HomeMy WebLinkAboutBuilding Permit 03-0369
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BUHNSV.L~E~
Heating & Air Conditioning, L.L.e.
12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005
Orslat Test Report for Job# S;l 5 I
Address .5 009 13L<.A. r r
Occupant
Dale of Inslall --,- '7. n.z,
Type of HT. F/A Y HW
Other
,
I-It. ''-lit r c. T (.:' City fQ IcR L ^ ~ t:
Space HT
UnitHT
Make ~ " )~ \;",--.,,/
Model (>~ I uP. '7<.lp. - 04';- 0 \
Serial b 7;(Y'J., (' (\'-\UU 3,
Input lll\ .IV...,.., (-.,tu H
Pilot Type
Pressure
Input CFH
Slack Temp
Date Tested
Company
Technician
HOT SURFACE IGNITOR
~ . -: CO2 c; 4 '!~
* 02~ ~/.
CO :J.?,~
tl(/()~
BURNSVILLE HEATING & AIR CONDITIONING
~.C~,r',.,.____ 'iO.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
tMq
f!j urf: /,../ 4..
, ' -
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.. FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o j!LUMBING FINAL
ol!f MECH FINAL
DATE TIMe
f;..- /E')
']- 3'"1
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/~~-
COMMENTS:
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~R:1J'LL FOR REINSPECTION BEFORE COVERING
Inspector: IVV. . ownerlConlr:
CALL <&47_9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
""""n
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
-E)NSULATION
~~INAL
o SITE INSPECTION
COMMENTS:
rI\~ ~1-~ DATE
SCHEDULED ~ (13103
5c:c9l &OFf I-lt<) -(RL.
nilE
CONTR.
PERMIT NO.
()~ - 3M1
o "yo"ILLING
o ~ilT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
::..J<,~<-'E (ul{(l..51DP e f.-n-t('-f (5co'1)
~f.A. o-rl'\~r<. GA~f':::, S-ro(ls
- UI>DE - ()i(
o WORK SATISFACTORY, PROCEED
XCORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InspectorJfA- .j . ~_ ~ OWner/Conlr:
CA~L~~O ~~ THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
IIUNOn
---_.'-~-_.,--_.._..,..- ...-.-.- ....~ -_.._--_.._--~._---_..._...~,...-
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~" 1--<1
ADDRESS
SCOq
(!J/ rIF- I-#s
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~r3C;f
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o jlEWER HOOKUP
.iil"PLUMBING FINAL
o MECH FINAL
o EXIGRAD!FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
(9 (elM.tJ /r(
YlInh.# tJ(
o ~RK SATISFACTORY, PROCEED
'CORRECT ACTION AND PROCEED
o CORRECT,r )~LL FOR REINSPECTION BEFORE COVERING
Inspector: Y ~ "l1l'> Owner/Contr:
.
CALL <&47-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNS1<<)TJ
-------- ---~---,_..".__.._.._...
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ._' <'1 C---f""l'""::J
AND UTILITY CONNECTION PERMIT 3 -c:::;;I-O . V..:J
Main File
~se type or print and sign at bottom)
JDRESS
5000/
ZWPr )/~/("Nn 1"MI L-
IVNER
ame)
6 F (Y}11.
fKUYo' ,S;/Tt:.
~dress )
JILDER
rame)
Jntact Name)
ddress)
Sfm&
&tE-T j JAf:a.lLu)
'FE OF WORK
[JJ"'"New Construction
DDeck
DLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
Misc.
I. White File I PERMIT NO
2 P;ok C;'y 03- -'/':""'9
3. Yellow Applicant -<.f, I
ZONING (offic,u,,)
p u.... 0
PIDdS- L!OJ.. -010-J
(Phone) 651- 'I~Z- SZ1JD
fA6An. IY/J1 55121
/110
(Phone)
(Phone)
DPorch
ORe. Roofing
t/;JZ- ZZ;- '19~
ORe-Siding
Dutility Connection
9~ ~.5
~reby 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
110rized 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
ffiltted plans I am aware that the bUlldmg officIal can revoke thiS permit for Just cause Furthermore, I hereby agree that the City officIal or a deSIgnee may
"upon ropertyzZ~.e:~~ 6C- /37/ -..3/.zr ~
, SIgnature Contractor's License No / ~b ~
iGAL DESCRIPTION (ollice use only)
~)T J.j BLOCKS ADDITION 'hrJ113prz C/ltS r
itJ..!&- MmE$
~J0 II!o/lWWli:-:/
~
mit Valuation 9~Q()o.,()0 I
mitFee $ 9Z.3.75"+
n Check Fee $ &'00. ~J./ l-
te Surcharge I $ 15.00 .+
laity I $ I
mbing Permit Fee $ /00, 0 D I
'chanical Permit Fee $ IOd,od I
'fer & Water Permit Fee $ 3'5. 5"lJ I
s Fireplace Permit Fee $ ~O.()O I
his Application Becomes Yow Building Permit When Approved
~'~I-
rfiolo:l
Dale
Building Official
DAddition
DAlteration
#
#
I
I
I
I
I
I
I
$ I
$ CdJI4--. &9 I
,
. 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
'0 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
ed. ,...
2 . 7'~~
~ --
Planning Director
I Park Support Fee
I SAC
I Water Meter (Size5~1";
I Pressure Reduce'?
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
(V Fuel" (;:, (.1
/ 1_ 4 ?':-'"'1
I Paid
I Date
~~
#
#
$
$IZ7~.l)d
$ ,d6a.o 0
$ ~5.o"
$ /:J.,00. IJd
$ 700. ()O
$ /50d,OO
-
I Receipt No. !:IL/::r/ '1
Bv ~p ...-
0-
~/o:J
Date pecial Conditions. if any
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~
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Main File
White - Building
I'" ('anarv - ~nalneellnu "f
Pink - Planning
TM (-.."I.., or It.., I..'" Counlry
BUilDING 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 wQich is proposed at:
/i .~ f
~<: ./} -j" ,_:,~:j i..i " / f
-." 'i 1,'_ I \/. -,.-/, A-/'\
' ~ " .,~,i '_. .C I "
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...... '.~../?,'z<,<...".-"
Accepted
:x
Accepted With Corrections
Denied
Reviewed By:
~(\
Date;
I../-:;)I_Q <.
Comments: See Reverse Side for Additional InformCltion!
me"r, h I,.
See A ttachments' 1) Gr"r1ing Plan, 2) Erosion Control MellSlIrp"
"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."
._ ,_,,~""*'_'N'_'___
~~
Main File
f White . Buildiiia":>
. Canary . Engineering
Pink - Planning
Thf'("f'nt..rnfthfl.abCount.,.-
.RIlILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT. 'Ph UL f:.I-m~
APPLICATION RECEIVED. 3 - ?g-~3
The Building, Engineering, and Planning Departments have reviewed the building permit
app';,.Uoo jo< 00''5;; ;;'nM;iP#ij~
Accepted
Accepted With Corrections ~
Denied
Reviewed By:
~-L',
;e-.tJ
~j.J Date: ~I Oft' 3
/21/ ~..LJ} ~-~,
t!h..-- ~ ~ ~
Comments:
J(~ --'~
t
&v.::tA./J,
"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."
Main File
White - Building
Canary - Engineering
~ .. t"lannmg)
The Crnltr of Ihr L.kt' ('OUnlf)'
F1ll1lDlNG PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
'7
.-
/"
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
C';;:-'Y
/
~/' C----
Accepted
Accepted With Corrections
v/
Denied
Reviewed By:
Comments: . If, (' .
~ 1~~ Date: ~o~~
~ ~:.-. .,..:1- .~- -~ ~dtJ
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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."
pr 04 03 09:44a
METRO GENERAL SERVICES
763-428-2968
p.2
GIllIN. rlLf:
YELlOW . ....rt.tCA..,
QCK.D . ClT 1
NOTE: sewer and Water
contractors must
be registered
with the city.
APPLICANT:m.e1.:M .~oJ~W.u~PH9NE: 7h~ - tf..:J.J?-~:l38
I7\' S-r (YI,cHr-:tI=-[,""MN .
ADDRESS: ~C'jO ~\V''''''' 1~Nl=: S~31LDATE: .if!3/f"I'"
SIGNATURE: \... ~~Q. -g. ~~~ _ .."BLDG. PERMIT #
SITE ADDRESS: 5 0 0 cl 73..t2ull-~, t;;-:r f1A-<k PI D#
Vr) ()
FILL IN THE BLANK~
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
FN- 95".:1..- 1ft( 7-tf"l-L/~
S.W.No.
3~3b9
1. Estimated length of water service
S-('"\ ,feet.
2. size of water service
( 1/
inch (es) .
3 .
Location of any couplings
Type of sewer pipe. ABS
from structure C5 feet.
PVC 4-" Cast Iron
-
4 .
'----
5. Estimated length of sewer line
S>?'I
feet.
6. Clean out (if required), located at feet from
====:::::::::~================~~===============================
This application becomes your permit when approved.
DATE:
BY
========f7;/~==~~~=============================================
FEES'~ a ~ ~~M,f- sewer and water line connection permit.
~~~_~ Surcharge
lJo~ TOTAL
Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge. --
Sewer and~~"'~ ~tI"~tri~~ .W-sue~ for new constr';lcta,n.~ be
recorded 1Y1~ \W:jll~J.t1lil . rnlJ. t card at the tJ.me -?f!!.D~ce
to insure at no dupli e sewer and water perm ~~~e
~ssued. APR 0 7 Z003 LJ <;;:~4fI'"
DATE~PAID AMOUNT PAID
*
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*
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...,.....,
,.....,.
By_
REC'D BY
r;r
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.-;....
~, :::";,~:: ~ECEIPT #
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+ ~;!' .1~:~t~:~~ "w . . .
~"~l*,".: 16200 Eagl<::Creek Av. S.B., Prior Lake, Minnesota 55372/ Ph. <"52) 447-4230/ FAX ('152) 447-4245
, .if::>' An Equal Opportunity Employer
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j-:I.J;.:.:;ra~" T:,,)(~ ()r Fi,"Ctur~ I Q1l:.1n[l\" Typ(~ of Fi;O::iJr::
..J/ ! EJ.r:: lqlJ I.v~~h Qr W(!:llllH shs"'\',::- I. of. R,1u:rn-lns
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1 :1c:'.Vl!.!-': El~~:l)r
S:lckri"w. A.,em 01 V
S:lcktlow Assemhl:' Test
I lawn Sarinkle. . '"
lOw".
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Show~:'" Sc.::.ll
Sink:i
B<lI" Sink
W"~'er Clo~e' t T vii",)
3
Hi. 's(:HE.Dt;U:
[::.c!u:;:~.-:L CCr:1!:':"'.c:',=~:l.I &. Mlllti-f:mily t % of lob '::J;):[ 'Nicb,;J. Sj9..s0 minimur.1
RcSidocbl. Nc'.v One: &. T'o"o-F:unily SC;:9.!O
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E.;::ir:1:.t~:! c.JS~ :s
6l.:.ik!.i~; ?~:7;:it ,;
PLU",W(NG PER.\.UT fEE S
STATE StJRCl-t~GE s
TOTAL PER.;....m FEE S
lb. P-4JD
.5ou"lD'I\'G ~
~17-
(omc; L:.1C Ord!')
r This A~pncJ.don Bcc:ome:J Your Buiidinz Permit; ,"Vhcn Approved
I
i P~id
0'1'"
I Receipt No.
I By
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8u.llojjn~ OfIiti~r
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;952 894 0925
# 1/ 4
6- 6-03;10:57AM;
Date Rec'd
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
: ~~~, ~::, I PERMIT NO. '.,) - --::<1 b rJ
l. Y~llow Appllf;.ml ....::> '--' ~
~ ~ or Drint and SiliID at bottom)
JRESOOq (jILl~'(
ZONING (off",uscj
I-f+s,
~
I r.
-
,AL DESCRIPTION (office use only)
Burnsville Healing (X A1\J. mG.
12481 Rhode Island Ave. So.
Savage, MN:~tl.1122 (City) (Zip Code)
'-\ \)\.l/\ '?- (Phone) C(52 - ~9l{ - 000 S-
'LlCANT SIGNATURE ~~ lJ... ~ .4 u .~ DATE
'--.) '..) ---
, APPLICANT PLEASE COMPLETE BELOW
- ooNEW CONSTRUCTION Q REPLACEMENT 0 ALTERATIONS
tNACE MAKE AND MODEL L-0ttl (J;fJ'{......, 0;l b Q~ -SO FUEL IV oJ:. ~Gt ')
JE SIZE RETIJRN OPENINGS 5 INPUT 50. 0-00 OUTPUT 4 b . 6 DO
(
TYPE OF SYSTEM HEATING OR POWER pLANT
IT
BLOCK
-
NER
:ne\
~ress) q, \ <s
-
'LlCANT
lmp'
dress)
ntact Person)
PID
ADDITION
PuL \ k l--ttr7'YU::S
1'JiJ\.J
(phone) 05 (- L/5)-5;){IJ
~61j0J/7) /111'11 ';;5/;) I
PrUD ~
I
'Sw-k.. IL{O
(Phone)
toflofo~
I ----.~-.
OWann Air Plants
OGravity
o Mechanical
agu.ir Conditioning
OVen!. System
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
~yUSf.
lb PI c..6)..Y-
d-...TuN
EPLACE MAKE AND MODEL
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Jstrial. Commercial & MultipFamily
Residential, Additions & Alterations $39,50
Residenlial, AC Only 6'U ..o...q, $39.50
-11,100 ,co ~a !lOIA.
Estimated Cost $ -t Building Permit # , !/'I\tQ ry/~
, $ 3> I SD fJ/~J' .o~ I <h..r
$ .50 r::' ~ ~
ice Usc Only) $ ~ 1\ ~ I&~
'his Application Becomes Your Building Permit When Approved ~~\~~ \~ ReceIpt No.
~'l ~ l} ry(\\\3 '
~ ~fi)at~\J~ l' - Y
Building Orntial Dat~ } \
identlal, Heating &. AIC (New Construction)
idcntial. Heating Only (New Construction)
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
24 hour notice for.U inspections (952) 447.9
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)RIOR LAKE DEPARTMENT OF M:lln File
BUILDING AND INSPEC~
INSPECTION RECORD
SITE ADDRESS soo, 8/1f."fT H+s rR.
NATURE OF WORK A/~~ c..ONS+r/;C..c,+i "A,/
USE OF BUILDING ~ Iff4
PERMIT NO. I:) ~e. i.J DATE ISSUED _
CONTRACTOR . ~ H"'A~S PHONEkD,...z,-,.,- "'toW.5
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
'FOOTING 4VlA*{ (l(JjCTOR W--7r DATE . l
, FOUNDATION (Prior to Backfill) I 1A ~ 1ft?'? I t./-.l--8""d3. /s:si'-3
PLACE NO CONCRETE UNTIL ABOVE' HAS BEEN SIGNE.D
ROUGH - INS
V t;y~
;/l/Y ./
,...---,~
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
11 ~ }t.CI)
c;. ,J. Crd(
(j,'?701~
JIl1./
;i!ip
(;.- a-dJ
G 'U'Ol
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/CIe- e,(:?- 0 ?
rvP
j
q~l/--rf!.
-
(W/
v1;y7
OCCUpy 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.
{j-FrlJ
<j- hi-().,
BEEN SIGNED
FOR ALL INSPECTIONS (952) 447-9850