HomeMy WebLinkAboutBldg Permit 05-1041
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 4..- g...,~
I PERMIT NO. OS: 104-/1
(Please type or print and si2l1 at bottom)
ADDRESS
, \f lb.LYo.,-l&J;ew L^..
G~y~
,
Nw
LOTdb BLOCK ,
LEGAL DESCRIPTION (office use only)
Date Rec' d
F il. I. White File
e. Pink City
Yellow Applicant
ZONING (office use)
pt/SfJ
ADDITION :Sc.tlv..s POJ. h'rs-J- AJJ~ h'f\~
OWNER
(Name) Bu: lJ~r
(Address)
BUILDER
(Company Name) W~(' 1\I\,o,^" Ho"'"'-~ t
(Contact Name) ~.....: 5 (l ~~-.. :J. ~ "
(Address) ~,.,.s Gu; IJ:^G. _ I g~s- PJD.."l.i'"A Dr,'ur
.r
PID,}5"-li3)-O~-O
(Phone)
(Phone) 6S-1- '-106- '-1400
(Phone) kU" ":\ t.. q - 7 q ~ 4
I Su: ~e.. c\-OO. ED-jo",-; Mu S's,;).~
TYPE OF WORK QG New Construction 2Deck o Porch ORe-Roofing
OAddition OAlteration OUtility Connection
o Misc.
CODE: B1LR.C. OLB.C.
Type of Constroction:
Occupancy Group:
Division:
A
B
I
E
III IV
H I
2 3
V
M
4
ORe-Siding JKILower Level Finish II Fireplace
A
R
5
B
S U
PROJECT COST/VALUE $ ,~O. 000. Q 0
(excluding land)
II
F
I
I hereby certify that I have furnished mformation 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
above-menl1oned properry 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
:c~:v:~ t;er'fJ~thermore, I hereby agree that the Clry official or a d;si~e;~ enter upon the property to perform nee~~n:~t:.S-
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
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
. J} J1M...o, 0 (J
$ (2.- 3 ,. S" 0
$ 7'Os" _ (.,fl
$ (" S' . 5"0
$
$
$
$
$
I bo,. () 0
100,.0 d
3~ _ ","0
~D. t!)D
This Application Becomes Your Building Pennit When Approved
~- . ~
~'-'I
BUlldmj! Olllem
1~/tJ3/o S
Dad:
Park Support Fee
SAC
/" ~
Water Meter ~Jl";
Pressure Reducer
$
$ IL/S"- DO
$ 2-50,00
$ 50,00
$ ISo{J,oa
$ lOOt:). D D
$ i.~ DO. DD
$ j
#
#
-
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
$ 8. /..3~. / f)
./
Paid k I ::J ~ .1 J'
Date /~.,;) I/. ~r
Recei)t No. .sQ3:Jr-
Brt-.
(j
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 Ciry Planner constItutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
iSSU~'- .~ /O!t7/0r,h~ ~ ~
Planning Director Date Special Co itions, if lilY I .
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 ,., II ~_ -..../J i,.-J ~
16200 Eagle Creek Avenue Prior Lake, MN 55372 ~ I -
./
Main f'lile
White - Building
Canary - Engineering
rPin~_ - Plann~
BUILDING PERMIT APPUCATIONDef,ARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1-1 jJl~{2.'}11 /t.-1(~
1.).., ...., /\ c-
-1 - J 6 -(J "..)
,
\.L./,t)'/1" ."
/'-....,.' v ij.'-'~::;
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/' /,. . . './ ..' .""
a/fir J--Lt:.?(t/ :';..I-',v0
/1//(,,/
Accepted
Accepted With Corr~ctions
~
\
Denied
Reviewed By: ~ ~
Comments: ~ a..L-( ~;. _:::tz:'). ~)
v ,
. , , '" ~_... ~-7'--
~ .A.o ~.,.,....... ~ ..J1II.........A._-~.
, Q
Date:
/d~s
liThe 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."
MAin ~ile
~hit;-:- Building:::)
Canary ;, I:rfglneerlng
Pink - Planning
NAME OF APPLICANT
BUILDING PERMIT APPLICATION D~RTMENT CHECKLIST
I-Ij~ ~
9 - c;( 3 -()--S
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
lij/tol f)cu.,/(u~d~
~
Accepted
Accepted With Corrections
Denied
Reviewed By: $n · 41. . : ~
Comments: ~ a.& ~, r Jl~
,..
Date: /lJ~?~S
.
. ~ ;. ~~
~ ~ /p~(~~,./J,
liThe 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."
t/".----- -'--II
Main File
White - Buildin9
""Genary - Enqlneerinv
Pink - Planning
NAME OF APPLICANT
BUILDING PERMIT APPLlCATION DEfARTMENT CHECKLIST
~
1./ J ....{l.A1AJ/YJ1~
9 - (;< 3-CJ5
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
11//0/ f)M/(U~~L:Jy~
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
~
Date: IO-6-oS-
Comments: 'See Reverse Side for Additional Information!
......,
See Attachments: l)~Grading Plan, 2) Erosion C;ontrol Measures
"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."
12/20/2005 TUE 16:17 FAX 952 767 1900 GENZ-RYAN
!gj 004/025
CITY OF PRIOR LAKE
HEA TING/Affi CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
(!'lease tvp_e or print and siltIl at bottom)
, ADDRESS '
.iff lfl! ?Clr KVll Vv
~~~..;. IPERMlTNO~ 1ljUJ
J. Vdlow AppliOllll ttiiiI' .., -;'
\.-11 If) f /
ZONING (olfice
use)
LEGAL DESCRIPTION (office use only)
. LOT ~ \(BLOCK \ ADDITION
PID
OWNER \ , I Pi r\,C ') ,
(Name) \)dVV \_,)rY',(LI'l(j
1-1('.' ^,-/"'If>('
\ k.l\ t L '-:;>
(phone) (P51- Q(Y5- 370Q
'lon5 (')i!'t. (), r:L ~JI:'\.""
(Address) I 0 vI f-' I t-rlCl... LAr, ';)TC vZuU
t:.Qt1 OJ\ f\v'11\/
r::- r- . 'J f"\
;J') (r~. if
....,
APPLICANT r. PI ,')
(Name) uLlil.- kJjflYI
(Address):A:xJJ W. HWvi 13 blAynsvillc
I ~dr~) _ (Oty) (Zip Code)
(Contact Person) ,.J:Q\I\ ^ ~ \( ~\Lt\0~m(ill (phone) Qf") 2~ ll{lr I~fl
APPLICANTSIGNATUR/1!:JJ QJ. _ a ATE J1J I 'jJm
V APPLICANT PLEASE COMPLETE BELOW
~BW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND ~ODEL ~--~n () 6,^ G 4- (\U +.\- ~L" R.- q n FUEL .lillJ~. h~S
FLUB SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWann Air Plants 0 Steam
o Gravity 0 Hot Water
o Mechanical 0 Radiation
'6f4ir Conditioning 0 Special Devices
DVenl System 0 Other Devices
(Phone) qp)~ -7 /.pI ~ 1000
c.-::.r rJ. ?-"-7
~,fJ:)J
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace '. $39,50
$39.50 minimum :t:ll, ~tN
$99.50 Residential, Additions & AlteratiesU/' A,'''' -.
$64.50 Residential, AC Only L..uif.Jo ~;:';;:I
Building Permit # 'l!RAfrr
$
$
$
.50
Industrial, Commercial & Multi-Family
Residential, Heating & NC (New Construction)
Residential, Healing Only (New Construction)
(Office Uie Onl)')
This Application Becomes Your Building Permit When Approved Paid
Date
Bllildinll Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
12/20/2005 TUE 16:16 FAX 952 767 1900 GENZ-RYAN
~ 003/025
CITY OF PRIOR LAKE PLUM:BING PERMIT
Date Rec'd
(Please type or olint Rud sign at bottom)
ADDRESS
J4 {tv I -PCtJJCVl~w
~ ~: ~~ I PERMIT NO. &. -ID IJ,
J. YellDw Applica.. ...::;JI 11 ,
ZONING (office use)
.,-P..lV)f j
. (phone) qr:?2-ttrf - (ODO
B~.{JtVI c.,V die., M N ~'J:~37
(City) (Zip Code)
(phone) Q5t-l(fl- 1'Xj2
DATE AJ!i.ltl)
I ,
APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
1 I Floor Drain
~i_l Lavatory (Bathroom Sink)
. I -, Laundry Tray (lor 2 compartment sink
I I Shower Stall
t I Sinks
I Bar Sink
~ ; \ R.l I Water Closet (Toilet)
Residential, New One & ~~~~ilY $99.50
Residential, Additions & """"~
BuUding Pmni' # eUILDING PERMIT
LEGAL DESCR..t.t'uON (office use only)
LOT ~t..oaLOCK I ADDITION
OWNER! I 11)1f'C' 1f1(\ " V'II 1 .L-" .'L'
(Name) JJu i') r \ in 1.' 11' I III ;(VY ~
(Address) I X-Q0 PI (A7CL Dv-. ~ ;a)
. APPLICANT fl_ 1) J
(Name) q~- ~favl
(Address) 2200 \N. J H1.'\J fA 1..3
(Ad~~) )
(Contact Person) L(1l.~ ,-_\C v) U.
\
A..PPLICANT SIGNATU
I Quantity
-1--\ I
It
FEE Sl,;l:I.J!,;UULE
Industrial, Commercial & Multi-family I % of jOb cost with a $39.50 minimum
Estimated Cost $
PLUMB~GPERNUTFEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid
Building Official
Da!'e
PID
(Pi" -0 "F: ,..., -7 ''''v''.
(phone) t,")/ iL ).- '5 (rl
(-Lt [1 rut') 1\1'\ N '75 i;)' d-
..J
J
Type of Fixture
Rough.ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
I Other
.50
Date
!fOl&?;":.---~'
!t!t~ NIP If /1 {IJ iff
~c s i 2. /'j
~~_.___ I
----~
~.<::::>
~-'
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
12/20/2005 TOE 16:16 FAX 952 767 1900 GENZ-RYAN
IaI 0021025
Lfl')" OF PRIOR LAKE
SEWER AND WATER PERMIT
Date Rec'd
(please ~e or print and sign at bottom)
ADDRESS
\4 (LP :Po.(kv~/ LrAn~ ~
~ ~. ~~ I PERMIT NO. 5- ""'1'
). Gold AppliClllI ,.. II
ZONING (o1Iice use)
LEGAL DESCRIPTION (office use only)
LolJ...tp BLOCK I ADDITION
Pill
~=e~R 11 )fYlS \'YV)J\i/I Hun lCS
(Address) I ~Q '5 PI Ot7J1.-' D (, Sic XX)
(Address)
(phone)
h'lQOJ\ rv1N
(City)
D'J6J- q(fS- :-5700;
551 ).~
(Zip Code)
. APPLICANT (l_. nit I/t r-::::;
(Name) 0l(1.~1-_-" It-1I1 {if ill . (phone) v (V71- 7 If/!- (DDl)
(Addt=) 1-2f)O W.' i-hN11 (3 BI4I€Jl/5 Vi/l-e... IV\N 7;?;37
"Address>\,\ . "(City) (Zip Code)
(ContaCt Person) -f Q ':) \. \CJ) 1,LOt' AY'\ WJ (Phone) Cl.Y) ~ -l.l ,0 ~ J f.5 2
?UCANf S1GNATU~Lotl ty}UJ. J1 Q()1 O./A ) DATE I fA! /1 ! 0,5
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from Structure feet.
Type of sewer pipe. 0 ABC 0 pvc 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
FEE SCHEDULE
Residential sewer and water line connection $35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39.50 minimum
Sewer connection only $17.50 Water connection only $17.50
Estimated Cost $
Building Pennit #
SEWER AND WATER .t'hKMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
PAID WITH
.5oeUILDING PERMIT
Building Omcial
.-m
~\tI~J,o:~\
\\ \\\ rEf; t 7 ~Q5 l".J\
24 hour notice for all inspections (952) 447.9850, fax (952) 447-424 B 'f _~'
/ Paid
Date
(Office Use Only)
I This Application Becomes Your Building Permit When Approved I
Date
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS j4./ I' I ~~ ",~ ~ME Mill"
NATURE OF WORK ~ CMI.r.II.r;.ft) (NIJ ~.c.. ~1Ut~ ."-J
USE OF BUILDING J: If:: A. _
PERMIT NO. oS: /tJ+1 DATE ISSUED _lfJ /_ ~ 10 r
CONTRACTOR ~ ~ll\Er PHONE~ff
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
Ylain File
DEPARTMENT OF
BUILDING~ND INSPECTION
..
INSPECTOR
DATE
I FOOTING 1}.I1N"l (, IY-lh
I FOUNDATION (Prior to Backfill) '1 ~ r, I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~~o... ~ Ic.c~s A\',," I
~ FINALS
4/Il r.2~
V /V/-
" /.
~b' ~~~
rvz/
UNTIL ABOVE HAS BEEN
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.
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
GRADI~G (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
"c- IP' ~~t / L
f~ ~7"''' I
/ .
I / /
rp ~S-k~
U:.: ~ -.r/t/G'/ .
. ,
-.e
~/v~
G/};~
SIGNED
FOR ALL INSPECTIONS (952) 447-9850
.,,,'Ji
1 ....-.','. ,_u
..,
; ,@trfifitaft nf @ttttpant\!
CITY OF PRIOR LAKE
~epa~Jtttenf nf ~uilbing Jlnsperfinn
Minal Permitted D Conditional C.O. Expires.
\
,
This Certificate issued pursuant to the requirements of Section 110 of the D Residential! D International
Building Code certifying that at the time of issuance thisBtrycture was in compliance with the various
ordinances of the City of Prior Lake regulating buildingCO;:;;ruction or use. For the following:
Use Classification S I IV c:; L E. r~;V/ / '- V ,..0- Bldg. Permit No. () 5. /64- I
Occupancy Type _ /<:' .3 Type Construction V Ai Zoning District PU ::0
Legal Description ---L Z &: C I., JEF;:- 6 ;..::::::,7'?c/7o l~ T
ownerof~uil' g . SiteAddress /-f-/fR/ ;/;I-)/<!KV/6tv '-iV.
Contractor's & Ad41 I? c;, I~ :;-/' IrI A./ IV /-1 ()/~/ 65
/1 L City Planner
I /' IBUilding Official
Date: (.... },..'O/I) Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/4/tJ/ (JuAlviUV' LA
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
D.JNSULA TION
..e1'"' FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
Jl"lftECH FINAL
COMMENTS:
.--- ---
DATE TIME
.(;__ ~-dZ
c;c;- -/' ~/
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/"
( / J
\ (c-10x
"-
-.........
-- )
/::](0 ')
. ~
-
-
-.......
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~'5&-LL FOR REINSPECTION BEFORE COVERING
Inspector: rl/r"' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
IMNOrl
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETY/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
BI('I~t.III*v /-",..
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
G~~- ~;(
-
L,v/b f1,f- d-(
DATE nilE
S. 2l.~
\,v (I'IJ' ntl?n
DS"/()I//
.)(~.JlIFILLlNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
W WORK SATISFACTORY, PROCEED
/ ~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InSpector:~~ Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
DATE TIME
CITY OF PRIOR LAKE ~~
INSPECTION NOTICE SCHEDULED
Rv kO,'e.4 )
ADDRESS /4/ {pI
OWNER CONTR.
PHONE NO. PERMIT NO. ~ -10 c...J I
o FOOTING ){~LUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION ~EWER HOOKUP o FIREPLACE FINAL
o FINAL PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
((~
~. (~Uf-
~IJ~
, rA
. tI
(1_ \~ -ozvt-
~WORK SATISFACTORY, PROCEED
~ORRE TION AND PROCEED
o COR CT R~'7JA R REINSPECTION BEFORE COVERING
Inspect r. /, ~,.' Owner/Contr.
C~ LX~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
'J
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY I
INSNOTl
Job Address 19/k' b.. .-.... c../.
Heating COntractor G U1 2 - /?..;",,-
,
Name of Tester 1:?
Date (, /1... zip t.
Percent O2 ! ~ I ~
Percent CO ~......
Percent C02 7. '1 %
Stack Temp 320/0
Combustion air is adequately supplied per
UMC Sec. 606 (/ t!:.5
..J----
Input