HomeMy WebLinkAboutBuilding 02-1290, Porch 02-1487
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/' HOUSE HEATING TEST RECORD
IUtI~ #/rI /frl/$ 01: APT. _FLOOR _CITY
OWNER
JOB #
6' f?8 7
/// /-;/
ADDRESS i 1/ r/
OCCUPANT
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA _ FA _HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
MAKE~b7 , /L ~~?' t../d!
Model .~~o~V
SUBURB
CONVERSION
MAKE OF BURNER
Model
Seri 0 I
be),o-6'c/
/
Max, BTU Rating
MAKE OF FURNACE ~~~
Model
INPUT
~J C~N]'OLS
THERMOSTAT ~~~~~at Plug
Valve I ( t' I'
Limit
Limit Setting
Fan Setting
Pi I at Type
Pilat Make
Pilot Model
Pilot Timing
L.W. Cut Off
;1
Vent Size 2
KIND OF LINER
Draft Hood
Filters Size
Ch imney Location
Chimney Construction
SIZE NONE
RegulaTor
Number
Inside Outside
II- 2Y{ 'L-
Pressure
Input CFH
Stack Temp.
Form 235
67
L/1....~7 ')
Per!:ent cd.
2 .....
Percent 0 /,) ria
2 C) /;1:>.
Percent CO . 'FA-?
Smoke Bomb Wiring
Draft Test Tag
Door Pressure Lighting Inst.
Date Tested 0/'- -3:/.- ~S
Company T esti ng Frederickson Healing & A/C, 3650 Kennebec Dr., Eagon, MN 55122
Name of Tester ;i;..7 0~;C;S8 .'
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
;.!I.........t/
'- / /
,--
)..- <-: d ,..., 'Ii:' .....J
F/L~
Date Rec' d
{/;-q-1J~
1. White File I PERMIT NO
2 Pink City .0 2...../2f ao
3 Yellow Applicant . . _-.:; ~
ZONING (office use)
, '-'
) . "
.n 1((,
1;2l..
/1-;--
'- .'
LEGAL DESCRIPTION (office use only)
~ ~ ~
LOT.5 BLOC~ ADDITION}-- (~,...: JV";I;. . J-.~
OWNER
i. //~) '/1~ .)
(N ame) II '" c_. '-) f ..1/..:".^"/;"" J
iYO? I
(Address) / (' 1 " ~ 11:\ 2 A
j.J; ! <:
.'i .\
2."./)
PIDc2.s-- :;"'fj 0-0:)(,,1 ~()
1-17.5 ,", (:; .r:;
(Phone) 0)-1---(/()~'" r//j{:10
/ l.. Ar' A) <~ ---,-,
L ~ " / C. 7
/'///' <",' . ,,)
'-.--". ..... '. '
/
f"V")
..../:-.{./
BUILDER !i /;/ 2" I i
(Name) (Phone)
;2,{ '02_ ~-.c-:' /'," ,,;;, -.. ~-"";-. ;2,.'']-'''' ;? <--:f ~1f'
(Contact Name) (Phone) (\.~ - '.) Y
~ . I / .
(Address) \
\
TYPE OF WORK ~ New Construction ODeck o Porch ORe. Roofing ORe-Siding
o Lower Level Finish o Fireplace OAddition o Alteration OUtility Connection
o Misc. PROJECT COST IV ALUE (excluding land) $
I hereby certifY that I have furnished 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 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
:te~~=eeded inspections ('"':). .. c: _ ? /
I.. /) /;/,:"'-''Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
City SAC and WAC
Water Tower Fee
#
#
1-/4-. tfJ.-
Park Support Fee
SAC
#
#
8Sb.~
'.100 . CO
. oj?
Water Meter Siz 5/8 ; I";
Pressure Reducer
''-''''-.
~--.
Builder's Deposit
Other
TOTAL DUE
s Your Building Permit When Approved
Date
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
tes a tenwora.:Y=erti!1cate of Zon~~mJliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~ /c1/i',?-f E-
.. .xk~ /?~ h ~
Date Special cond~ard
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
White - Building
Canary - Engineering
Pink - Planning
Thr ("enfrr flf the I.lkt Counll1"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT q-q-o~
APPLICATION RECEIVED WL4t~~ ftI~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: .
/LJ/71 ~tiZL/1t~ ~ L!T-
Accepted
Accepted With Corrections
x
Denied
Uil~
Date:
f-It(-oc
Reviewed By:
Comments:
Q~ (11)2 ~ ~ds-
"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,"
~~
Thf ('fnlN or Ihe take ('ounll1
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
;' .~
I
,/ f
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:'
//// /
Accepted
Accepted With Corrections
v
Denied
...4, {', t~
AY- ~~A
~_ 0p
~ a-Le ati~ ~~
~n-cP~ ~~~
u
Date:
Reviewed By:
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."
M~r1-UC
White - Building
Canary - Engineering
Pink - Planning
Thf Cfnlfr of Ihf ".kf ("ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OEAPPLlCANT
APPLICATION RECEIVED
q-q-cJ~
'W~;;~""Nr~J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
IL//7/ :r~~ ~ (!-j--
Accepted
'X
Accepted With Corrections
Denied
Reviewed ISY: E Date: crill) lOL
Comments: . Se Reverse Side for Additional Information!
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Erosion Control Plan
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"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."
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FlREPLACE PERMIT
Date Rec'd
~~?7
~: ~e:n ~~~. I PERMIT NO. '7 - /;;;. YC)!
3 . Yellow Apphcant . <.:7 .
~~~~tmW;-:
I / <!/ I zc::l hr/ x.
,
ZONING (affieeuse)
d~/
C/J
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(phone)
(Address)
vJ 65/d.
APPLICANT /7 , / ~ _ /
(Name) /7///~ //c.....ec/C..d///c~ (phone) &5/- tt:/'5/-277~"--
(Address) ~~ZJ /~~ke.- 0" E~/k / ~~~~ /??A
(Address) (City) J (Zip Code)625~
(ContactPerson), h/(~ ?~~~ne) ~57- L/~-d7?7
APPLICANT SIGNATURE! It. r~ DATE
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o ~chanical .
.ffi\i!- Conditioning
~t. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64,50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
_$39.50
Estimated Cost $
Building Pennit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
/.50
(25
/-
('."'l
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Building Official
Date
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
651 633 8884
FIRESIDE CQRNER
#7155 P.001/OOl
CITY OF P
IlEA TING! AIR CONDITI
. J..AKE
Date Rcc'd
~b
~w S:enrn I PERMIT NOo(}_ _ I
(Please e pt
ADDRESS
ZONlNG (ollice u'C)
1417] FOUNTAJNCOURT
LEGAL Dr~CRlPTION (office lJse only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Nf\.Jne) WENSMANNB~ES
(Address)
(Phone)
APPLICANT
(Name)--AT,J,..lliP fIRESIDE DJ3AS:.J.B.J;STDE CORNER
(Phone)
65J.=633-256 !
(Address)
2700 NORTH FAJRVJEW AVENTJE
(Addres~)
ROSEVJJ.LE
(Or:y)
(phone) _65J-633-2561
S5U3_
(Zip Code)
(ContaCT: Person)
BRENDA HUSTON
APPLICANT SIGNATURE
BREND/1 HUSTON
DATE
till] L02
xD NEW CONSTRUCTION o REPLACEMENT o AL TERA nONS
FlJRNACE MAKE AND MODEL FUEL
FLlJE SJZE RETURN OP~NrNGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants OSte:1m PLEASE NOTE:
OGravil:y o Hot W~ter Air Condirjoner Unit..;
o McchAnicllJ B Ro.dlarion Cannot Encrooch into
OAir ComjitiQning Specilll Devices Required Side Yard
OVen!. System o Ot.her DevIces Setbacks
FJREPLACE MAKE AND MODEL HEATN GLO SL-750TR
APPLICANT PLEASE COMPLETE BELOW
Industrilll, Commerci3! & Multi.Family
FEE SCHEDlJJ..E
I % of job cosl Resldenrial, Ga~ FiT~placc
$39.50 minimum
$99.50 Residenr.ioJ, Additions & Allcra1jons
$64.50 ResidentIal, AC Only
$39.50
Residential, He3ring & NC (New Consfruclion)
Residenti.3l, HC3ring Only (New ConSf.rUcl.ion)
$39.50
$39.50
Ef.timatcd Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
@yj.../Plkt/lh)
glj .~~
~. U/!.J[J;ffifVr;;,
-. . 'I'c';J
(omr.c lJ~e Only)
- don Become/.l YOllr lJullrling Permit When Approved
~ II'.
.! B.lJ.lll2E..BJlJ~1 ,.. Dote _ () - I By
nlllldi"1l1m'i~irvirJw Avonue North, RosevillE:J,nf81N 55113-0847 ho A (fl51) 63.J::2IiS.L.I":.aX-(.65:JJ.633:.88&1
~ll West Highway 13. Bumsville. MN 55337 Phone (952) 890-0758 Fax (952) 890-5408
24 hnur notice fM *'1 in~pccllflns (952) 447-9856, fl1~ (952) 447-4245
MN CONTRACTOR UCE/,/SE #20090911
Paid
Receip[ No.
FILE ~).303 02/14 '03 10:54 ID:PLYMOUTH PLUMBING
F A>~ : 76:35.3:31121
PAGE 12./ 47
~E. . f,,"f
YfU.OW . ""PlIC".T
GOlD. CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
S.w. No. ;<~ );}q 0
Sewer and Water
contractors must
be registered
with the City.
A PPLI CANT: {l ~ (, ll't\r\ P \ <.J. iIV\ ;~ PHONE :(7lJo'))S:J2:> -" L1 :'57
(1-.DDRESS:JY,l_ _ fOlW\t-a\v'\ __\\"'-, C::'\.-. DATE: rl--\L\-O~
\8 IGN A TU..c:).JLQ()(' lJv'N.~1')\.uQ.Q1II. BLDG" PERMIT #
SITE ADDRES~: PID#
FILL IN THE BLANKS
1. Estimated length of water service
,
~\()
feet.
2. Size of water service
\ \ \
inch(es) .
J. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS pVC Y Cast Iron
5. Estimated length of sewer line t-10
feet.
6. Clean out (if required) I located at
structure.
feet
from
===;===;=======:====:~~=~==~~========~=====~=~=~======~===;:;=~===
This application becomes your permit when approved.
BY
DATE:
~~~==~;====;==:=========================;===============~==~======
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection pe~mit.
Surcharge
'fOT AL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
*
RECEIPT #
REC'D BY
16200 Eagle Creek Av. S,E., Prior sora 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal OppOnUfilty Employer
FILE No.938 12/18 '02 10:56
ID:PLYMOUTH PLUMBING
FAX:7635331121
PAGE 2/ 7
---
~~~
~.....~I N III i. $ 0 ~_~...... .'
---
D...tc RCl:'d
CITY OF PRIOR LAKE PLUMBING PERMIT
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APPLICANT PLEASE: COMPLETE BELOW
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R~SILic:nlilll. N~w Unl: .I:: TWll-F:UTlily };4l) 511
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Fsrimnred Cost 5i.t..i:]"'6c:) .t::f[J
8\1 i1ding Peml il Ii .
Pl.llMBtNG PERMIT FEE
ST.:" TE SURC!-LA.RCE
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TOTAl- PERMIT FEE
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
OUf'J ~:!"~ \ '-J
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White File
Pink City
Yellow Applicant
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02--/403
I PERMIT N OrC' 2...- I "t.- er 0 I
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(~O:~~::use)
LEGAL DESCRIPTION (office use only)
LOT .5 BLOCK.2 ADDITION~; JU V -;-1..... I I',J
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hdlS
210;)
PID .;:....-;-'-- ") ,/<:'J :):7'(" ()
OWNER
(Name) W(.-:C/J";-,t',^^.~ ..)
(Phone) f.;><:1-'16~"///"-",)
(Address) /'01 <.:-
P't t-? L'
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BUILDER
(Name)
~
__~ MMt';~
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
orch
o New Construction
o Misc.
o Lower Level Finish
PROJECT COST IV ALUE (excluding land) $
o Fireplace
OAddition
OAlteration
OUtility Connection
ODeck
ORe-Roofing
ORe-Siding
I hereby certify that I have furnished 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 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
enter upon the property to perform needed inspections.
~ -;-;:r
( / Signature
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
~~
Building Official
1(/, z..k z.--
( D~te
/ (/ \-2
Contractor's License No.
If ,- -< (
'- ~ ~J
Date
,. -" ;
- ;.-" .'---
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ /('Z~4{p
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
~ -1d~
Planning Director
) / (/'Z~ tl.---
ate 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
V\I\A-(N R~ -
PRIOR LAKE DEPARTMENT OF LE
BUILDING AND INSPECTION f6YC.e.kt-ES
, ---...
, \
INSPECTION ~E~ORD 01~
SITE ADDRESS ~I ~Ll NTl'\r,....:J titLCS" C:{--t '-.=~-=
NATURE OF WORK ~ a.J ~ te.e.H
USE OF BUILDING
PERMIT NO. ()z- L 4~7 DATE ISSUED ~7...lo'"
CONTRACTOR WD-b/II\ANN M-o~<=S' PHO E ~5( - 4{)fo - 4'1G:J
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING ~p I Lhltf:> {tfJ
1;Vv{J I {to! 1-603
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
fZ/J 0 /02-
l/~ tY3
t2-/'3 D 2-
12-/JojD2-
II 3
lfAv /J t 2-/18 fo3
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
2 tojD"-
HEATING 'Z ~ tft3
DO NOT OCCUpy 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
PRIOR LAKE
INSPECTION RECORD
Q",
t\&tV\ ~'l-e
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~JlAto.\\t\. 8.Jls
NATURE OF WORK tJ~
USE OF BUILDING <SEA
PERMIT NO. ~- / z ~ DATE ISSUED "(- ''I -Dc
CONTRACTOR tu ~w:, PHONE QS') -;}..s3- TJ!f bf
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING ,;tv( I b'-f}-cf1~
FOUNDATION (Prior to Backfill) D.~ J..) --oJ-.
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
J)...- }D
tJ I ~JQ'3
ll.-- 30
1),,- )D
1" 1CV3
/l..... ') D
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
GRADING (Prior to Sodding)
BUILDING W
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
FINALS ~i~~)
(; .' &~ .())
UNTIL ABOVE HAS
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850