HomeMy WebLinkAboutBuilding Permit 03-0122
~"""~""""",,,,,.....~"~l'!"'.~~-...t1f'-'
--"1'*- . ..._.~..,. ,-~ ........- .~-......... ......-----
~
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
.- 77
(J-~
ADDRESS
,1"- ( sck~ 6/v.f-? fff-s
OWNER
CONTR.
PHONE NO.
PERMIT NO.
:]- f 1-1.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
... PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: .-X'
, ( (' ~IIVtO\lt rM{- t::..-~
o WORK SATISFACTORY, PROCEED
rRRECT ACTION AND PROCEED
o . CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
. A IVJ {- J,}'- cf"t
Inspector: .II V 1 / C:> - Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSliOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS --.Sta '-( (11 vfF (-ItS
OWNER CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.liif'FINAL
'6 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
Sx:! cl l' ;"-( -r ~ ()/{
~
/' {
/ /'0<'-
~ C----'l "
DATE TIME
r;- 2 ']
:? --IL- J...
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
----
---,/-- ~
V; /__
,
----
---
1
/
~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ,;t1? G. ~J-o~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
BUHNSVILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Savage, MN 55378 · 952-894-0005
Orstat Test Report for Jobl 503 '3
C. }
Ity tf? Ii//? LIl t'L
Address 5051../ f)U,d/ Itc/&;//"lS -rRe
Occupant
Date oflns1aU ~. 1<( 03
Type of HT. F/A X HW Space HT
Other:
Unit HT
Make LLtJJJO'..
Model C?G,Q:::> Sb ~
Serial 5 go'3()Oz..oS L
Input So ,000 f5ru \.\
Pilot Type
Pressure
Input CFH
Stack Temp
HOT SURFACE IGNITOR
3 "5 \ 'I\J(., C02 (0 3
SO 02 75.7
\Od CO g
Date Tested . 5. 2 \ 03
Company BURNSVILLE HEATING & AIR CONDITIONING
Technician ~ 0
C::S/;b P1F1/tJ FiLe
CITY OF PRIOR LAKE BUILDING PERMI): te ReeT
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main Fi~_e
l. White File
2. Pink City
3 , Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
--r &tJ 5tJSt!
J5tuFF fle-;oIds 7kA/~ 26,
J
LEGAL DESCRIPTION (office use only)
/' ;? A
LOT 7 BLOCK I ADDITION 'j Jt116'i.1l lJl(Sr /-ftJlhTl~
PID
OWNER ;') , /
(Name) TtJLr~ HoYnfS
(Address) &-/5"" ilPlZltI wt~ r 1 J,(ll/t/
. ,
(Phone)
.5iJ IrE J ~VI
'"
CA6ffn
Jtln
55/2-1
BUILDER
(Name)
(Contact Name)
(Address)
s.trm%-
t~/lf Z iA-SLJ11/ttJ
(Phone)
(Phone) ~Jz - 2//-tlf.f:~
TYPE OF WORK
Jjt.New Construction
OLower Level Finish
o Deck
o Porch
OAddition
ORe-Roofing
ORe-Siding
o Fireplace
OAlteration
OUtility Connection
o Misc.
PROJECTCOST/VALUE (exc1udingland) $ ~?~ bJ9.s
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
:"'"Z?'q~~ ,&- /37/ /z/5b~ Z
// ~i:ature Contractor's License No. / Qltfe
I Permit Valuation 90. I ()(J , f)O I I Park Support Fee # $
I Permit Fee $ '9,;1,3.75 I I SAC # $ 1 Z75,00
I Plan Check Fee $ ~oO ,44 Water Meter Siz~I"; $ 2.-50,00
I State Surcharge $ Lj5.00 Pressure Reducer $ '15. () 0
I Penalty $ City SAC and WAC # $ .I 20C), f:) 0
I Plumbing Permit Fee $ lot) .OfJ Water Tower Fee # $ ;bO, r)(J
Mechanical Permit Fee $ /00,00 I Builder's Deposit $
Sewer & Water Permit Fee $ 35.50 I Other $
I Gas Fireplace Permit Fee $ 10, () D I TOTAL DUE $531+. '91
, w
This Application Becomes Your Building Permit When Approved Paid ,1i;1 liti , !;; 9 Receipt No. tI ~ 7 7 d-.,
~ .. Date ? .-' U- ::<.. By c.jP"'/
':f~~ ~/ ~ 4/03
Building Official / - 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
]i::p~pm>ry/~~A7~~-;;;::mpmu;re"fO<rnp,"~~,~
Planning Director ' D~te - 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
/77,kf tic.) h i..E
See Main Fi~e
ThE' Crn'ef or the l.ab {'ountry
White - Building
Canary - Enaineering
(Pink - Planninv
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/.l
,
~/ -
The Building, Engineering, and Planning Departments have reviewe9 the building permit
application for construction activity which is proposed at: .' //
5tJ61 n~UF'F ffi!q!lts 7l?AiL s,c,
- J
I
t
I
I
Accepted
Accepted With Corrections
//
z:;--r
Denied
Reviewed By:
~.'J
__ ._ -/ ~ ...:iJ/ J / /
d -~ -r- Date: / /~ /A ?
.~ #~ ~~ /~/}~
/ L..'"C
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."
See ~ain ~i~e
Thr Crnfrr of Iht 1.."', ('ounlry
White - Building
(Canary - Englneenn-g>'
"'lnk - t".annmy
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
~-
APPLICATION RECEIVED
/
i
,,~., I" j
10-/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at /7 / ' .'
rfl.'\~U_ (\//: ,,1,'-1 ) "//'1-1
::>v , I \.>'I/-1:1! l,,;.J.,> ( c;,VuZ'o .
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
/YJ4b
SC -( !J1et,'"" F; I (
Date:
/-e~7-03
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."
AAt-J Fl'LE
See Main File
The Cf'nlt'r of Ihe L.kr Counlry
~hite - ~ulI~:un~
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 9.11 tti: ~
APPLICATION RECEIVED / - d - 03
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction ,activity which is proposed at: &-t- /? ~ /J..
C0s4 'i3Lt1FF IfElc,/#-S' 7iCA/L 5:6. !3L I cY01tkc~ 7-
v
Accepted
Accepted With Corrections
/'
Denied
,.
Reviewed By:
~
~
-:;r~~
'h1~ -=/~,
Date:
/b7~3
/
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."
Jan 21 03 09:49a
METRO GENERAL SERVICES
763-428-2968
p. 1
GREEII . "RoE
YELLOW - A""LICA"T
GOLD - CIT"
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
(f1~rt( 'I 7- if z, L/~
S.w. No. O~ -I ~J-
FAY-
NOTE:
Sewer and Water
contractors must
be registered
with the City_
APPLICANT:~
ADDRESS: G"'1 q c;)
SIGNATURE:~~~
SITE ADDRESS:,
~ ~ONE: (7b3~4a~-~~3~
.-c... ../
~ N~ DATE: 1(~l/o3
~:;-. ~;J'YlN' 55'316
~~.~LtL-BLDG. PERMIT #
I.. LA FI= HE./G u PI DiI
. r l.s~
FILL IN THE BLANKS flit.. S.t:.
1. Estimated length of water service
so
feet.
2. Size of water service
171
inch (es) .
3. Location of any couplings from structure
(\
feet.
4. Type of sewer pipe. ABS PVC If 11 Cast Iron
5. Estimated length of sewer line ~b feet.
6.
Clean out
structure.
(if
required) .
located
N/A-
at
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This application becomes your permit when approved.
BY
DATE:
========~:{k7==;:;~.;.4=============================================
FEES: !lie!.! P"f-m. i- Sewer and water line connection permit.
Surcharge
jtJ 6 F~ e- TOTAL
* 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 building permit card at the time of issuance
to insure that no duplicate sewer and water' permits are
issued. Jf:'oJ. 1:, 1'') . '
AMOUNT PAID -'~IE,~
DATE PAID
RECEIPT #
REC'O BY
- - FeD 9 4 2003,,' ,Ifr, .
-- ~'
.,,5 By QC::
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (&2) 447-4230/ FA.X (<<1.) 44)-.lr.t45
An Equal Opportunity Employer
...,.,.... . ..... "
"\00 ~ ,l. r ..
",/..:.",.~...)'.
, oa "..,
1:- I / ./" \ ';-
, ,\-
- -
\ - , I ',',
.\~'
" "", '(,..
-.... ~""!o':'':).J
CITY Of PRlOR LAKE Plr~rEr)'G PER\rIT
D.;'. ~
1- !,,\~.~
JI"" l~-h'
:. ,-:","1 \:::',
; '(-l'~t... '~;t1..,:}1Tt
PER.\(jT .'1U:3 ~
--------
- ~', '-".,-'---,
_....., _." 1\_' :~:~_: _.:.
- - - -.' .
"'.- .....--.,#
I ?':-:;c .-.r-:-:~~";" ~~:;c t::! ~I'.:'- ,It ~11~::~:
_$:IJ5t/
D~M
~'" iT
lJ' ,J /
/2~f/tlkt1
'-,
--
(I
. ,-
. ,
:"::'':'.~,,: Q:::~I':?~:=T:(:I:-" '\\JJ~~=~:.; ;::.i~/)
= r ," ,-'."
- - - -.....
:::~
. , ,
-
.,':.,~ C [7:,::--:
. 1'"\ -::-: ~/ j /;11
:;'.'_'.~" -'~l f
. ' ~. . . .. , .
I ,~..L:..::~::
; ::~~,-:::.:
.:. :;?' 'C ~ ',7' ~ Jf) //
',:':.;;~:l2O,{(rJU fL!ILp
, l.~,':'-:~~~; _.?~() 11~~tJ/ll:tf/ /1f/,f
',':..::-:::..~: ?:~~,;::!
: ,-;:.;r:::: ..!2jr2 - ~?..l.J /02 /
;/(3 / ~11 f1 " :s~j fL.,"
... -- .J... _.:s.. _ _
rc=::)
( ..:.. J...~ :=::: ';
-. .... . ,
(_:;: '-,:~:
(~~,~c.~ A, ~#.~
-.
t -- .:"::-:1.:)
0.'; Tc
M~ /91JJ
.':',::?~.rc.':',.\~J: :5~(j:t.:... T~J.~
( .~ IJ:~ itr: ~'
~
I
/
;
I
r
?
_/
/
/
_J
AP P UC.-\."'T P lE.-\SE CO~"rp tETE BElO\.V
Typ< of Fi.:ttul"~
6<1~:1 Tut) \\itch Qr WIC!1i.1!1C j;'cwt:::"
I D!sh'-\i:J.sh<:::"
! fil)l.lr Or::l.Jn
I L.J.'/;J.CQrl (8;nhrclJr.1 S'i:~!-:)
i l.1um:r:,' Tr.:t;-. ( I or:: ":[:~iic:rr.r.;C:=lt :iln:,
I Showe:- Sc:!.lf ,-
I Sinks. ;;... .
I Bar Smk
, W:w::- Closet (T<JtlO:::l"'''''' .','
Tvp.: I'l f Fi:w.tr,:!
I
I
I;' .
I
"'I;,'
I
I R-Ju:;.n-in:i
i W.lc;::- E~:lre:-
I Vi:!.,::- ~u r'::1c:r
I SC.lnd P;r.~ r\V':l.:min~ ~rJC!ll:':<::l
I .::)c:..V.lg,= Eje-':::\:lr
I 8~ckrlow AJsc::nbly
'C," ., "'''.1 'BacktlowAssemb(y Test
. ,.',./ l~wn Sprinklc:r '."
." ""1 Othc::- ,;,," '".f'" 0,
;
--
I
;::.Il';..:;;+~~.:?j.; r ";':. :,.."
" , " ,.;,if>;" .' f E.E .::iCIi.ED L"U: ',:';~,~'.~h;,;~~:?;,;,~,;:,,~~);~:,;,~,';J:">::I"
rCl~U~~'-:::1. Curn~c::::~l &. M\\ld-~'::lr:1il:, [% ofjc1o c:>st wic.'1. :1 s.i9,50 minimum " R~ic';ci;.z. N....v One .i. Two-F=il~ St;9.$O
, ' ..;,.!, :',,i:."R,::[icQti~'.AiJdi:ioitS .f;:~!.~on:j SJ9..m
'''':''''-:'' :" ',:_ ': ~,",: ~:~i-":.'~';~~'f')lc.,;~~~~;'~'~~:'l..:.t.~;:,i...',r.;~". u'.
E;.;.;m:l.to::.! C"':$;: ,S "'."i..., '~',";",,: ,:..~~\'j' euiit!in; P:~lc #~)~~~~'1~:'.l';"!~?'.__,
",,~';;Ui~\9i~~~i~f';~"~$:~~~~~#f~~~~l.t~)T'~,D.ti~~.,,:
_ ~.,'~!i:~~&~~~~~~l"'~S==:;'o"'''\ '''8tJILrJINGU'' rt
. ". ".~""~'''.''',:'''- ....,'''-:..- 'r,.",.~.;,:tl:S,. " "",' PERMIT
, ,TOTAL"PER""nr ~~J!. ........S .,;.""..,j;;;.ld,-';:...,;,;.,.. >~~,',,,,;.
,'";:: c~::;::"O.B=:~~ 1(ou, BUild;:~~~:~"i~~~'f~~~;7~.,p, /<0.
", O~tc"" ; ],1 DMAR 2 0 20~~ ,/ U /1 By Ir
. :::' .....:' . ,- '< ~.~;.;:.~.~~t;.........,it'.::~-;-.~": r',''',~,'.. ' ..:':"I.t i.,h;.;:,~'1~.~~:~~.~".~.,.,\,'.t~.:~-::.' -:,(,:~~:Y '~;_, "" .,' ,~,).
, :~ IhJl.lr nll':H:ll (o),r:a llln:spot'CQon:s 19:!:) +.& <.' r:u: 19:5:L "-'7 :-I:..j
. .
----
--
. '
Bllill.lin" Oltici:ll
t:>0/C'0'd
--
.. ;'~.:.,,~. ~ ..~t,,:..,
. J.::, ~:~.:~".,~,- .:,;~,t:j.f~.~~.'::<:-,:,', .; ...:,:.' ,....;...,,;'....;,~>.r:..: :~;'--.:>;,"i?i
-
Jtj I OJ~N I EI~nld^3lltt()
t:>C':t:>l [00C'-6l-d~W
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. Pink File PERMIT NO ~
2. Green City . ~ ..../' '""'""'\
3 , Yellow Applicant '- ~ 01- <:::r-
(Please type or print and sign at bottom)
ADD505cJ Blull tkljkb
-Ira,"
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
p~ lk 1-lo't'Y1 eS
'6 \5 NvJ Pa.vt,u~
. (Phone) 1o~/- L/'iJ... 5;200
5LA; +~ I LID I 201jClt1. !VI N 55"!;) I
, vi ,
(Address)
APPLICANT
(Name)
(Phone) Q'5;;l- gq 4 -000 S
(Address)
Burnsville Heating & Ale, inC.
12481 Rhode Island Ave. So.
Savage, MN S~1122
(Contact Person) <.. \U..,L,\,t., . (Phone)
APPLICANTSIGNATURE ~ Q.~ DATE
APPLICANT PLEASE COMPLETE BELOW
{glNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL I-en(JCfX 6;?1.o 19? - 50 FUEL Nd..i-, qQ.s
FLUE SIZE RETURN OPENINGS 5 INPUT 50: 000 OUTPUT ~~ 000
TYPE OF SYSTEM REA TING OR POWER PLANT
(City)
(Zip Code)
, .
3/~,I03
f
DWarm Air Plants 0 Steam
DGravity 0 Hot Water
o Mechanical . III rfV 0 Radiation
~ir Conditioning ,veP I VV "ic 0 Special Devices
DVent. System I O~;;2 0 Other Devices
B- 010
FIREPLACE MAKE AND MODEL
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
Industrial, Commercial & Multi-Family I % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AIC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
o 00
Estimated Cost $ 5, c5 0 I Building Permit #
$39.50
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
qq,'50
.50
/()O , OQ ,1 A )
/J M tr f/L/
Paid Pi f'::r .- Receipt No.
Date g;"?y /{)3 BY{}--
u
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS SOS&( ~~.. Kt(~ 1T(Ai~ S[,
NATURE OF WORK NEi!-~STlilen1~'
USE OF BUILDING _ ~. _
PERMIT NO. 03- OIZ-Z- DATE ISSUED JjJttfl'l
CONTRACTOR ~O' oF~. PHONE-&lz-Ill- m~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
.
~SE!" M~i~ FiLE
DEPARTMENT "" .... ~..... ......&..-. ~ -J
---- - -- --
BUILDING AND INSPECTION
INSPECTOR
DATE
I
FOUNDATION (Prior to Backfill) ~w\ I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~lv\
FOOTING
~1"'1
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
I('f
1/1/(/
'1-/7 -0)
L-( -- J- 1- d"3
..
JtlIf
y1Ip
t-,-{ 1 -03
~--/7 <;:6'3
-rl'Ml!r'~ACE
GAS LINE AIR TEST y1ILv.lfv"\.(.~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
l'\1a~
j
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
vvri
C9 --J- >.~d)
i/Iff J -,. J-7-crs
tIW1 ( -- ).,- r- rI)
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