HomeMy WebLinkAboutBuilding Permit 03-0370
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Heating Air Conditioning, L.L.c.
12481 Rhode.-!~ltmd Ave S, Sa I., rll1!~. 952-894-0005
""
0rs1at Test Repoftfor Jobl _t)-:) se
Address 5011 6., urf 1J...ir;..Jn<:c,
Occupant
Date oflnslall -r. 7 - <:)";l,
Type of HT. F/A y HW
Other
I ~. Cilyj?1' wi!.
,
LA x.c
Space HT
UnitHT
Make I,.; . 1f\J~ v
Model /:5'lMf!"LI-I(~. D'iC; OJ
Serial ~.; xO 31 O'-lil'f P
Input '-In 1""('1 A TV< .H
~,~
Pilot Type
Pressure
Input CFH
SlackTemp
HOT SURFACE IGNITOR
C02
02
'-"!.- CO
L~
Date Tested
Company
Technician
" ).:--)D3
BURN$v/{LE HEATING & AIR CONDITIONING
/
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
$'4'1
(!jcJfP
fH-s
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
)i5 FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
-
DATE TIME
~,)t)
Tr
~~ >?I>
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~~.svu(
'!----tV/a, (
,
fl' WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~ A~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: Y Vt' g, ).0' 0;' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~,(
ADDRESS
~If
o>/ufF f145
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'3 - '370
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
O)>EWER HOOKUP
JIfC PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~~A
aJCc:~t?5
rt WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ffi t - ('if) Owner!Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
See Main File
1. White
2. Pink
3, Yellow
3 -d-f{-() 3
I PERMIT NOc?3 j 7()
File
City
Applicant
(Please '!vpe or print and sign at bottom)
ADDRESS
-5011 PWfr ;.j~/("JoIn 1M/'-
ZONING (offi" u,,)
PUD
LEGAL DESCRIPTION (office use only)
LOT3 BLOCK3 ADDITION ~mBr.n. tAusr AtJ/JI/lOl.1.
PID,;ls-ij002 -G6CJ-o
(Address)
PuL'[& J/~0 ! r Inn
~J.s Ma1Jlwcsr f~,
6J 11fi
7/16A11
.
OWNER
(Name)
II/I> ,
I
(Phone) i6J - L/ '>Z -5Zf)O
rrb1. $)2}
.
BUILDER
(Name1,
(Contact Name)
(Address)
.SA111 &--
I! 'l.II~_'AI",
.. - ///IT' D tJT.J,;#-7u.-v
(Phone)
(Phone)....Jj2 - ZZJ -I/~K
TYPE OF WORK
~ew Construction
DDeck
DPorch
DAddition
ORe-Roofing
ORe-Siding
DLower Level Finish
o Fireplace
DAlteration
Dutility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
9~ t1YS
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 budding offiCIal can revoke thlS permIt for Just cause Furthermore, I hereby agree that the City offiCial or a deslgnee may
;te'An P;Lrty;Z::~~ms ~ _ /37/ ~~~
" / Signature Contractor's Llcense No 7 ~ate
I Permit Valuation 'fa"Doo, 00 I Park Support Fee # $
I Permit Fee $ '1,;;.3. 7S I SAC # $ /2.. 75'. O~
I Plan Check Fee $ (000, tyt) I Water Meter ~e1JA; 1"; $ 2,t;;a. 0 II
I State Surcharge $ </5. II 0 I Pressure Reducer $ qS.OO
I Penalty $ City SAC and WAC # $ /20d. on
I Plumbing Permit Fee $ )ao. ad Water Tower Fee # $ 700, 0 0
I Mechanical Permit Fee $ /oO.OD I Builder's Deposit $ -
\ Sewer & Water Permit Fee $ .:$5. 5"'0 I Other $
I Gas Fireplace Permit Fee $ qt), Dt) I TOTAL DUE $6.314-"u,o/
This Application Becomes Your Building Permit When Approved Paid 'J-"')liI- ~ 11 Receipt No. {lL(d-rl
~ . Date
"1' .u..I2/-J '//to/O"3 /1 '::'l ""l.-::2 By ~/
-, - ./ '
Building Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with ~ty Zoning Or'l:a:Xd mlY proceed as requested. This document
:~=z Phnn~3:'mpo,uy C'rtifiC~1 ;~mg ~O;lion" ond illows consttucticree"lVtaIl1 CPileuponcy mustb,
Plonning Director ' t Sp,cial Conditions. if ony
24 hour notice for all inspections (952) 447-9850, (ax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
See Main File
T~ ("11'111'" nf ,... I..k. C_fttry
~ . ~ulldln!l
c. ;.". nqineeri~
Pink - Planning
NAME OF APPLICANT
Iru1.I.DING PERMIT APPLICATION DEPARTMENT CHECKLIST
O I' if.
I, ! ~,.-,? '.,", ' ("
r if l) ~Jillrl'&:'? '''lI
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APPLICATION RECEIVED
.~), I C~_ /'-',~-:'<
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity,which is Rroposedat:
~-l;// t! li( l/I-s ;-6 I I
Accepted
Denied
Reviewed By: Jll?f/rfJ,
Comments: .5 C 'L /lie, f>'\ {:,,/ f'
x
,
Accepted With Corrections
Date: LI-.21-03
"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 th~ provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~~
See Main File
~nIte - I:SUil~mQ:::>
Canary - Engineering
Pink ' Planning
TIl~ e..nl... of Ih..I..k.. Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
rP t6lfe IJom&5
8- d5?-03
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
c9011 ~/t0PP Ilk Ira}' /
Accepted
Accepted With Corrections ~
Denied
Reviewed By:
~~~
Date:
~// 1/03
,
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."
----1
See M~ln File
White - Building
Canary - Engineering
c-1'Iii1< . t'lannotllt>
Thf c-fnln of thr L.kr ('ounll'}'
RIlILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT.
,. ) /
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s;
"-"" ---"'-
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:
.', ", /~ ,..F i
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{_j , I ,,_.,./' / i./ ,I f! }
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Accepted
Denied
Accepted With Corrections
~
~
.:.f:......
Reviewed By:
Comments:
~d <..,- - ';,
-
~.JZ.J .ok
Date:
~ /11 hn
......
,
"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."
Al"r 04 03 09:44a
METRO GENERAL SERVICES
783-428-2988
1".3
GU.E._ . fM.1!:
YELlOW - APPLICANT
GOLD - eIT1
NOTE: Sewer and Water
contractors must
be registered
with the city.
APPLICANT: -YV\.o1n:o ~o~~~PHONE:..7h~ ~ t.l-ri..'6-d.93K
. ST, 111 rcli ,'U:;:.. /"l1N Ii I ..
ADDRESS: <?"7.,9(') Glu.e.NV\ ~NE..' 553'110 DATE: ...,.- 3JrL~
SIGNATURE:....---..\...k~ p~ . BLDG. PERMIT '#
SITE ADDRESS: .501 i ''R/.1.t~f Mot.1;;/' J,Nu,'L PID#
,F~J:!r, IN THE BLANKS
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
FAA '15;J".~ 'I"7-'I"J,I/,[j'
S.W.No,
3-'5,0
1.
Estimated length of water
III
Size of water service I
service
s-~
feet.
2.
inch(es) .
3.
Location of any couplings
Type of sewer pipe. ABS
from structure c5 feet.
PVC~' Cast Iron
4.
'-
5. Estimated length of sewer line
5?\
feet.
6. Clean out (if required), located at feet from
====:::~::~::~================~~~===============================
This application becomes your permit when approved.
BY
DATE:
========ff~/~=~~~=============================================
FEES: a~4 e~~M,i- sewer and water line connection permit.
~ '~~~) Surcharge
C tVa ~ TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge. --
* sewer and water permits' issued for new construction must be
recc~ "~ " . 'ng permit card at the time of issuance
~o i ~ '@t{~t[] ~ [E \!o licate sewer and wate& PArmi ts are
~ssu .! ~ ~~
DATE,:PAI y, APR U 7 2003 J AMOUNT PAID D~~
RECEIPT B" I REC'O BY ~ ~-9~)'
16200 Eagl~:Creek Av. S.E,. Prior Lake. Minnesota 55372/ Ph, (,,52) 447-4230 / FAX ('151) 447-4245
An Equal Opportunity Employer
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CITY ()f PR10R lA}:..E PU.':--'f3,:'';C; PZR...'-fIT
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wacec Clo:;et (Tc>rf..,I
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HE :; C fiED LLE:.
fncl1:i:::;t!. Ccmr:;e:-c:::ll &. '''[u.lri~r~mily l~f, oCco COst 'Nirh:l 539.50 minimur.1
E:.;~im.J.t~~ C.Js: S
R!::Side:lci:Ll. New One Jc. Two-FJmil~ 5;950
::t.;:::c=~:ial. ."I.!~;{jcns ~ .J..::;:~-=:un:i 5:7':0
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This ^pplic~~ion Bccome:$ YO:Jr Buildin: l~ermit Wben Approved
PUJII-U3lNG PER;\UT FEE
STATE SURCH......RGE
TOTAL PERMIT FEE
BuddiR( omci..:
Due
oy
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6- 6-03;10:57AM;
;952 894 0925
# 2/ 4
I
CITY OF PRIOR LAKE
HEATING/AIR CONDlTIONINGIFIREPLACE PERMIT
Date Rec'd
i ~~:" ~::, I PERMIT NO, '2._ ~7 ,..{
J. Yellow ApphCIIRt J <oJ Y
(Please!yp! or print and si21l at bottom)
ADDRESO /I Blv./{
Hfs.
fy,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
j
~
Ii
,
LOT
BLOCK
ADDITION
PID
p tUu::1
I
'SLVi-k IL{O
(phone) 05(- L/~)-5;;}{yJ
c;(j()GUt7J (J1 rV ~51 ~ I
)
APPLICANT
(Name)
(Phone)
Burnsville Healing & All., me.
12481 Rhode Island Ave. So.
Savage, MN:Allliaiffl-1122 (City) (ZIp Code)
(Contact Person) ....\ \f-L/\ 7 (Phone) '1'52 - 89 L( - 000 >
APPLICANT SIGNATURE ):vj...u. Q ~ DATE It; (to f O.:s
"J....., I I
, , APPLICANT PLEASE COMPLETE BELOW
klkEW CONSTRUCTION Q REPLAS;EMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL L-0t/)flIiJV b~19 Q-;)-SO FUEL No.). qC{)'
FLUE SIZE RETIJRN OPENINGS 5 INPUT 50. om OUTPUT t{ b ~ 6 Do
(Address)
:1
,
~
J
;"'~
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
~ir Conditioning
OVenl. System
L-.M/vusf.
I b f\ c:..6;;tY-
rJ-,TUN
,
HEATlNG OR POWER PLANT
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
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Healing & Ale (New Construction) $99.50 Residential, Additions & Alterations $39.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only ~ $39.50
If 101') cO ~~~
Estimated Cost $ , l : l) . Building Penn it # i= fI!/~ '()~~ J!f)" ~
HEATING PERMIT FEE $ 3~ /5D '~.bu iQVJ ~ '
STATE SURCHARGE $ [j ~..;/O f^-" -..J ~J'
~;:: :p~:."" ...... Yo" ..:::"::::: :::- ' I "tf; ~ (~~ ;~I~I "No
I Datil JUN 1 -By ~ (lJ
Building Officinl DatI! U '-(;'
'J
Industrial. Commercial & Multi-Family
$39.50
~
14 hour notice for all inspections (952) 447-9850, f,a.~52) 447-41.1:
PRIOR LAKE
DEPARTMENTO~a ~,{. FOl
BUILDING AND 1~&TtWaln 1 e
INSPECTION RECORD
SITE ADDRESS SOil 81 u,ff llis T~
NATURE OF WORK ~IN '
USE OF BUILDING ~ F R
PERMIT NO. 7D DATE ISSUED _
CONTRACTOR S PHON~. ;)'-~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
, FOOTING
~I
I
j
SEWER / WATER / SEPTIC
FRAMING L..J / r _
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
~
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I
I fA ~/m
~Gk
~
h- t 7Dt03
II!) I ~e t<<?
]
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
Yl1'/
16' ~ ;,-d- tIJ
vvV.I
WV'
<<-/-n")
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SIGNED
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