HomeMy WebLinkAboutBuilding Permit 99-0700
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";;~I OwnerofBuildmg Site Address 4520 HUMMINGBIRD TRAIL NE ~, ;j:
(:,.~;, Contraclor',Name& ','.'", NOVAK-FLECK INC. 8857 ZEALAND AVE N.. BROOKLYN PARK MN 55441 !
1"",.\' ",.
(? (.L' ROBERT D. HUTCHINS A1P~ilyPlanner JENNI TOVAR , "....~
(' -:-~ BUlldJDg OffiCIal :_
l~~~: Date: /~-d)-7" Date: "~
(~ ~ ~ PO:.::NACON5PICUO~PLACE _ _ ; ~
(- ....... ........~..,~-.,..,.. ..~....,'.+....,.,...~..l~.,.~.~~., . ~....,.,. ~I-.... ,....., .... ....... J&,i'
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<<trtffirau at <13rmpanry
CITY OF PRIOR LAKE
~_ 1llepartment of lSuiIbing 3Jn~pection
~inal Permitted 0 Conditional C,O, Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various ordinances of the
City of Prior lAke regulating building construction or use. For the following:
Use Classificatic"
SINGLE FAMILY
!
R3
Occupancy Type
L12,
Legal Description.
Type Construction
VN
Fire Zone
_Bldg. PermiIN^ 99-700
N/ A '. Rl
Zorung District
B3 KNOB HILL 3RD ADDITION
'0"'"'
-,;:;
-C.',
/
,
!
ADDRESS
OCCUPANT
HEAT LOSS
SOLD BY
Electrical Work 8y
TYPE OF HEAT
MAKF
Mod.l
Serial
INPUT
HOUSE
!.I~2o \if VMM.INC>f$'~
^,OJ,A-l_K
DA TE HTG. INST.
H EATING TEST RECORD
~APT. _FLOOR
~OWNER
~;::- -...
CITY
Pnt,.i:/ f- U<"
X .SUBURB
INSTALLED BY fl . r r ~
. ..............- w
. Gas Line By
GA_FA~HW_STEAM_SPACE HTR. __UNITHTR. _OTHER
GAS DESIGN
f.-HC;~--
\R--&--' H- tD E.A'^'> 'C {(.
FO<; b.3 0 2- F 1'Lq '" og (,>0"':'
1.6>O.~ (t.' "v,
I
rl=9/'lTROLS
THERMOSr~T .'. ~ ~H.ot Plug I g
Valv._~~'-t It.Lz>:<l4--rOI (,
, ~
L;m;t gEl Tu j ~ '\
"'I'7d"
T......( ~.JI",.. r
.,. (!'i- r:.... :S P ArL" C
J....c.. ,,~. " ~
--
?...~{./.
Limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing
L. W. Cut Off
Pressure
Input CFH
Stack Temp.
Form 235
?,.-S ';"",( 'p.,c.ntC02~ L~
[0 'O.......-..P.'c.nt 0 ," /,0
..., _" 2- /
"'I L~ Percent CO f"j0
Wiring
Test Ta~'
l-------+--=---=- Lighting Inst.
, t< I '-t Ictl'l
tLLC.L.,A.-ft-
<;:U\ ,-{
UCJ
MAKE OF BURNEP
_ Model
Mox. BTU Rating
MAKE OF FURNACF
Model
Vent Size
5-'
KIND OF LINE}'.
Draft Hood :>r~.t.
Filters Size ,~
Chimney Location
Chimney Construction -
Smoke Bomb ~.
Draft
Door Pressure
Dote Tested
Compony Testing
Nome of Test.r
CONVERSION
r"-/
/"-.
/ "-
'"
SIZE
NON" X
.. Regulator .M.~l""''''' ,,'\ L "'7"2. 1:~ L
Z~ )' l Number
Inside \.. Outside
LC,,4-'C'''b ' ~
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~
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Form #5
, ,
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
1/-5'~q
10:0-0
ADDRESS U.t;?D
Wu~I,Mi
cOfAR.
PERMIT NO, qq - 7 co
OWNER
PHONE NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION ~ 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
~SULATION 0 SEWER HOOKUP
~ ~!NAL 0 LUMBING FINAL
o SITE INSPECTION ~~EcH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
ftt1S:~ y{;\ f~ 1'\IvUJV r\--c cltr-
",fJ \f(~ _ Gw':::-~ ~_S ,
~) ~ ~ ,~ ,L,.. . ~ r~
(.t) ~~ L~vV\ --hJo
W ~Thb %j;Jffr, '- (J J-\.cuc-S-
CCJ lhduJ' "A A" u",__h/?
j
~
( f~A
.......... d
co
b,
Y"- (-eo J
"",.,
~
U
o~
-
-
--~
CALL 447-911 '0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
(:ODE REetIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
V lNSNQT1
"
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
L/SZD
SCHEDULED 10/4-('1l 2: 81')
Hu H 1'1 (tJ~ et R./)
OWNER
cONTR.
PHONE NO,
PERMIT NO.
CJ1'~70d
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING Rl
o MEcH RI
o WATER HOOKUP
o SEWER HOOKUP
~PLUMBING FINAL
o MEcH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASL1NE AIR TST
o
COMMENTS:
I. P......,..t" @"..,,,-c.. .t..",.J.L, ..,I-.~. p"",\- ......,.,{..~
2.. IT.....: 1,." ~f .t;,..... loi.:,..... ~~
~. f?c,,^,,~ ~
o WORK SATISFACTORY, PROCEED
Ji' CORRECT ACTIO NO PROCEED
o cORR K ALL FOR REINSPEcTION BEFORE COVERING
Owner/Contr:
V I
..llliO FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ
"
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
4~o
~:
7-{S-cq
'l~~bfVl ~
!\'l,3"~''''<\'~ONM
SCHEDULED
ft:?o
OWNER
PHONE NO.
PERMIT NO.
Cn- 7(/0
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNOATION
o DEMOLITION
o FIRE PREV.
o PLUMBING RI
~ECHANICAL
WATER HOOKUP
EWER HOOKUP
o SEPTIC INSTAll
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRADIFILLlNG
o LKSHOREnMETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS: Go . L:..
c;!J PA.-.., ~f (
, ,.....J) .,p._ ill
.:15 P..:-. 1::' I" ~WO.
A'4'.u:;,..:o ..A......... t2-~ ...,~
. I/L. <L ., .,L.:.u".:... Je-..... ~ _
....... I. "
..2<:"'- '=11';.:1-- '" A..-
~ <t-e fJ"'....Lf'J. 0
~' ~LiL,(J" 40.
I r.ertfL- ~.,.--X..
__ ~~ ~r
..,.. J '.:.-..:0.. ~ ~--t;';)
~J" ViP~
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1.../- '" r -,,;
@
I
aI WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK'ffALL FOR REINSPECTION BEFORE COVERING
Inspector: .0-j ~, Owner/Cont,:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
"
'''T^'' "',,_.,--- ""~--,-'''.__. .._..
O~ PR/O,,"
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4,J'NNESOi."
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
JUN - 9 1999
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12, S'TE ADDRESS
4520 Humninqbird Trail N.E.,
3. LEGAL DESCRIPTION
LOT
12
BLOCK
3
ADDITION Knoh H; 11 1 rn Annn.
140 OWNER (Name)
15, ARCHITECT (Name)
16. BUILDER (Name)
Novak-Fleck, Inc.,
7. TYPE OF WORK Fireplace (J
A1terationsLJ
(Address)
(Address)
L White
2. Pink
3. Yellow
File
Cily
Applicant
Permit No.
c;q- 700
1. DATE
5/27/99
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth) (Depth)
(Tel. No.)
12, NO. OF STORIES
4 level
13. TYPE OF CONSTRUCTION
sm, Detached, REsidentii 11
14, FLOOR AREA APPORTIONMENT USE I
I
/
P'D ,2.5'--3#-02.7-0
(Tel, No.)
(Address) (Tel. No.) "i",q-.q~:J:; '-
8857 Zealand Ave. N., Brooklyn Park, MN 5544~
Septic 0 Heating 0 Plumbing CI Reroofing 0 Porch 0 I
Addition 0 Finish Attic CI Residing CI Finish Basement 0 I
I
x
'/
r
'-""
9. PROPERTY DIMENSIONS
Width Depth
I '
SETBACKS: Required
Actual
Front
Book
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILD'NG .5t: n
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS _.
16. ESTIMATED VALUE
$ 147,300.00
~7. Cu;~;:i~liuN DATE
Est. 9/1/99
10. CULVERT SIZI:.
Yes No
Sia.
Siaa
MATERIAL FILED WITH APPLICATION
SO'L TESTS 0 ENERGY DATA 0
. formation on this application which is to the best of my knowledge true and correct. I also certify that I am the ownElf' or authorized agent for
m2t aU uction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
it for us. ;urther~ I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
. ,. '/ ~ #0001631 5/27/99
~atur. ,- ( / ... _ _ Li:se No. Date
FOR ADMINISTRATIVE USE
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
PERCOLATION TESTS 0
SETS
COPIES
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION J L./ t'j,(JCY)
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A BEl H R M
Dlvlslon1234
1.12"2. ,,-S-
. '7.2im.
StatoSurcharge """""".""".".""" $ '7j..::scJ
~".f.l~".""""".""".". $ 1 00 ,CJ CO
~.p,csystem ".".tl.'b""."""".". $ J Q6.D 6
D\her'""".'1r.~"""""..""...". $ -SS.c;n
fi$iGLm. UM"
This p.' a' B mes Y4i Building Permit When Approved.
By ~ Oate t'/7-'t '7
Certificate of Ooc:Jncy
Permit Fee ................................... $
Plan Checking Fee ......................... $
City:
~
~\~\
Check if
Deferred
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC """.".""."".."".""."".."" $
CollectiveStreetFee ....................... $
BSrj .eX)
} (? S(M'H
Sewer Tap ................................... $
License Check Fee .... ..11..... ............ $
Pressure Reducer .qa................... $
MeterHom................................... $
Water Meter """"""".."".""."."" $~d.J$5, 00
o Sewer & Water Connection Fee ........... $ I. 2J"~r'9) . rJO
o WaterTowerFee ........................... $ Ji'!IC) . ro.:::>
45.(')0
Water Tap ................................... $
BuHder'sOepos~ """""""""."""". $ ""'C;eJ.~
..
Other ......................................... $
Total Due """.""""""""""". $ '-/UJ~/(). . / t-
Pa'd 7t:-7().71- Rece'ctNo, 3C~
Issued Oalo tR/U/"'i' BV~ ~
This Is to certify that the request in the above application and accompanying documents Is in accordance with the City Zoning Ordinance and may pr~ r~~st~. This document when
S~the ~~, r constitutes a temporary Certificate of Zonirl9compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be Issued.
:.... ,A~ 4-.t2..-'i:'"1
-- ity Planner Date Special Conditions if any
24 Hour notice for all Inspections 447-42309:00 a.m. . 10:00 a.m.
II
9v. 70 D
ThO' C....'..'of lh.. L.k.. Counl!')'
White - Building
Canary - Engineering
Pink - Planning
BUlLDI~ P'=~MIT APPLICATION DEPARTMENT C.HECKLlS'(
NAME OF APPLICANT
/V'[I (//-1 K.. - F t.. 6 c. K-
&/'-;/C;CJ
APPLICATION RECEIVED,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
L/520 /--IU'I"iN I /Va 5/12v ~
Nt:
.
Accepted
./
Accepted With Corrections
Denied
Reviewed By: LJAI.:rFA E"~~"''''AAJN
Date: 1./z~/q~
Comments: RVNOPF f\'tvsr r..~ (!o"'vE'r'E:O 70 4No "'LON("
.D~I"t(I\J~c.€
f.. vnL, rY c.q."E ...E.u-r:s ,<\S ~VU-/ I'ls P~Ac.nc.4L .
1'.0,.JSTA..UC-T.OIlV
~U'C.I.E,,~ _ ~..foc.)",,() f::1o..JTE.P.. '-r-ltS L.~7" rf?o-.. J../Jt41MI/'J6!llfl..f)_ ~~ ?..-Jt...y.
DAMAC.F1\
C.ONc..n..~ WI4L.K
?"qAl~LS
WILl-
i3r; REPJ.oc.E:/l By
T"J.-tF-.
a"'>'L~D'l..
PA.to~ 1'""'e h...J",,- S,CA.) oF=JC'.
~ 1~I"DIlMAr..^" ctJ
REJ'E..R ~ tE. ~ ,n€.
SeE.. Ilrrl/c.>-l....E.AJT<:, I. f1......... (!lI.ltor:;, IAJMIic:T1..v //'Jron.I'tl/no.v 7 t!QAOuvr. Fl.AN
'3.. E.R.oSI'l/IJ c'G,...,Tl'l.oi- ME'"A5uaCS
t/. tIC.oSfOJlJ C}ONTIl.DL.,. PL.-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 ptovisions of this code or other
ordinances of the jurisdiction shall not be valid."
, ,
',,~,,",.,.. ~~' . . ,,_ ._ ~ ~ _. J_.~
"1l"1'~. ..~^~-~.~._....,,,,,~
II
-'.~,." _ Y'~'''''''''~'' .m........"""!' ~""',~~J _____"y,"'"".
White . Building
Canary . Engineering
Pink - Planning
Tht Ctnltrof lht Lib Counlry
B..U.!l.D1NG PERMIT APPLICATION DI;PARTMENT CHECKLIST
NAME OF APPLICANT,
APPLICATION RECEIVED,
./ '. '/-/ J
(' c. (. /:.,'-:.._
/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
" II. _,'
/
f,
Accepted
v
Accepted With Corrections
Denied
Reviewed By:
~
v
~~
Date:
rn -'J2-/-fi
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."
~)
99 - 7(7)
Thl!' (',nll'r of chI!' I..kf Country
White - Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPJ"ICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT /V tJ {/ /-f K- - F t-6rl-K-
APPLICATION RECEIVED tb/ tf / Cjq
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
452-.0 HVn/l1/ f116 SleD Te.
NE
Accepted
Accepted With Corrections <
Denied
Reviewed By:
(li~~
Date:
(P-/?-?'l
Comments:
I.~ ",l( Qtt~ ~~
"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."
--"-----,-------'._--,---,,_._-------~"---,,".._--_.._~.--"- ''''_._-----''~_._-"'-_.------.--
_H - pw.e
.,eLLOW . ."~ICAJfT
GOLD. CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. qq-]OO
NOTE:
Sewer and Water
contractors must
be registered
with the City.
APPLICAN.;lh,OfY\~",.'Y\u.~\::-J, ~-r D, PHONE :LDI.,).-q~-'77/'7
n..._'1 C'\ \ ..... _ ' ,
ADDRESS:l5::lc\ \'~')J.Lll_ Q. N\:1J~PATE: L. -~-qq
,
SIGNATURE:~::~//l,,",~ ~ FOa~." BLDG. PERMIT # qq-rOo
SITE ADDRESS:~6;:}r. \\00.~~\"tf'rA\~L PID# 25-.3<14- 0,-7-0
FILL IN THE BLANKS
1. Es~imated length of water service
L\s-
feet'.
2. Size of water service
inch(es) .
3. Location of any couplings from structure 4~
feet.
4. Type of sewer pipe. ABS X
PVC
Cast Iron
5. Estimated length of sewer line ~c;
feet.
6. Clean out (if required), located at
structure.
---
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
Th!, s, aapp~p,li a/} ion becomes your permit when approved.
BY.. i!'iSJ.~ --, DATE: ~ -~,)'1
------------------------------------------------------------.------
--.--------------------------- ------------------ --------------------
.l::""ET:S:
$ 35JKO
$ .5 Surcharge &. QA A.
: 35. ~ TOTAL .~ .~_
Fee for either sewer or water individually
$ .50 surcharge. --
Sewer and water li~e connection permit.
*
is
$20.00
plus
* 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. .
DATE PAID
RECEIPT #
AMOUNT PAID. . ~rJrn' . "...
~."rr p\:.I"'I.~
REC/D BY ~\NG
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employe,
11
CITY OF PRIOR LAKE
PLUMBING PERMIT
I. Shoe
2 Gold
3. Yellow
FIle
Oil'
Applicant
Th.. c,,'uuor lhlt ukeCo'mll.,.
PP No. qq -70()
APPlica~t\""~"'{)\"m'n~ (' 0,~ Phone:.LPI~-q~" < -'1~n
Address:\Et"';\ ~~_~" ^~ 6.'\'-\',,,,,,,~b 'Iv\~ ':::J-:"~-'\':
Signature: ~ lilt\...-. ~~~"
Legal Description: lot -1.Olr Block ;& Sub RMb \S;., l. - &"l_~.
Site Address:4S d.n ~\.l..~~, <y~\ rA ----r",..:. I
Building Permit # CJC!-7{)() " PID # z.S" st.f-C? - Oz. 7-0
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
Quantity
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Rough-ins
Water Heater
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
Water Sollner
Stand Pipe (washing machine)
Sewage Ejector
Back/low Assembly (RPZ, Double Check, PVB)
Backflow Assembly TEost
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi.Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
GRAND TOTAL $
$
$
$
$99.50
$39.50
v
This permit is granted upon the express condition that said
contractor. shall comply i'n all respects with the ordinances
of the State Plumbing C th~ame d:n~ts thereof.
. '1'99 DATE
ATrEST
Call for all ins tions 24 hours in advance.
~ PAID WITH
~BU\l.DING PERMIT
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. Permll No. qt1~fO()
PrIor Lake, MN 55372
HEATING APPLICATION I PERMIT
Date ~~/99 PID' z.5~34-q- 02.7-0
Sfte Addre~s t;.~ J-ft1I1?hliNhn-.J !./r;/ I
lot /2- BIock.3 Addillon Cl:./II06 H/t.-L- :;:5'''0 ,!'IOON.
OWner's Name .A.J-rx;J::~ RPrJ:
~>CS?- 7eohri 4.A? A) [Py-cvH.r.Mrr
- - . ~ , .
Address
Heating Conlractor
Address
RICCAR HEATING & AIR
2387 COMMERCIAL BlVD, NW
. ~ ,:' JIJO'.'ER. M~~ ::~~1
Telephone ,
Furnace Make & Model tJ(hePrn
Model Size fyj
RJ-t-
Conn. load
Fueltf/Of
Flue Size
/5
9
Sl;
Supply Openings .
Return Openings .
Inpul,A:::x:2.CW Oulpul X2CVO
Edr.
Clm.
TYPE OF WORK
754-4000
TYPE OF SYSTEM
Warm Air Plants
Gravlly
Mechanical
Air Condllionlng ...,Rhcon-> ..:J~
Vent. Syslem
HEATING OR POWER PLANT
Steam
Hol Water
Radiation
Special Devices
Other Devices
New Construction
y
Repair
Est. Cost $
Replacement
Est. Comp. Date
Building Permft. ,
Alteralions
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAl PERMITFEES ~
.50
Q9-700
,-( PAID wmf""",
. BUILDING PERMIT 'I
Receipl ,
TYPE OF STRUCTURe.
l. hull.
1.0fftll
J. Yellow
I lie
Cil)'
Conlraclor
/997
Single Family
Commercial
y
Mutl~FamUy
Public Other
Two-Family
Induslrial
~-91!m
. ,
Fee Schedule
Induslrlal, Commercial & Mulli.FamUy
Residenlial, Heating & AC
Resldenlial, Heating Only
Residenlial, Gas Fireplace
Residenlial, Addilions & Allerallons
Resldenllal, AC Only
1 % of job cosl ($39.50 minimum)
$99,50
$64.50
$39,50
$39.50
$39.50
Remember to add the Stale Surcharge on the boUom ollhis applicallon.
The price 01 your healing permlllncludes one rough.ln and one IInallnspection,
Addilionallnspecllons will be billed at $35.00 each.
House Healing Tesl Record musl be submllled with 'v.'irll'Y' I!mIIIII '''''''''''I before build-
Ing cerliflcale of occupency wlU be Issued. .
I:I!;A[ CALCIJLATIONfll'lFOIURFO wllh number of supply and return openings IIsled per
room with CFM's per opening. New slructures or addillons send lloor plan wllh supply
and relurn localions 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,
Clly Hail business hours are 8 a,m, . 4:30 p.m,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447-4230
I hereby apply fot a mechanical systems permit and I acknowledge thai the
Inlormalion above Is complete and accurale; thallhe work will be In conformance
wilh the ordinances and codes of the cily and wilh the slale building/mechanical
codes; that this form does not become a permit until signed by the BUilDING
OFFICIAL; that the work will be In accordance wilh the approved plan In the
case of all work which requires review and approval of plans.
rw i1 .1 J. m/7i
.
Dale
~/30/qq
Date
Building ORleal's Signature
P.RIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 45;(0 HUVV\W1ilAjlo.r-c\ -\ro..i\
NATURE OF WORK Ne.w C<1\<.~tuJo"- ~\~~.
USE OF BUILDING Sr;D .
PERMIT NO, <71 - 7(Jo DATE ISSUED (. -/7- 9. q
CONTRACTOR AJ",vo..l.c - f"\ PC Ie-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
./. ) I~
, FOUNDATION (Prior to BackfillI A uq.:r I t'J-f- ('~~lf9
PLACE NO CONCRETE UNTil ABOVE HAS BEEN SIGNED
ROUGH - INS
@; ~t'.
(ClU
~/41'. ~ (j
Ir '
PLUMBING _ 7 \. ltiJ) ~
HEATING (if required)~~V~, }/-9'(;P '1k/-r" lJ I
FIREPLACE" 1/:1) ,gft/<r'f - I
GAS LINE AIR TEST Ifl) I K,Ah I
COVER NO WORK ~NTIL ABOVE HAS BEEN SIGNED
1-' I I
FINALS
11)6 II/~'J
f'tv4. Il.;}'3~
I FOOTING
SEWER I WATER I SEPTIC
FRAMING :3:::~. ~ ~. 9-/-11
INSULATION ~ W' 4\pl1{~
ELECTRICAL
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY
- .
113,
I
UNTIL ABOVE HAS
NOTICE
DATE
h.I-99
)- 1~' '7'7
&-Z3-CZO;
9. ()i-l- 99
"O-v
~~./ 0 ~H
BEEN 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.
Call between 8:00 and 9:00 A.M. for all inspeotions
FOR ALL INSPECTIONS (612) 447-9850
II