the City Planner c:onslitutcsa. ....r _....ry Certilic:ate: of ZoninB compliance and aUows c:onstruc:tion to co" , .,.:. Bc:rore occupancy, a CL'l'IiflCate or Oc:c:upancy must be
issued
Planning D:., . ...
Date Special Conditions. if lIIIY
24 hour notier for Illlnspectlons (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
ApI'" 20 OS OS:SSa
Bl"'adle::t Schultz
SS2-233-0130
p.2
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue file I PERMIT NO. ,-6- ~/1~
2 Gold Cily
J Yellow Appli~t
(Ple:ase: type or print and siRn at bottom)
ADDRESS H ...<: 'l N <:;- ZONING (office use)
'-t S"~:{i l.. m fY) ~ t. ~ b, f'r:{ - Il:d, . ~
LEGAL DESCRIPTION (office: use: only)
LaTa BLOCKO> ADDITION Kf\ob. H; It
--:<-..R~
IV
PID ;;;'$., 'y.f9'CC'8'o
OWNEB.-.,
(Name) -DrdrHel..1 f":
(Address) ~J\ h,e A. ~
c" I (
-:'1' f) l-\ ( t"'-t::..
(Phone) f81-=:;'~'2, 3;\- 0130
-'
I\~)-J e
APPLICANT ,...., I <"" ,,- VI. ,.
(Name) J.L..AfL; __ ~/1, )C'~' i 1.,~j,1bli/{j (Phone)
Ji..~O,/ ::/<'" 1-1 d " #'1 I /
(Address) Llv-J 7 ~.J,.J I ,r i-' t- I7dl/l- ,[/;.1,1,
(Address) (o(ty)
(Contact Person) j)J!/i,' c 5::II''''2:t/../ r (Phone)
/a:.:.r..t ..; ..4.._-e.----..._
.. /'.
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or witbout shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
I Bar Sink
I Water Closet (Toilet)
APPLICANT SIGNATURE
lei Z '--'5''(i7 - 19 74
~) .>53 ~]7
(Zip Code)
t:)2 --50 y -Y~'7"/
7:' Y'-(?-5""
DATE
Quantity
Type of Fixture
I
I
I
I
Rough-ins
Water Heater
Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
Lawn Sprinkler
Other
I
:e
I
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-family $99.50
Residential. Additions & Alterations $39.50
Estimated Cost $
Building Permit #
".' . .
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
5 PAID WITH
. CSUILO/NG P~RM/T
(om~t Us~ Only)
This Application Becomes Your Building Permit When Approved I, ",\I~i~ fI:] ['III
II ' : F' I?
; I ! ! c,'l I..
.,,~ Date
Buildinll OrticiHl Datt I \1 \ -AP~ i-tt 200~
14 hour notice ror all inspections (951) J~-~50, fu (951) 447-4245
16200 Eagle Cn'ekAve., S.E., Prior \.,ake, MN 55371-1714
,.._\1
...j f --------.--.~-
BY:
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
---
ii/((~/c1' d ~ dt15
Date:
~~
Building Permit #
Site Address
Pill: Zoning: ,-
L/3SY #~~d ire
Subdivision:
Legal: L B
E.:risting Structure: "'YES or NO
CONFORlvIS TO ZONING
ORDlliA1'{CE
YES
NO
I
I
Is this an expansion of the existing footprint or
building height?
Is the property located within the flood plain?
YES NO
Refer to Planning
No
Refer to Planning jJO
Refer to Planning
tJ(J
Refer to Planning
tJ{J
Refer to Planning
IJtJ
Does the alteration include any additional kitchens?
Does the proposed alteration include any outside
entrances other than patio doors?
Is the proposed use of the finished space or
alteration for anything other than a normal single
family home (office, group home, day care, e!c.)?
THIS CHECKLIST MUST BE COMPLETED .-\i.'fD INCLUDED IN THE BtrILDING PERJ.'YIIT FIl.E TO
MAINT,UN A RECORD OF THE REVIEW,
T .\TI'~rPT ~ TF\ALTG-lGZ.DOC
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS J/S~9 ' TUiL ~.6.
NATURE OF WORK ,"I1JDt- J 4-118L #i~, ~ If
USE OF BUILDING $":':: (J.
PERMIT NO. ~::;; DATE ISSUED sit. iM
CONTRACTOR _ ~Ul"rz.,. PHONE~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS Bf SEPARATE DOCUMENT
INSPECTOR
DEPARTMENT OF
8U1LDING AND INSPECTION
DATE
I
I J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING V~ t.I r Lt-1Jf
INSULATION J
/.~
ELECTRICAL I
PLUMBING N/ 1/11
HEATING if r 1/L1// (j
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
~ 7
/
/
OCCUpy UNTIL I ABO~AS BEEN SIGNED
NOTICE.
This card must be posted near an electrical .senilce 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.
8-/J-c9J
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 4b~ . '7
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
"
J:
U~/l
-+l~j~
I
DATE TIME
SCHEDULED t3 .I{-o-l
g,~ IY-
I.f.UfN-... /
CONTI.
PERMIT NO.
S -lif!
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 GASLINE AIR TST
o
()' ((\ r-t' .
l_ _~~-\{ w
...[] WORK SATISFACTORY. PROCEED
X CORRECT A ION AND PROCEED
o CORREC WO ALL FOR REINSPECTION BEFORE COVERING
Inspector: , /] Owner/Contr:
CALL 7- 8 0 FOR J..E NEXTlNSPECTION .. HOURS IN ADVANCE.
CODE REQ VREMJTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~ INSNOTI