HomeMy WebLinkAboutBuilding Permit 99-0330
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DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ell3oJCJ1 2.: 00
3t/25 6LVNW~/bJe. 7ie...
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq~330
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION e
FINAL ELO 4-
~ SITE INSPECt
COMMENTS: \.
(~u5-f2-
1 . SOt":> ~
~. ~N0
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP /l 0 FIREPLACE FINAL
12J- PLUMBING~ FL r~ 0 GASLINE AIR TST
~MECH FINAL A r\D .
IN~ ,^,,-'P \J~\V\p ~ S~
\ (1.<-~>
S(eo,J t)~
o WORK SATISFAC:~TY' PROCEED
'9S0RRECT ACTIC N D PROCEED
o CORRECT tiC)~.". . C L~ FOR REINSPECTION BEFORE COVERING
Inspector: ~ ~. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
il'AND UTILITY CONNECTION PERMIT
DATE RECEIVED
_'I.
~
, .
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS l-'i J 1
3y.l,f; /~ ~
3. LEGAL DESCRIPTION V
LOT / .s- BLOCK
ADDITION ".I'fk~~
4. OWNER ~)
~NIV
q'f-32-~ MItUJ Ft~
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq- 330
1. DATE
Af-/;J.-? 'j
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
I Sf
.y PID A5- JJ-.;;l- 0.31-0
~
13. TYPE OF CONSTRUCTION
(Address)
5. ARCHITECT
(Name)
(Address)
6. BUILDER (Name)
k.J~
}.J~
(Ajd~es:}.L.
18',$ I' ~r f>...-
&~ ~ S5J.2~
V Septic 0 Deck 0
Addition 0 Finish Attic 0
7. TYPE OF WORK Fireplace 0
New ConstructiontJ....-"'" Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Tel. No.)
(,5/- .yU" ~~(J ()
Side
USE OF BUILDING
flffi
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
;).;J,5 600 en
17. COMPLI!fION DATE
10. CULVERT SIZE
Yes No
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 ~icial can revoke ~ permj)Jor justiJfuse. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X AJt:ZNY ~ Y ~ J'7.7~/:J /Yr~ ?-}2-"
, ~nature License No. Date
TYPE OF CONSTRUCTION: I II III IV{ V
Occupancy Group A B E F'::{l I ~ S U
Division 1 2 (J) 4
Permit Fee ................................... $ I, S \ 2 . '2. ~
'182.Q7
I l '2 . ~0
Plan Check Fee ............................. $
State Surcharge......................... .... $
Penalty ....................................... $
I (? 0 00
lo(J . C/O
sS ,t:::;(J
GaS~ir ~acep it ...~.... .............. $ 40.00
This i ti , mes . ding permi?h7 t:proved.
By "J Date.... ~
~ . ,
Certificate of Occupan
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Issued
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Side
SOIL TESTS
o
o ENERGY DATA
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
~as::ctXl. CJ Cl
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee ........................... $ 8~('J LOCf'
SAC ......................................... $-J--cD SO .~
Collective Street Fee ....................... $
Sewer Tap ................................... $
~~ t. $
Pressure Reducer ...:'/l'J.................... $
Meter Horn ....;;..."........................ $
Water Meter ..j~t......................... $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
LIs .DQ
l ~ 6 .on
I . aOo .ao
"l? Ar) .C)Q
Builder's Deposit ............................ $
Other ......................................... $ I. vs. '<. '1 '2--
Total Due .............................. $ WO' J q...
Paid 'i t)3. 'Z..- '- Receipt No. :J,y, I ""L
Date 4-/3~/ II tj By UJ-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordilance aJd may proceed I requested. This document when
s~~ltn r constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
- .. L.{~,q~99
City Planner Date Special Conditions ~ any
Front
Back
BUILDING DEPARTMENT VALUATION
City:
~~~~
A' v0 1k
./~
24 hour notice for all inspections 447-9850
" ---~- - .-----
'"
Date
JobAdd.... 01J~I1u/~
teating Contracto~I'A.I' /1 ~" .
ame of Tester ;?, / .
~-.;!.y.44
7
c
,.
Percent O2
Percent CO
Percent C02
Stack Temp.
~
1;'5
Combustion air is adequately supplied per
UMC Sec. 606
Input
,
~
"',"",,' "''''''',-=''
I, ~",~~_ ~ ...., I' '" " II',""""
.-
,
- ,
White - Building
Canary - Engineering
Pink - Planning
lhr Crnlr. 01 thr Lokr Country
,BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT,
APPLICATION RECEIVED.
t\f',i f"\\(~
,/
i
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
v
Accepted With Corrections
Denied
~ . ^ -
Reviewed By: ~ 1!?'AAA../AA.-.
Comments:
Date:
L/ - {q ~Cf1
;'1;:
"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."
QQ-330
The Cf'nfer of the Lake Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
W~NSHAN HOM E:S
4-/13/qq
. I I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
/-
Accepted With Corrections
Denied ()
Reviewed By: ((u.. -e Il
Comments:
Date:
4-( q --7-1
"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."
1q..330
Tho C..t., .f lit. uk. CO..II')'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPYkATlON DEf.ARTMENT CHJ;CKLlSI
NAME OF APPLICANT
APPLICATION RECEIVED
\\E.I\l'::rIAN Helvl ~S
4/1":5/CfCJ
, i '
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
342:5 (;Lt,JI\JWttT€1t TR..
Accepted
/
Accepted' With Corrections
Denied
Reviewed By: jJ~I-T6R. E....R.EslIC.fIlNN
Date: 4'%.2./<;9
i
Comments: $EL gvIL.O''''~ PEQ.r4Ill, #- 9'1- 3Z.<j- (34/2.1 ~L~.AJW1Jra TiiJ
1
ron.. CO"\.l'Y\E'A1TS _ J.l\JFetf..MI4T,oiJ f ArrttfU/""ErJr-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."
~., . CITY OF PRIOR lAKE
J ~ 16200 Eagle Crek Av. S.E. Plrm" No. . qq- 33 0
PrIor \.aka, UN 65372
\D
......
~ HEAllNG APPUCATlON I PERMIT
~Ie U! 9 I I ~ PID '. 2.5"':362.. - 030 - 0
~.Addr...?*-IQb ~ ''j1UO o.hA. ~ . rull I
2,)6 _ 4 _hk~"u\a~ "M. qy,,~
OWns'" Name U.)d) J\. ~ ~rY\.. \l 1) )
Addreu_ \ c:;{C\6 r-p \QJJ~ ~.
"....lIIg Con\faclor ~ D.n D - ~-'
Address. )WIL)S S~SU+ T,I
T'-,phOne' , t.+~!3-114tf
FurnUlft Make' Uodtl h oflJ1() 't..
Model Size ~QtrA~4- 'CO
CoM. Load .
Fuel nnJ hnJRue SlI,
o .
Supply OpenlnQs. Q ~
zRltum OpenIngs, ) 0
~'nput/rf>, cnJOUlput ql ,CCO
r!..; ,;
~Edr.
l!)
crm.
TYPE Of SYSTEM
Warm NI Pian's
Gravtly .
M.echanlcal, ",,-
Air Condblonlng .
Vent. System.
HEA11NG OR pOWER PLANT
Steam ,
HoI Waler
Radlallan .
SpadalDevices.
-
Olher Divas
E
Il..
N
~ Aheratlol\5
...-l
TYPE OF WORK
Replacement New ConsllUction ------
EsL Comp. Dale .
qq - :33()
Repair.
0)
~ EsI. Cost $ . BuildIng Permit It ,
c;j HEATING pERMIT FEE $, C3jq. SO
g: STATE SURCHARGE ~ .50
a: .
TOTAL PERMIT FEES $/00.00 RecelpU,
~ PAID WITH
BUILDING PERMIT
rvPE OF STRUCTUR~
SlnQI8 FamiIV
Commerdal,
v
TIHO-faml\y
Indll6lrlal,
Putmc
Fae Schedule
.... .....
Qt.
~
1. Ora
,. y.u..
Multi-Famt\y _
_ OUlar
Indus'rlaI, Commercial & MuiR-FamIly
RllidenUaf, Heating & AC
R8I1denIlBl, HealIng Onl'f
Residential, Gas Fireplace
Resldanlial. Adrlitllllls &. Allerations
Ras[dential. AC Only
I" ollohCOlt ($39.50 m1ntmuml
$99.50
164.60
$39.50
$39.50
$39.50
Remember 10 add the Stale Surcharge on the bottom of this applica~icm.
1be.prlceClI your heating permillncludes ona rough-in and onelln.' InspecUon.
AddiUonal inspections wBI be billed at $35.00 each.
House Heating Test Record must be submitted wiIh ....\~Irllno rp,.~" "umbM bafcw buDd.
ing certlfic*e 01 occupancy wL'1 ba issued.
,..FAT r..I r.1 I' .TlO"'~ ~F('\\ URFO wilh number 01 supply and return openIngs Usted pili
room wilh CFM'. per openlng. New s'ruclur81i or additions send fIaor plan whh supply
and r.,um locations shown. HEAT LOSS CALCULATIONS. PAYMENT AND
APPUCATIONS MAY BE MAILED TO THE CiTY OF PRIOR LAKE. 16200 EAGLE
CREEK A.VE. S.E PRIOR LAKE, MN 55372-
Cily Hall business hCNm are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CA_. CITY HALL
447-4230
I he.ebv apply for a mechanical system. permil and l a&knowladge thai the
ilI10Jmalfon above \s complele and accurate; thatlbe work will be In conformance
wl\h the ordinances and codes 01 'he cUy and wllh the 6'ate bultding/mechanlcal
codes; 'hat this form does no' become a permll until 81gned by the BUILDING
OFFICIAL; that the work will be In accordance with the apPloved plan In the
caS8- of .U WDrK which reaui,es review and approval of plans.
'1/9.1 Jqq
Dale
Date
--RPR. 21 . 1999""" 1: 22PM
GENZ-RYRN
NO.66? P.2/6
ell v OF PRIOR LAKE t a E.-
. PLUMBING PERMIT f qq- ~.~
Applicant; h 01l.4 -- ~ ~ .PhClne; 4'd.'?-. -l \ L.\ \.{
Ad~ress: . ~L\ ~ .~ b .qJ}i, ~
Signatura:~~ ~ .
Legal Description: Lot M 16 Block W ~SubA ~ ~m.1JL ~~
SiteAddreS$:.-!~LlQ~ ~ ~ .
Building Permit' ,PID' ,;)5" 352,.- 0 30 - 0_
NOTE: This permit ~i11 not be processed without complete information,
FIXTURE UNITS
1'11. C.nlCf Qf lllf La~ (;DIInl"
f
Quantity
\
J
I
1f
\
\
(
3
I
)
Type of Fixture
Bath Tub with or without shower
Quantity
Type of FixtlJre
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
eaclCf10w AssemblY (RPZ, Dauble Ch~ PVB)
l3acktlow Assembly Test
Lawn Sprinkler
Other
-
-,
-EL-
-L.
DishWasher
Floor Drain
Lavatory (bathroom sink)
_----od>..... -
Laundry Tray (1 or 2 compartment sin")
Shower Stall
Sinks
Bar Sinlc
Water Closst (toilet)
-
FEE SCHEDULE .
Industrial, Commercial & MUlti-Family
(1 % of job cost, $39.50 minimum)
Residential. New One & Two Family
Residential. Additions & Alterations
State Surcharge
$
~ _qq.'SC
$
$ .
$99.50
$39.50
.50
GRAND TOTAL
$ J/)0..00
This permit is grllntecl upon Lh~ CJiprc5S condition lhat S:lid
CQntrlactQr. shall comply in all respects with the ordinances
of the StlllC Plumbing Code :and the 1IR'~"9 ~~f.
_ P.E\.lfY"~O' . DATE
lV/fA. / ATTEST
Call for all inspcJi:,ns 24 hours in lldvnnc:e.
~. PAID WITH
,BUILDING PEr:::' ".,.
I. ; I
16200 Eagle Creek.A.v. S,E.. Prior Lake. Minnesota 553721 Ph. (612) 4474230 I FAX (612) 447-4245
An Equal Opportunity Employer
-RPR. 21. 1999 - 1: 22PM-' GENZ-RYRN
NO.66? P.3/6
.... . PW.E
"a.I.D. . ....ucAIIT
GOLD . err.
CI'l'Y OF PRIOR LAKE NO.gq.. :330
SEWER AND WAl'ER PERHIT
NOTE: Sewer and Water
contractors must
be registered
with the city.
APP~ICANT: J:j ~ -R..M().,4IL) .PHONE:~Q3:.lI~
ADDRESS: 14145 ~ _%~~ ~_DA'I'E:~~Ll39
'r.)
5 IGNA~ .1>............ _ _BLDG. PE1>lIIT # qq. 33 ()
SITE ADDRESS: a.::f.t.,{,~Wo# Z.S'" 3S~ -030-0
3-IQ5
IN THE BLANKS
, I
LJO
feet.
1.
Estimated length of water service
J inch (e:;;) .
2. size of water service
3. Location of any couplings from s~ructure
4. Type of sewer pipe. ~BS pvc~ Cast Iron
,//'0;
5. Estimated length of sewer line ~ .feet.
6. Clean out (if required), located at
structure.
feet.
feet
from
~;=====D===_=~==~===~=====~==~==~=====C=:==-==.==~==========~====
This application pecomes your permit ~hen approved.
BY
D~TE:..
=====;;;;==;::;;=:;=========..:=...==...===============-==""'=-- ,.-=====---======""'=====
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
. Sewer and water permits issued for new construction must be
recorded on the cuilain~ permit card at the time of issuance
to insure that no dupl~cate sewer and water permits are
issued. r'/ PAID WITH
DATE PAID BUILDING PERMIT AMOUNT PAID APR 2 3 1999
RECEIPT # REC'O BY ~~
$
~
$
35.00
.50
35.50
Sewer and water line connection permit.
surcharge
TOTAL
FEES:
. 4629 Dakota St. S.E.. prior Lake. Minnescta 55372 I Ph.. (612) 4474230 I Fax (612) 4474245
AN EQUAL OPf'OFmJNrTY E.'4fl.DYeR
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. qq....3..n
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Dale /}/; jq9 PID. 25-352-030-0
. t" .
SUe Address 3C;d)C) G~nFlI..Jnt-R/\ r;j)1.~J-e ~ZSD
Lot /5 Block L/ Addilion U 6LVNJ1//Jr~-c.rvn-I
Owner's Name & )O~ML.- ~M~~
Address 2700 N. FAIRVIEW, ROSEVILLE. MN
Telephone II . 651 - 6 33 - 2561
FIREPLACE
IMlWlJP Make & Model ci I,,~ A1 t;/":-.
Model Siz~ .;ST -'JV1/'_
Conn. Load
TYPE OF SYSTEM
Warm Air Plants
Gravily
Mechanical
Air Condilioning
Venl. System
Fuel
~
Flue Size
Supply Openings
Return Openings
Inpul OulpUI i.A1rm
Edr.
HEATING OR POWER PLANT
Sleam
Hal Waler
Radialion
Spedal Devices
Other Devices
Clm.
TYPE OF WOAK
Allerations
Replacemenl
xX'
New Conslruclion
Repair
Est Comp. Date
7/.:Jm
. . .
QQ-330
PAID WITH "-
BUILDING PERMIT]
Esl. Cosl $
I 1M. a)
Building Perm~ ,
HEATING PERMIT FEE $,
STATE SURCHARGE $
TOTAL PERMIT FEES $.
.50
Receipl"
TYPE OF STRUCTURE.
I. PiI.1<
1. el..,."
1 Yell"",
L
c:
File ..j
01, I
Call1ncl' 0
I-'
I
\C
\C
o
0\
"
~
W
)>
"TI
..I.
Single Family
Commercial
Two-Family
Muhi-Family
Other
Industrial
Public
Fee Schedule
InduSlrial, Commercial & Mulli-Family
Residential, Healing & AC
Residenlial, Healing Only
Residential, Gas Fireplace
Residential, Addilions & Alleralions
Residenlial, AC Only
1 % of job cosl ($39.50 minimum)
$99.50
$64_50
$39.50
$39.50
$39.50
"1
lD
III
..I.
a.
lD
n
o
"1
:3
lD
"1
Remember 10 add Ihe Slale Surcharge on Ihe bollom ollhis applicalion.
The price 01 your healing permit includes ono rough-in and one Ilnal inspeclion.
Addilional inspeclions will be billed al $35.00 each.
House Healing Test Record mllsl be submilled with buildinq mmnill'll"""'" belore buile
ing cerlilicale 01 occupancy will be issued.
HEAT CALCULATIONS REQUIRED wilh number 01 supply and relurn openings lisled Jl
room with CFM's per opening. New slructures or addilions send lloor plan wilh supply
and relurn localions shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE. MN 55372.
0\
I-'
I\l
0\
W
W
Cily Hall business hours are 8 B.m. - 4:30 p.m.
ALL WOAK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447-4230
00
00
00
I hereby apply lor a mechanical systems permil and I acknowledge thallhe ~
informalion above is complele and accurate; Ihatlhe work will be in conlormance
with the ordinances and codes 0' lhe cily and with Ihe slale building/mechanics
codes: thallhis form does not become a permit unlil signed by the BUILDING
OFFICIAL: Ihallhe work will be in accordance with the approved plan in the
case 0' all work which requir,s review and approval 0' plans.
,
lit /'19
. Dale
7 II 199
0all
11
.
o
I-'
Building Officars Slgnalure
r-t
o
.
0.
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. Permil No. q 9 - 330
Prior Lake, MN 55372
V
IX)
IX)
IX)
l"l
l"l
\0
HEATING APPLICATION I PERMIT
Date l-d\- Gte. PID" 2.5- 352- 030-0
SiteAddr~ss 3LfjS 8L.fNNLU~ DnvJL.. ~2SC>
- I
Lol /6 Block 4 Addition G'-VN'f1/'rrre,e" !so u-n-l
Owner'S Name .uf o...n~(Y)CO...ry) .fur\t....L ~
~-~
r-t
In
\0
Address
HealingConlraclor ALLIED FIRESIDE dba FIRESIDE CORNER
Address. 2 7 00 N, F A I R V I EW, R 0 S E V ILL E, M N 5 5 113
Telephone". 651-633-2561
FIREPLACE ~ ~
tWmQl9 Make & Model _ N
Model Siz~ lQ.(X)() -rer 0
S-
QJ
l:
S-
O
U
QJ
1)
Conn. Load
Fuel _ N .\-ilh
TYPE OF SYSTEM
Warm Air Planls
Gravity,
Mechanical
Air Conditioning
Vent. System
Flue Size
Supply Opanings
Return Openings
HEATING OR POWER PLANT
Steam
Hot Water
Radialion .
Special Devices
.,..
Input.
oUlputdl \000
J
VI
QJ
S-
.,..
ll.
<
r-1
l"l
..
IX)
o
(J\
(J\
I
r-1
N
I
,...
::l
F")
Edr.
Other Devices _
Clm.
TYPE OF WORK
Y-
Replacoment
New Construclion
Aile rations
Esl. Comp. Date !-~lo - 9 '1
\ \ 00 .00 Building Perm~ 1/. 99.- .330
~,' --
,-. PAID WITH ~
. BUILDING"PERMIT J
Repair.
Est. Cost $
HEATING PERMIT FEE $_
STATE SURCHARGE $
TOTAL PERMIT FEES $_
.50
Receiplll ,
TYPE OF STRUCTURE
I. Pin. '.
2. (imu ' .1
], V.lIO'"
Single Family
Two-Family
Industrial
Commercial.
Fee Schedule
Induslrial, Commercial & Multi-Family
Residenlial, Healing & AC
Residential, Healing Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential. AC Only
Multi-Family /
Public Ot"/
.",1
1 % of job cost ($39.50 If'"
$99.50
$64.50
$39.50
$39.50
$39.50
Remember 10 add Ihe State Surcharge on Ihe bollom 01 this application.
The price 0" your healing permit includes one rough-in and one final inspeG1iO(\'
Addilional inspections will be billed at $35.00 each'e bUild-
tJ8lo1
House Healing Test Record mllst be sub milled with buildino Dermit numbeJ.
ing cerlilicate 01 occupancy will be issued. \is\ed pe
iogS IV
HEAT CALCULATIONS. BEQUIRED with number 01 supply and return opei' .",\'0 SU~
room with CFM's per opening. New structures or addilions send 1I00r pla~o E
and relum locations shown. HEAT LOSS CALCULATIONS, PAYMENT A~ ~l;.
APPLICATIONS MAY BE MAilED TO THE CITY OF PRIOR LAKE, 162OV-
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. . 4:30 p.m. , . \"'11 \\~l\.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CAll C~
447-4230 \hll\ the
e dg8 I "\la"ce
I hereby apply for a mechanical systems permit and I acknowlecftJ." ,0 CO" 0 \I "ical
inlormation above is complete and accurate; thatlhe work will be i~ ~\d\l\91l1\~ll~\NG
wilh Ihe ordinances and codes of Ihe city and with the stale bUildi,,~f~"'l \M B . the
codes; that this form does not become a permit until signed by tllYc::::-~ed pia" III
OFFICIAL; thai the work will be in accordance with Ihe approveC1!i
cr 01 a II work which requires review, and approval of plans. ~e-
, ,/ .../~...
',. '. ...... rl {lBta
Building Offical's Signature
7~e~
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 3<1;2<<\ G''t^ ~
NATUREOFWORK _/J~ ~
USE OF BUILDING SFA
PERMIT NO. c:r ~ -'TsO DATE ISSUED t..(-/(,-79.
CONTRACTOR L )o..J\A.VdPJ' 1/\ ~ /'
,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
It:,
INSPECTOR
DATE
. FOOTING (~~'r.<<~./I.
I FOUNDATION (Prior to BiCkiiU) t'~' I (~ &-1-99 v A~~
;
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC .f;q.:h 5-,),1 r<jJ
FRAMING \,..\,,~\ '6"?(~'\ 0) 7/~/rf
INSULATION Vh~~(!l/10q'l L.\.-' ~. ~-"2.~
ELECTRICAL
PLUMBING t(:V1)f)/1 ~,g-~<{-'11
HEATING (if required) V vt ?-1#?''7 L..t... ~~, ~~1r ",
FIREPLACE (\,\ ~7Vl;"'~ et..S,.z.,." (/VP "7J~1 &,0, 0...\. ry"'~7-" W:'i f>.l'~..v' tj
GAS LINE AIR TEST v
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
"M._~_VJ"\nD I I
FINALS
GRADING (Prior to Sodding)
BUILDING l' cO. tu fl/11 qLi
ELECTRICAL '
PLUMBING
HEATING
DO NOT OCCUpy
lV E I~'~ r-'!~
(;:J)3h6/<f9
()
~th 00/1'7 {L ~ ~ I >>.(~ti
?tV ~h,/"f tLH ~ ())(~
UNTIL lABOVE 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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850