HomeMy WebLinkAboutBldg Permit 05-0398
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
.---
L/; ds-65
See ~ain Filei~e ~:~y I PERMIT NO. as-. o--:>ql),
3 YeHow Applicant :..:> I l/
(Please tyve or print and siltll at bottom)
. ADDRESS ZONING (office use)
,,25r7
tJqTl'r F, 1/
tJ~y
/
LEGAL DESCRIPTION (office use only)
-
LOT <1 BLOCK J ADDITION
,
OWNER
(Name)
(Address)
/Vw
WeNfH19/V/v
~rL.
(Phone)
B~D~ JI
(Company Name)Wf?Nf /119 /V /V N ,m 1'..1"
(Contact Name) Gar y
(Address) /P' 5' 1'1er :z..~ J.) r f' ~ q k
PID..,15""- 'Y/i'- I;J.I.-o
(Phone) C,.5? - ~(J~ - "frOb
(Phone) 6/~ -J~?- 7~/~
/J1A.1. ,/}'SJ;).. ~
TYPE OF WORK ~ Construction ODeck o Porch ORe-Roofing ORe-Siding
OAddition OAlteration OUtility Connection 0 Misc.
CODE: ~.R.C. DI.B.C.
Type of c:t';nstruction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV
H I
2 3
V
M
4
OLower Level Finish
o Fireplace
/ tnJ
PROJECT COST/VALUE $ J~ O()O
(excluding land) "'
A
R
5
B
S U
I hereby certify that I have furnished information on t/lis 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-menuoned property and that aU construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
:cia~ iJ; ;:;ermit f07~ hereby agree that the city official or a .~y;:;ter upon the property to perform nec~:;;n~ oS
/ // ~gnature Contractor's License No. Date
V
Permit Valuation
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
-
f/38: OtPO,OO
$ / Z:P'/. So
$ !:32.., &J-?
$ f.oq.OO
$
$
$
$
$
lOt!) , t!J 0
lOt), 00
.35. S(j
~, 00
This Application Becomes Your Building Permit When Approved
~~
Building Otlicial
5/S-~S
, Dale
I Park Support Fee
I SAC
I Water Meter CiZ;5/jj) I";
I Pressure Reducer-
I Sewer/Water Connection Fee
I WaterTowerFee
I Builder's Deposit
I Other
I TOTAL DUE
/
~7er: qr
I., ..J-() ,.8 ~
Paid
Date
#
#
#
#
Receipt Nt>.
By /1...
/
$
$ /qS'(},OO
$ Z~O, 0 ()
$ S"a, 00
$ !SaO,DD
$ IOc:J 0, &lJ
$
$
$
/
,."
&. 7(Jfj.1~
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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 requcstcd. This document
~~,ro9~c~"~"':;;;~;""'~~"S'eme~Maiii1~i~e--'~
Planning Director / ~ 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
See Main File
White - Building
Canary - I;nClineering
<('"'Ylnk - Planning)
NAME OF APPLICANT
BUILDING PERMIT APPI.ICATION DEPARTMENT CHE.CKLlST
-j l/l\_"-'
F::ju j1/lk'-<:J
1/ );l__/)"l--'~--11d /1/i1/11....-
f
11- d~-<-:' ~
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
o 5 8 ~ II /a/;1/fPJ?P /Ltul
/ Accepted Wrth Corrections C /
Accepted
" Denied
Reviewed By:
~9-~
Date:
6h-~S-
.
Comments:
~
i-I
~
. ,
.,f
-J
.,f
'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."
See Main File
(White - Building')
Canary - t.rig1neerlng
Pink - Planning
BUILDING PERMIT APPUCATION DEPARTMeNT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t(~~
1-/ - d-S--~ ..
~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
0s8~
,
/
Accepted
Accepted With Corrections
Denied
Reviewed By:
~~
Date:
S/s-/O~
.
Comments:
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. II
See Main File
White _- 8uildin~
('1;;anarv - Engineer.
Pink - Planning
BUIUlING PERMIT APPI.,.ICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/ I }j /\1 .. A ,." .4,( /.~ AA /1/1 .
(.,.1 ./ P>'.Y v'Y-'" Vi' . . ..../"T I- f _
,
1-1- :d-S- -~ '
\( ,/ h'l'-, ""
.1:: '....,' ... , ,/1"..(Z --J
i ", ~ ,-,. ......... ,,,~
. ....,.,(,.,...." ".... .'.....
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
a ~ 8' /) / /,V~-~)-~--' /..'~YJ /? [7
} ---- , , A j f;e. ~f #.t1 / 'f-rJ /~
/ - ,/ :/'
t ,,/'
/(au/
/
i'
Accepted
Denied
X",
''0"
Accepted With Corrections
Reviewed By:
Comments:
/rIllS
S.CC 1l1~/..^ hie-
Date: 5-a5'~
"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,"
07/01/2005 FRI 13:23 FAX 952 767 1900 GENZ-RYAN
~ 011/025
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
(please tv.Pe or llrint and siJm at boltDm)
ADDRESS
I) r .U\ f'>
(?\()xlf l WeV'JCl.tl LlX1.y t\lcO
I. 0.- File "-1t.ATT Nn.~
1, Yelloll' City r .I!..l.'U1'.l.l '"
), Gold Appll_
ZONING (o/llce 1ISe)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDmON
PID
&=~ II )fJfI~ \"{V)nrl \-tDiYI[S
(Address) I ~Q 5 PI OCZGl.l D V < S-tc d-CO
(Add:ess)
(phone) iPP)J- QCf5- -:'nCfj
tDJJOll ~v}N 551),')
(City) (Zip Code)
I APPLICANT {~ rl J I
(Name) ~(1I11,- 1011 a (11
(Address) 1-1J)O \N.' J-hi\!li 13
/ (Addre~) , y .
,/,- ""'-)f II
(Contact Person) -K I fAt) "<.1 ,If, VI [f/
17LICANT SIGNATURE (f.rx/Y'~.-, R/11&.iJJlf
(phone) Ij J/)2 - 7 IPI- (ODD
B1A Jfjll S V;' f r-e" fV\N C:-;?;3 7_
(City) (Zip Code)
IV-)-, ~/::7 f I YI""
(phone) L1.... ,-}., - I (t' I - ( .Au .J
DATE U!2f)/O:S
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 Permit #
SEWER AND WATER PERIvllT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
S
$
$
.50
PAID WITH
BUILDING PERMIT
(Office Use Only)
I This Application Becomes Your Building Permit When Approved - ~ r ~p~ IE 0 ill I~~
- BuildlDg Official Date. .Jm: 0 6 2005
By
Receipt No.
14 hour notice for all inspections (952) , 47-9850, fax (952) 447-4245
By
07/01/2005 FRI 13:23 FAX 952 767 1900 GENZ-RYAN
l4J 012/025
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please tvEe or priDt and sign at bot:IDm)
ADDRESS
'1 r::: ell
/7\ ') /)
LA)Q,--\-cvtClLI LUCey N Cd
~~: ~~ I PERMIT N05. .:sf8
' YoIJow "ppli....' ,
. ZONING (office use)
LEGAL DESCRIPTION (office we only)
LOT BLOCK
ADDmON
PID
~=R I.UfJrf)VYlr1Yi'\ ~iT)(\f)es
(Address) \ ~qf) PlOt7.>>.. Dv. );~-t :;tn
. ~~~fANT ~.el1?- - lUj CH1
(Address) 21./)0 W. l-tv fA /..3
(Address) )
(Contact Person) ..<1 V)\ 1=2((, VI (I c
j/J '~'.'. ' K() Q j/J. I '-t .'/: ;}...
APPLICANT SIGNATURE i(V>>'J( / t j. /[/l)C.Vl
(phone) f [f)i-(;Y')'5'~ ?i7tA
f-D 01 ({ Yl pVIN ry5fJ.~
J
(phone) Or.r?7-- ,{ff1 , (ODO
~(AJ2J1c,l!d If..' M N 'SS337
(City) (Zip Code)
IJC~'\ "If;-7 I.! I '.
(phone) {)d,'-! If} / -. I Q .J
/ /')/'2..0' 1/1S-
DATE V/ ..) IV
APPLICANT PLEASE COMPLETE BELOW
I Quantity Type of Fixture
I c) Bath Tub with or without shower
I I I Dishwasher
I \ I Floor Drain
I L.II Lavatory (Bathroom Sink)
I ! I Laundry Tray (lor 2 compartment sink
I i Shower Stall
I \ Sinks
I Bar Sink
./~ I Water Closet (Toilet)
Quantity
:')
I
i<-..i f
'{
Type of Fixture
Rough-ins
I Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I BackfJow Assembly Test
I Lawn Sprinkler
I Other
~J!jJ!,; Sl.:.I:1.EDULE
Industrial, Commercial & Multi.family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $ .50 PAID WITH
TOTAL PERMIT FEE $ ~
(Office Use Only) .:\ ic:-.Ic:\ ,_., n \...7 .-., 1".- G PERMIT
n J I L I r::: ~ I :, I r; I ' \
This Application Becomes Your Building Permit When Approved U< P"aid~ I' .1 u ,_c] 111 Receipt No.
I,
l- -N1ll:-O e f06j (; 'i By
Date --'1.
24 hour notice for all inspections (952) .M. fu.f?~14.7:1!~ :;...:.::-...
Building Official
07/01/2005 FRI 13:23 FAX 952 767 1900 GENZ-RYAN
~ 013/025
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/~l..KEPLACE PERMIT
Date Rec'd
I. Pink
2 0.....
3. YoIlo...
~!~ I PERMIT NO.~ trClla
Appli_ ."" .~
ZONING (office
lift)
(Please ty:Pe or "tint and siltll at bottom)
ADDRESS
?!5~ r; LV OJf({rtL t
u )QJ}j t'~Ll)
I
I LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
OWNER I \ \ /;v,c i f\ ,'I /"\
(Name) \.i' J'\.i ,_:X'\ II) Xll I
\-\()'n~
(Phone) (Y51- Q00.. 3700,
(Address) \ gqrs (J! aIel- Dv, Sic ?DO
E-cltA eUl I\A f\{
.~
55/ ,jJ.
APPLICANT r 1'\
(Name) GrCryl.- l.cJAflYI
.)
(Address)~dil) l)J. t.+Wv} 13 BU.ynsvillc ~J3':)7
(Contact "-'n) K 1/11 \ pM) J~ (PMne~a~7&1- rely""d')
,J,.(1.11l' '1 J.ol/ll4'/J /J1j (.'1/21 /I\~
APPLICANTSIGNATURE{~Oi\.I . --"\ r./LJ,tJu~ (it' DATE j). J ) 10-
- APPLICANT PLEASE COMPLETE BELOW
. ~w COl"STRUCTION D REPLACEMENT D ALTERATIONS
FURNACEMAKEAN'oMODEL -.D'ln(),( (:rL!OU.w -::j d?:rcl{; FUEL ty{-f- (;,(lS
FLUE SIZE RETURN OPENINGS. r; INPUT fJt(XXJ) OUTPUT '7'iiLU
TYPE OF SYSTEM HEATING OR POWER PLANT
&ann Air Plants 0 Steam
DGravity 0 Hot Water
GMechanical 0 Radiation
t3Air Conditioning 0 Special Devices
DVent. System 0 Other Devices
(phone) q~~ -( if7 - 1000
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial &. Multi-Family 1% of job cost Residential, Gas Fireplace
S39.50 minimum
Residentia~ Heating &. AlC (New Construction) S99.50 Residential, Additions &. Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
$39.50
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50 PAID WITH
BUILDING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When APprov.)' a; , ~drF r~1 I Receipt No.
Buildine Official Date ~ .Il~:te (~ 6 lOn5 i!, '11 By
24 hour notice for all inspections (95: ~.... 7-9850, fax (951) 447-4245
8v .___. ._. .
PRIOR LAKE DEPARTMEN!OF See Main Filt
BUILDING A'ND INSPECTION
....
i
INSPECTION RECORD
SITE ADDRESS ZS87 WAT'EllW-AC.c. WAY N,W.
NATURE OF WORK ~ c.a ~ST I!U;(r'-o') (pJ I L.~. RJJl.,N).
USE OF BUILDING S,P:: A. ~
PERMIT NO. (j5, 0.398 DATE ISSUED 6/-rAtJr
CONTRACTOR WDJ'IMAJ,J "'.",es p~"'.:I"-7I./~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR JJATE ,
FOOTING ~ I 6/ul'ar
FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC / I
FRAMING (i'l) J 1/z]J('6
INSULATION {If; ! ~ j J 106"
ELECTRICAL II;', ·
PLUMBING 'O.~ P.P S -_2 :s I :v,,-W 10" t.-s -d::J'
HEATING (if required) l:IV/ /) /a3
FIREPLACE ' I
GAS LINE AIR TEST C#5 'I I,~ /~
, ,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~USe-t"II2A" I I
~ '" t1t t:.."..~ FIN A L S
GRADING (Prior to Sodding) --:k..
BUILDING Vu
ELECTRleAL
PLUMBING
HEATING
DO NOT OCCUpy
.
llj !dld,
I ·
~ (;'/'<9/~ J
,I @JJ , 7/fr; 1#+
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 shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
, ~...,""~, ,'';:'t~' ...~.;:.,.....': '1'';Jj,[~'"'' ..i ~',,~~ ;"1\;',','~(';1:g<1;\'!.':::)'-, ,/',<;;:_~L"",-"..:..i:~")<;"'-~':':l 1,;;';':li;';.t""~..i.lI,...:..-..-.~,:.:..,, ,;."'. j, ...- "~, .', II --"',".1",,'"
'''''''"' ,
iiliii
~1itIIt.
..
DATE TillE
CITY OF PRIOR LAKE 1 J '~f)r.
INSPECTION NOTICE SCHEDULED
ADDRESS ~ T? ~er{~ tU"'i
OWNER CONTR.
PHONE NO. PERMIT NO. S--)~
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~~TION o SEWER HOOKUP o FIREPLACE FINAL
~UMBING FINAL o GASLINE AIR TST
o SITE INSPECTION ECH FINAL 0
COMMENTS:
('\
(.? k +- c\o<;A. ~ -t A ()
Inspecto !) J' / Owner/Contr:
CA ~L J7~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH cl SAFETYI
lNSNOrl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 25!j?
LJ~.reJ20
OWNER
CONTR.
PHONE NO.
PERMIT NO.
[J FOOTING
o FOUNDATION
[J FRAMING
[J INSULATION
[J FINAL
[J SITE INSPECTION
[J PLUMBING RI
o MECH RI
[J WATER HOOKUP
P ~SEWER HOOKUP
~UMBING FINAL
[J MECH FINAL
COMMENTS:
,. ~_.J4~ u. ~
~. . -7 r"c;J-_-
f18f
TIME
4" - ~r~
[J EXIGRADIFILLlNG
[J COMPLAINT
[J FIREPLACE RI
[J FIREPLACE FINAL
[J GASLINE AIR TST
[J
[J WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
[J CORRECT LL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
Job Address 25 CJ 7 v41v1.1t' d.
Heating Contractor ~-AI'_
Name of Tester ~
Date -i/, fl. "
Percent O2 _7. f~
Percent co ~_
Percent C02. 7. 2. %.
Stack Temp 33' 'io
Combustion air is adequately SUpplied per
UMC Sec. 606 -r ~ f"
Input <::;-