HomeMy WebLinkAboutBuilding Permit 99-0551
APPLIANCE
.PERFORMANCE TESr
Locate near the furnace manual
LP Gas ,Natural Gas d (b .
JobAddress 17Sh~ ~SPuJ~ C1. .
Heating Contractor S c..o-tf If2 bot'l.cCo II) H'(J ~ ~(,
Name of Tester ...<)' co-H-
Date /0 -, d I ... q 9
Percent O2 (pt <6
o
Percent co
Percent CO2 -.If
Stack Temp. '31 'f
Pressure '< J S- LV C.
White - City Copy Tag - Site Copy
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/O-2/:J-" //:r;a
ADDRESS
/75'(P :7
K:IJG e- <<.Jo ().o
CONTR.
OWNER
PHONE NO.
PERMIT NO.
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
A "JiirPLUMBING FINAL
/0' MECH FINAL
COMMENTS:
Q ~ -b~
(iT \-\"h,^- ~
~~
. -
1 ?-5S/
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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ECTION BEFORE COVERING
Inspector:
E NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
ARE FOR YOUR PERSONAL HEALTH & SAFETYl
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
1756C)
SCHEDULED ~~7
e D6T6" cJa 00
+:()O
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q 9 -55/
o FOOTING 0 PLUMBING RI
o FRAMING 0 MECHANICAL
o INSULATION )ll3" WATER HOOKUP
o FINAL ~ SEWER HOOKUP
~FOUNDATION 0 SEPTIC INSTALL
o DEMOLITION 0 PLUMBING FINAL
o FIRE PREVo 0 SITE INSPECTION
COMMENTS', ,/ I( (' "1'?'A (" ~ .5tJ i _
~.A.fil ~O,.:::25 ~.
5"0"" - ~ ~
c". -;P.=- 1;" ~ e-L
~ ~ ~- ~ ~
~~ ~..-: iNk- ~ -'.O~ ~~
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~ ~~~' ~P;r ~ p~trr..J
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!A~I ;;';J I rC ~ -#~,-~ ~
~V\)^reL. (J~.~~,~
f -
~ ~ 4.
, ,
o EXC/GRAD/FILLING
o LKSHORE~ETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
/
,/ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK,. pLL FOR REINSPECTION BEFORE COVERING
Inspector: ..ro 1-1 Owner/Contr:
V
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECFI\lFn
1. White
2. Pink
3. Yellow
File
City
Applicant
MAY I 4 1999
qQdi5L
,
Permit No.
Sr\/~Ac\
~~~+ ~.6. IZI
BLOCK \ PID a 5-::.... -,?;CQlQ
W OODte.llL6J6 4- '1H
(I'-!ame) J.fO~~~~ s.1': (Tel. No.)
<;(.01 \ ~1J~~ k1~...~
(Name) t rf'-. (Address) Q .l!:el. No.)
~1- M.e$~~",,-'c- I ~ ~~ L..2S't
6. BUILDER (Name) (Address)
~lEN K1~~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. SITE ADDRESS
1~t1
3. LEGAL DESCRIPTION
\
12. NO. OF STORIES
LOT
13. TYPE OF CONSTRUCTION
eBSlOiiN71~L-
14. FLOOR AREA APPORTIONMENT USE
ADDITION
4. OWNER
5. At~~'\
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
4.31;-S51C}
SEATS
16. PROJECT COSTNALUE
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
Septic 0
Addition 0
7. TYPE OF WORK
New constructio~
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
Fireplace 0
Alterations 0
17. COMPLETION DATE
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
tion 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 lor
constru ion will conform to all existing state and local laws and will proceed in accordance with submitted plans.
urt rmore, I hereby agree that the city official or a designee may enter upon the property to perfo
x
L
License No.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
Side
Side
Back
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
DLANS & SPECS 0
SETS
COPIES
USE OF BUILDING -S.,::'n
...
SURVEY 0
I c:l~; ~O . c:>t1'
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV ~
Occupancy Group A B E F HIM. cP S U
. Division 1 2{f)4 2S
Perrnlt Fee ................................... $ 1100 2.
(05"1 .~1t Ll,<<~5.
(Pl.50 (P!-~#cr
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
City:
~o .c:x3
/()50 .00
Collective Street Fee ....................... $
Sewer Tap ................................... $
c;l.. I' $
Pressure Reducer ..... .'1.'fJ............... $
Meter Hom .....~.""..................... $
Water Meter ...7'f!)........................ $ / 2!5 LOO
Sewer & Water Connection Fee ........... $~ ~ . ~O
Water Tower Fee ........................... $ -Z () C) ~t9CJ
Water Tap ................................... $
Builder's Deposit ............................ $ If c.,-OO ~ ~
Other ......................................... $
Total Due .............................. $-----1-440. ""
Paid '7J/(, C. ., f, Receipt No. .3 53 '1 ~
Date ~h If'''! By IlL -" .
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rditl'ance and may pr~s requested. This document when
sign the City ner constitutes a temporary Certificate of Zoninjl. c.~ ommpliance and allows construction to commence. Belore occupancy. a Certificate of Occupancy must be issued.
~/2fI..~
City nner - --V' Dilte Special Conditions ff any
Plan Check Fee ............................. $
State Surcharge............................. $
l./5. tJ-o
Penalty ....................................... $
Plumbing Permit Fee ......q'l:.2"21.... $
Mechanical Permit Fee ...1,9.:5.<),1..... $
. tflJ-S':;Z
Sewer & Water Permit ..../.':{....;.... ..... $
Gas Fireplace Permit ....~.r.:.5.?J.... $
100 . oa
loO .C)O
35"' .~-o
40 . DC)
This~I11'jf'Becomri YQJJt Building Permit When Approved.
By ~~ Date ~-20~
Certificate of Occupancy
Issued
24 hour notice for all inspections 447-9850
/.. " ... f
../
The ('"nln or Ihr L.kr Country
White- Building
Canary - Engineering
Pink - Planning
aUII...DING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
, (
./
I'
, f ,.
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Accepted
./
Accepted With Corrections
Denied
Reviewed By: ,t. /ALi'13A !"Hlu.~Mlf/WttJ
Date: "II }.r-'I
I .
Comments: f(1I~oFF ~sr' BE:. Co-..l-JE.VE.n
70 ,&/I\tf.) II-L-.J~
D'ft.rtf (4JfM.E f
(Iii /-' TV &SE:.4tEJ.JTS 4s t\(.uu-t ....So
?tt,otC.TICt't L ..
SE:E. 1....F"ot:{MATlO~ 0"; REJf./UE _<"l)~.
"'-F$ ATTlV /oI"",~..tr.S: I. F.IUAL t:.ltllo.f: JAJ!>P~C.TIOt\.J lNFoftlWATloft!} 2. t:'1'l..4.rJ/AJt. PLAAI
'? . f" ~o<....^" to,,", TlC." L MEl.Jo:..JlI.E:s
0.1. Eft. tHo ,<J.u /" .. ^,TlC.flL.. R 141\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."
ff^
GREE. - FILE
YELLOW . APPLlCA.T
GOLD - CITY
CITY OF PRIOR LAKE NO. ~~,~I
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City.
ADDRESS: :. . -:" ~~:_- i '("~ .:...._.rI,' ~
SIGNATURE:~~~~
(. "0/.-1. ,
SITE ADDRESS: J'75b9 ~/t:JE"W()OO
p# (!L)/I/.sTle-U~-n () ~
~
DATE:
C!..- I .
PHONE: 4I'3~-300S
1:7110/99
BLDG. PERMIT # 'l'f-ss-/
PID# 25- 353- OOI-C)
APPLICANT:
FILL IN THE BLANKS
1. Estimated length of water service 6()
feet.
2. Size of water service
I i (
inch(es) .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
PVC )(
Cast Iron
5. Estimated length of sewer 1 ine .30
feet.
6. Clean out (if required), located at
structure.
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This
~~~ur permit when approved.
f.E - DATE: t //()/qCj
I' I
BY
------------------------------------------------------------------
------------------------------------------------------------------
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
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.
AMOUNT ~"J.J).~A\D WrrH 1"
R 6U"..O\t"G pe.RM~'
EC'D BY .
DATE PAID
RECEIPT #
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. 'i1 - 5S1
Prior Lake, MN 55372
Date
Lot
Owner's Name
aM -.I'
I
v~
Address
Heating Contractor Sco-tl r?O ~cPG tV ti tc;, i
( . <./
Address 5~OO Fa./~j,cuvk5> Au,
Telephone # C:, {^ (0 S c.l ~ a''3 7
Furnace Make & Model .:tf;? i Ie.
Model Size life ~O 760BFE.
Conn. Load K3l~ 3
Fuel /Jet't.
S-~I
Flue Size
Supply Openings 10
Return Openings 5
Input 1SroD Output 6oct:)o
Edr. ,
Cfm.,
IS-OD
TYPE OF WORK
New Construction
x
Alterations
Replacement
Est. Comp. Date
Repair
COD C i'll,
J
TYPE OF SYSTEM
Warm Air Plants
Gravity " ,
Mechanical ~{I!tf aii'!
Air Conditioning ..:2 '1.)... -If!);./
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
99 - 55/
~.J ~ lSo:~
Building Permit #
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
Receipt #
/
TYPE OF STRUCTURE
1. Pink
2. Green
3. YelJow
File
City
Contractor
Single Family
Commercial
x
Multi-Family
Other
Two-Family
Industrial
Public
Fee Schedule
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with buildina oermit number before build-
ing certificate of occupancy will be issued.
HEAT CALCULATIONS REQUIRED with number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations 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.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-9850
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
J~ ~ ;tJ~
/ ./' ,;,1~liCa~gnature
//V;;J~"'/'J -.-
V \.. l'Bu~ Offical's Signature
7/1q /99
I !1ate
?-W-t5
Date
05/11/1999 11:47
512-8947972
LAKESIDE PLBG
PAGE 01
~)
--'" --"
TIU' l. ''C'lth'r ,)f Ihr 1.*11.1.' Cmml,}
CITY"O.F PRIOR LAKE
PLUMBING PERMIT
Applicant: J... 4/~~ /g.,... fJ /,~ h"f .I.. ~ t
Addr..., ~ Z ,,,~
Signature' -_~.I,J ~ .
Legal Description: Lot I.. Block. I
SiteAddress:J7h~f ~IJU J!!.I
Building Permit" . 'QQ-:55! .PID # rJ tJ:J. .3 J 7 f' I'J1
NOTE: This permit will not be processed without complete information.
I. DIUii'
2. Gold
3. Y.cllow
"i1..
City
AppIicanr
# C/9-SS/
Phone: ~ /~ S'7Y- 7"LJ 0
.5: ~V~.,.. J4"1 ~
.Sub J'(tJODJeID(!!'6 +711
~Jt" ./! IDf~ (C)'l sf-.
Quantity - . Type of Fixture
FIXTURE UNITS
,
J I Balh Tub with or with~ut shower
n ,vf'\<r~ I Dishwasher
~ Floor Drain
~ Lavatory (bathroom sink)
Laundry Tray (1 Or 2 compartment sink)
Shower Stall
Quantity
Type of Fixture
Rough~ins
Water Heater
.:;
r... 1 ....-1/
L..,op. 0" ILl Water Softner
I · I Sland Pipe (washing machine)
L Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other I Dl'".sra>.., r J.. Ko~b.'b#O.)
Sinks
Bar Sink
Water Closet (toilet)
..:4
~
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of jOb cost, $39.50 minimum) .'
Residential, New One & Two Family
Residential, Additions & Alterations
Stale Surcharge
$99.50
$39.50
N\Q",\\('\Q
.uYt\\~V
'--....$ --
- (J
$ 915-
$
$ .50
GRAND TOTAL
IDD~
$-
Thi~ permit is granted upon the ell press c::ondjtjon that said
contractor, shall eomply. in all respects wiU, the ordinanc;es
of the State Plumbing COde Ilnd thE: amen~me~~ thereof.
c ~..HfrNO. -t.../ /4./t/f1 DATE
/r~ . . ATTeST
t/
CalJ for all inspections 24 hours in advance.
'(j200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 I FAX (6]2) 447-4245
An Equal Opportunity Employer
PRIOR LAKE
INSPECTION RECORD'
Q{-,
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS , 15"&,; f( .'~P l uor<")rO
NATUREOFWORK l\Jew~L"'"4 -
USE OF BUILDING S~D
PERMIT NO. 9Cf -55 I DAl]; ISSUED 5-20 -9- 7
CONTRACTOR C Ie,^- KIf)t7 ,4.11tCf S~
- t,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
.
I
I FOUNDATION (Prior to Backfill)$) I ~~( I ~-'l..'L -'11
PLACE NO CONC~E~5JJW~ ABOVE HAS BEEN SIGNED
r()vfl-.5lJ ~ 1~ u dli - INS
. SEWER I WATER I SEPTIC ~ ~;t:;~,.... c.- 2-t.---'1~
FRAMING ~ ~ "0- \t. DiD!
INSULATION ( /..1/, P'//~/f'1
ELECTRICAL V
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
I
;:?Iy~ 7/1~/~
7ft--o/"1 - ~
FOOTING
11P
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
_ I I
FINALS
GRADING (Prior to Sodding)
BUILDING i, (, ,I,) '7~ allloo
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
W,r.. 1J.<30"11
~ J..l./-oO
~)) /o/zU/f 4
,A Q~, lO/l,Z ~4
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850