HomeMy WebLinkAboutBuilding Permit 06-0937
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C\'I'i O\1pRlOR LA}(E B\l\LD\1'lG PERM.\'I,
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1'yYE Of woRK
Permit 'J a\uation
Permit Fee
plan Check Fee
State surcharge
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Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Firep\ace Perm Fee
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Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
APPLICATION RECEIVED
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NAME OF APPLICANT
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is propose at:
Accepted
Denied
IX
Accepted With Corrections
Reviewed By:
(lIYJ{l;
Date:
/0'- ';l tf-O(,
Comments:";: See Reverse Side for Additional Information!
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See Attachments: 1) Grading Plan. 2) Erosion Control Measureg .'
"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 v,iolate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
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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:
/707_1 ~~r-~ $vJL
Accepted
v
Accepted With Corrections
Denied
/2fJ If Date: It> )0 fb
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Reviewed By:
Comments: A
"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."
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SPECIAL STRUCTURAL TESTING AND INSPECTION SCHEDULE
Project Name
Project Location
City of Prior Lake Brine Production Addition
Prior Lake, Minnesota
SPECIAL STRUCTURAL TESTING AND INSPECTION
Specification (1) Description (2) Type of Report Assigned Firm (4)
Section Article Inspector (3) Frequency
2200 1.05 Soil Compaction SI-T Weekly
3300 1.03 Concrete Reinforcing SI-S Intermittent
3300 1.03 Concrete Tests SI-T Weekly
Notes: This schedule to be filled out and included in the project specification. Information unavailable at that
time to be filled out when applying for a building permit.
(I) Use descriptions per IBC Section 1704 as adopted by Minnesota State Building Code.
(2) Special Inspector - Technical, Special Inspector - Structural.
(3) Firm contracted to perform services.
ACKNOWLEDGMENTS
Each appropriate representative shall sign below:
Owner:
Contractor:
Architect:
SER:
SI-S:
TA:
SI-T:
TA:
SI-T:
F:
F:
Firm:
City of Prior Lake
City of Prior Lake
William Hennemuth Arch.
Notch Engineering Co.
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
~ Firm
~. ~~rr:::
Firm:
Firm:
Firm:
Firm:
Firm:
Firm:
Firm:
8-16-16
* The individual names of all prospective special inspectors and the work they intend to observe shall
be identified (Use reverse side ofform if necessary.)
Legend: SER = Structural Engineer of Record
SI-T = Special Inspector - Technical
SI-S = Special Inspector - Structural
T A = Testing Agency
F = Fabricator
.,
Accepted for the Building Department by
Date
PRIOR -LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 11 01 -; f\ vEL tVd',s,J 5,.. -::;.t.
NATURE OF WORK ~C>DI'noN
USE OF BUILDING Jff A/t2 I
PERMIT NO. 00 ... ~ 31 DATE iSSUED \0 ~{ o~
CONTRACTOR ~~B~ut-.~ PHONE .
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
FOOTING
FOUNDATION (Prior to Backfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
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FRAMING ~11
INSULATION v'
ELECTRICAL
PLUMBING ~ ~,
HEATING (if required) [i, ~.
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
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