HomeMy WebLinkAboutBuilding Permit 03-0012
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CITY OF PRIOR LAKE
@.rparfmrnf of ~uilbing c31nzprdion
'J Final Permitted D Conditional C.O. Expires
fh: 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 Classification
SINGLE FAMILY
Bldg. Pemit No.
03-0012
Occupancy Type
R3
Type Construction
VN
Fire Zone
Zoning District
Legal Demiption LOT 1, BLOCK 3, DEERFTELD qTH
OwnecofBuilding Site Add,e" /7.500DEEP.FIELD DR
Contcactm', Name & Addcess D R HORTON, 20860 KE!'illRIDGE CT, '1100, LAKEVILLE 55044
ROBERT
D HUTCI'INS
fylJUilding Official
/' I
.Y.
City Planner
DON RYE
Date:
Date:
.~,...-..;-'-'
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
ADDRESS
/73&u 2-,4- (., Dtuhi.:-u) PK-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR,
PERMIT NO.
()~-(JoIL
o PLUMBING RI 0 EXlGRADtFILLlNG
o MECH RI 0 COMPLAINT
o WATER HDDKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
s: UI/I 7k6c r;1~
, \!.Y
/-)
J 1<
( (IOY 5"
'- --
a-wORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECT/ON BEFORE COVERING
Inspector: ~ ., - 8;- OJ. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
n 3C 0 O,..",,h-c I d
OWNER
CONTR,
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
""INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
J<!"MECH FINAL
DATI! nIlE
{,-((
-s~ (JO( L
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
I ~I",,,r IA/Uct JM~t7t'"/"",,, 11-e-.. Sgd .J.-
'f """..."\ v r~r ~,_IFrb...-e.,;r-
([.-pvvd:)
I
1./11 fi (
(J.-:;a,f r fl rf I/C l
K-- /-O~
o WORK SATISFACTORY, PROCEED
;rCORRECT ACTION AND PROCEED
o CORRECT.~JV1ALL FOR REINsPECTION BEFORE COVERING
Inspector: _1JLr (;,.... ({ rO;' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
"""""'
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
-------------------r--
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
fit..
ADDRESS
/7 :to
V1-fr A-c ( d
OWNER
CONTR.
PHONE NO.
PERMIT NO.
5-CYJ/1...
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
;;rPLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
() r(l41dl.-( r.11[:U!?S
~ f'1~ LID Ool.1.lNlIs1u. rl/7l';"
t'" {11(;ir 'L<-5-,,1,I,,,,, 1..,,/ <,(Vod/ J/1
hll,wJ101.u''+
o WORK SATISFACTORY, PROCEED
r;I CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINsPECTION BEFORE COVERING
Inspector: . A(? ~ 1~-1f7 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSIiOn
~-_._--~--_._---~-_.__._-------_._~-~----_._-
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT It) - / '1./0 d.i
(Please lVDe or orint and sign at hottom) ( ~ ~&t 6
ADDRESS l'\ I) 'I r
XY-X'i'i LiPheP1. (y,'Ve.. ~
I. White
2. Pink
3. Yellow
File
City
Applicant
I PERMITNO'~~DO[,zj
I I ZONING (otliceuse)
LEGAL DESCRIPTION (office use only)
LOT / BLOCK:!> ADDITION ~HeltL CjI1v
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER D f) \ I J- ..-r.,., .
(Name) . K. nDn 00 -4-L4...-
(Contact Name) :St-'f'VPL_tc'( ,kSOY]
(AddreSs)~A8f1?/l ~r-U{ff ~~ 10 ()
r
,
(Phone) Cjsz..-'19l:T 7g{J~
(Phone) qfiZ.';"'Z7r.,,-13~..j
TYPE OF WORK
JlI New Construction
OLower Level Finish
ODeck
DPorch
ORe-Roofing
ORe-Siding
o Fireplace
OAddition
DAlteration
Dutility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) S '\15.. c\ li; 1
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 loca11aws and will proceed in accordance with
submitted plans. I am aware e budding official can revoke thiS permit for Just cause Furthermore, I hereby agree that the oty OffiCIal or a deSIgnee may
;tel4'nJe,.;,.:; t ededl s emons olr;)()O~<;;7 /^/4jJZ.
~ rJ - eontr,clm's LIcense No ~'t,.te
I Perml(Valuation 1/ t:;; ~ 77 Park Support Fee # $ 1550, () 0
I Permit Fee $ / f) g :3, 5 c; SAC # $ /294'. 00
I Plan Check Fee $ /O<-f.Il? IWaterMeter Siz~l"; $ C15tJ,tJtJ
I State Surcharge $ c;<i? 00 I Pressure Reducer $ L/5. 00
I Penalty $ I City SAC and WAC # $ / Z 19 CJ dJ ()
I Plumbing Permit Fee $ I t)tJ, t!lf;) I Water Tower Fee # $ 700. () 0
I Mechanical Permit Fee $ 100.00 I Builder's Deposit $ I~oo. tJl!J
I Sewer & Water Permit Fee $ 35,'50 I Other $
I Gas Fireplace Permit Fee $ t..jtJ, 0 (J I TOTAL DUE
~
~;:-
/~~A1 ~
Date
Paid
Date
-7 :; <:1 i, .L).;:)
; - ?'-{)'d-
$194/ 0.3
I ~~ceiPtr 3 J^-7
This Application Becomes Your Building Permit When Approved
Building Official
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
"':&.-. ' . ~ ~ #~ a.Lf .~ F~.' I
Planning Director
1/ ,.2,,1o-.?
Date Special Condition!, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
..
( ~
.
APPLIANC~
PERFORMANCE TEST
Attach to gas fine adjacent to regulator
Heating Contractor ;/!;,:..:g ~.
Name of Tester
Date foJ'l~/t'l~
Job Address
J,..~
/7.?t:.(J ~/I-i;lPd
41;J4/.~.../L.
~/J/
~66t-
7,'$'%
Dk!"""
/i
0. .y;;
d S.J:>Ofi=
Heating Contractor
Name of Tester
Date
Percent 0,
Percent CO
Percent CO,
Stack Temp
Combustion air is adequately supplied per
UMC See, 606 rx; <;
input --8~ "t:'Xf)
,
,
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
FI L6 wi
{)3 - 00 1'2-
(Please !VD~ or orint and sie.n at bottom)
ADDRESS
/13&'() lA.-//e/d 'i:>r/V( ),[,
LEGAL DESCRIPTION (olliee use only)
/ .7 Durf,'r.!/ 9/1-.
LOT BL<5CK ADDITION
OWNER
(Name)
(Address)
BUILDER \
(Name) D, ,2. /-hy4~
-::rc 5<;,-.c ~
(Contact Name)
f!,L;.,ts
(Address) ~O'Kt,() /~"hYICI<:/ (4...,1
L"!uu,J/" /11A/' .5S~r9'
TYPE OF WORK
o Misc.
o New Construction
Jkt5..ower Level Finish
1. White
2. Pink
J. Yellow
File
City
Applicant
I PERMIT NO. ().3-0/ fo / I
PID
(Phone)
Date Rec'd
I I ZONING (offic,u,,)
(Phone)
(Phone) tiS,;} - YJ'.5'- 7 JO l'
ODeek
DPorch
ORe-Roofing
o Fireplace
OAddition
DAlteration
ORe-Siding
OUtility Connection
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 building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter u~on ~ pr~pe~to.,ye~rm needef i~~~1,~ns.
X YjL/~.M b)Jlh ,!)tJw5ZS 7 /- ~oc5
.- - Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
1 Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
\ Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
PROJECT COST IV ALUE (excluding land) $ 1</ 77"-
$
$
$
$
$
$
$
$
5000.00
,
74 . 7S'"
/ .5?J
tto.oo
?J[17zcmBuildmgp:~~;;oved
Building Official Date
Park Support Fee #
SAC #
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I City SAC and WAC #
I WaterTowerFee #
I Builder's Deposit
I Other
I TOTAL DUE
iltl _/
- / 17' C/<J I
:J- 7-~
Paid
Date
$
$
$
$
$
$
$
$
$ 11r;,. 25-
Receipt No, C/3/1'lb
Bv I r..-/
This 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
~:::ds;;J;I;A_7a;:A'rut~. "mpor~ Cmill,," o~~;:;;mc' md illows cone:o: ~om~:o:~cCU~::~rufi;t;=::~t b,
pranmng Director Date Special ConditIOns, If any
24 bour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
&~1;
FfLS'
Thf-('..nh.'rof lhfl'I.lh("ounlry
White - Building
Canary - En!'lineering
<:PInK - ~Iannl~
BUILDII'KiPERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
j'-./
~<
/1
-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I (
,..1;
/
I
/ >J-:- /
r:/ _:/
. ,! -- ~j
( ,;:".,-/
Accepted
./
Accepted With Corrections
Denied
r-
Reviewed By:
~~
K-UA
.:fLdJ~
~~
Date:
//~/a5
Comments:
/
I
"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."
~~
~~
The ('tnlrrnf lhr l..bC."ounlr)'
(While . BUil~
Canary - I=.lIym"ering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
</
R ~rbr-/
I D- JI-I- O;J
NAME OF APPLICANT
APPLICATION RECEIVED
'1)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: ~
L9-POA~ (k Lo+ /,. /3L3 ~dJ ~
Accepted
Accepted With Corrections
~
Denied
Reviewed By:
~~y~
iP~ aU ~
Date:
P/3/~ 'L--
~~,
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."
&~
Qv1~~'~
,
Th.- ('''010'' of th..l.ak.. COUOII"}'
W_hj!.~_ -~in9_
r--~..a.i"fiol - E"plrteermQ':>~
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
-'r, t
1/ / / ,!~/ /.j/'" -(~':l"....../
</ I - "-..-./ /"
! D- / L/~ (,) .:.;
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
" i" (" "-' .~. g/" ~
! /I"-Y," 1 " .' '. ~
i. /i ~:/t7 , 4 Ii '/1 ........... I . .-..J
1~? ,.~ j "'_.'. " '__': ! J- ~~ LIJ, I, ' L
. ! }
'/"'\1 f.-' ./),-
i IJ.... .f';- / .'1/ c.
p~ ~/UJ /4-.11- ~ .(,1/ '.
. - -' - /! ".'
", .,...,.
(f'y.,
'..-"
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
/rf}-[s
Date:
/d.-27-02.
Comments: ~F! RF!vF!r~F! Sirle for Addition811nform8tinnl
rtlC,I'", F/ (C
See Attachments' 1) Gmrling PI>'!". ?) Frnsion rnntrnl Mp.>'!~l'res
"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."
Feh, 5, :003 ::33PM
GENZ RVAN PLUMBiNG AND HEATiNG
N0:554 P 919
Date Rec'd
CITY.oF PRIOR LAKE
SEWER AND WATERPERl\1lT
q'1r.ase me or onnt and 'b'" at botlllm)
ADDRESS
f 73&D D e</Z.rldd DK-SE I
;~.:. ~~'. I PERMITNO'J1?_OO ,,,, I
), 00Jd AI'PJIGlnt U ~ L-t"
" ZONlNG(.Jlk."",)
i..,
LEGAL DESCRIPTION (olliee"", only)
I~T 1 BLOCK 3 ADDITION ,~~ ele. ~ ( I J ~ fh
~,
OWNER
(Name) IlJii 119rtGtl "'_'~~~::-_ ,,~^
PlD
(phone) _ q,<....;J.2-qS5-i8N\
(Address)
.2D &cO KeJ!lBK\ bL-€.. Cr S'r-..I f'f'\
(A~,)
Lak~~ I lie..
(City)
<')6')L1U
(Zip Code)
APPLICANT
(Name' Genz-Ryan PIIUllbin" & Heatin;;
(Phone)
651-423-1144
(Address) 14745
'..ICANT SIGNATURE
So Robert Trail
(Add...,)
rl~~.\sh ~i1s
o ,u ~ -4r.l PJ;1
~o~eIY).o'-:tI1.r _ MN
(City)
(Phone)
DATE
55068
(Zip Code)
(Contact Person) ,
651-423-1144
Oi .-& - 03
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure
Type of sewer pIpe, 0 ABC 0 PVC
Estimated length of sewer line feet
Clean out (if required) located at feet from structure
feet.
o Cast Iron
Re:31dc:ntla,J sewer and water hne conneCtIon
Sewer connection only
FEE SCHEDULE
$35.50 Industrial, Com') & Muln-famlly 1% of job cost: wIth a $39,50 rnitlJmwn
$1750 Water connection only $t 7.50
Estimated Cost $
Building Permit #
SEWER AND W A 1ER PER1--ITT FEE
STATESURCHARGB
TOTAL PERMIT FEE
$
$
$
<~
'-
Buildilli Officitl
IhIt
I Paid
I DatFEB - 6
:!lAID WITH
BUilDING
I P'I31<MIT
I"' ct
(Office t1~f: Only)
I This Applieation .Becomes Your Building Permit When Approved
,''':
24 hour nottce for aU in'pecrloIU (952) 447-9850, C.% (952) 447-4245
Fe b. 6. ~ 0 0 3
~
~ - ~
. ~ ~.t,lt~e.so~t'-
~33PM
GENZ RVAN PLUMBING AND HEATING
No~654
P 8 i 9
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~ ~;;:~; I PERl\UT NO_OJ? -00'''' I
J. Y<ell,.", ~tlll<<ll! :J ~
(Pl.e.1!t- Lytle or "nnt c1J1d sim at bottOm '\
ADDRESS
ii3idJ Dee;e.-h{'ld ~. S,f.
ZONlNG (officc",,)
.,,'
LEGAL DESCRIPTION (office ",. only)
LOT \ BLOCK 3 ADDmON ~.,e..f1 e I J cr-~V\
PID
I OWNER
ONam~ DR Horton Custom Homes
(phone)
4&;2' q '2~ -7'2lJ()
(Address)
::z.0'~(P(\ ,I Ao/1?1l t--,.", C
~ /Le.' ,,);o'_l ,h><=-'"
Sie. J CO
Lt:du.vd'c., .~\AN 58.cLJ w
APPLICANT
(Namc:)-G"'....._'C,........ 1)1 .._1...-f ""'f: (. ~,..........;.....S
(Address) 14745 So Robert Trail
(phone) ..6.5.1rI.? <_1 , (,./,
Rosemount
IlN
55068
(Zip Code)
(Contact Person)
(Address)
0Vl IQ (Sf) +ttt (\ ')
Q\N~ ~
(City)
(Phone)
651-423-1144
APPLICANT SIGNATURE
DATE
:2 -';J- -03
APPLICANT PL.EA..'JE COMPLETE BELOW
I QU:l.ntity 'type ofFixtu~e Quantity I Type of Fixture I
I ^ Bath Tub with or without shower A I Rough-ins 1
Dishwasber 1 I Water Heater 1
, I Floor Drain Q-"L Water Softner I
I '~ 1 Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine) 1
I Laundry Tray (1 or 2 COIDlJaronent sink I Sewage Ejector ]
Sbower Stal) I BacktJow Assembly I
I Sinks I Backtlow Assembly Test I
I I Bar Sink I Lawn Sprinkler 1
I ). Water Closet (Toilet) Other
FEE SCREDULE
fndusmal, CommercIal &- Multl~f8ml1y 1% of Job cost wIth a $39 SO minimum ReSIdentIal, New One & Two-Family $99.50
Residential, Additions & Alterations $39 SO
Estmlilted. Cost $
Buudmg Penmt If
Buildin~ OtlidaJ
Do.te
I Paid
IDfEB-6
PAID WIIH
50'
BUILDING
I~ii.
I By ..J.
()
PLU~mINGP~TFEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Oftitc Un: Only)
This ~\pplica(ion Becomes Your Building Permit When Approved
24 hOUf notic. fOf lUlo'pection, (952) 44 7-9850, fax (952) 447.4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
df?DY
~::y I PERMIT NO. ';...l -- ,....,
Apphell1t d lit.?'-
I. Pink
2. Green
3. Yellow
(Please .!We or mint and sien at bottom)
ADDRESS
/73UJ ~C'/~/L~- 5~-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT / BLOc0 ADDITION
PID
g.::e~RD,~, HorTon Cusbm Home~
(Address)d();/W .~hrie\Oj (2+.; Lo.kevi Ifp. Mf.0
APPLICANT II 'I' t M h--
(Name) rtl./Ot1 e~ ,J,1/1{l. (Phone) !1J51-45:L-cf(775
(Address)3lPS{) f<le.nr'l(A bee..~. Sfp #/ ~-:Q_aQY') 55/.22
(Address) v (City) (Zip Code)
(Contact Person) ~f..prey, Z;rnmp.r.rn Qn (Phone) to5/-A/S:J. ,:}77~
APPLICANT SIGNATU~J ~iZ (!. Ji?""~ D~'!15
APP ICANT PLEASE COMPLETE BELOW
I0NEW CONSTRUCTION o REPLACEMENT 0 AL n;:RA nONS
FURNACE MAKE AND MODEL 'Br'f"'t- 3~A-v'l?I.U)j 0 FUEL J\.JQ.tum.1
FLUESIZEIf'cla.s'i. '? . RETURN OPENINGS Lt- INPUT ,C,OCO OUTPUT 6lD.bOo
TYPE OF SYSTEM HEATING OR POWER PLANT
(Phone) q5~' q 'f?5 -7,;(7..2...
,t)50A../J...!
OW.rm Air Plants
OGravity
o Mechanical
~ Conditioning
[!'Vent. System
o Steam
o Hot Water
D Radiation
o Special Devices
o .other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
. FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64,50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential. Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Official
Date
Su. PAlD ,..
.50 ... ~I..i:JIN ym.,.., .
~ ml G P~f1~/1'
m 1 8 2003 I U)/ Receipt No.
~y I
(Office Use Only)
This Application Becomes Your Building Permit When Approved I
Date
By fr /
24 honr notice for nil inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please tv1Je or orint and siu at bottom)
ADDRESS
~. ~~~w Ii~icant I PERMIT NO. 3 - ) d- I
17360 DEERFIELD DRIVE S.E.
ZONING (office use)
LEGAL DESCRIPTION (office ose only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name'
n R HORTON
(Phone)
(Address)
APPLICANT
(Name) AT.T -TED FIRESIDE ORA FTRF.STDF. HEARTH & HOMP.
(Phone)
ti5] -ti33-25ti]
(Address)
7700 NORTH F AIRVlEW A VENTTF
(Address)
(Contact Person)
BRENDA HUSTON
ROSEVILLE
(City)
(Phone) _651-633-2561
55113_
(Zip Code)
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
3/24/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
OUTPUT
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVen!. System
o Steam
o Hot Water
o Radiation
D Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEAT N GLO SL750TR-C
Industrial, Commercial & Multi-Family
FEE SCHEDULE
] % of job cost Residential, Gas Fireplace
$39.50 minimum
$99,50
$64.50
$39.50
Residential, Heating & AJC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39,50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
PAlO WITH
8UILOING PERMIT
Buildine Official
Date
~'~~'~ \1 '\\j \r,
R 'J, a 1\l\l3
eceipt No,
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-98
, ax (952) 447-4~
B~~
/J--
~
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~12.. ~LD m, :;, E ~
NATURE OF WORK ,Jc:z,...J ClJAJsr- R.ue:n'o,.J
USE OF BUILDING SFA,
PERMIT NO. Q3- (7 (')/2- DATE ISSUED /~J/d 2.-
CONTRACTOR p,p-, 4;2TC,J . /,...k, PHONE 9sz-~, - Ify<f
,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF (1(~ ~
BUILDING AND INSPECTION
INSPECTOR
DATE
I FOOTING I ~L ~ I 1-(("
, FOUNDATION (Prior to Backfill) I",e flOlVIAN"/ / 1f\J{/ I /-l. I / \- J- q
PLACE NO CONCRETE UNTIL ABOVe HAS BEEN SIGN'ED
ROUGH - INS
SEWER I WATER I SEPTIC L-I un iti,s I/Irr;
FRAMING i)lrI.(",~,,,:> 011 t.\ IJvf "l,-\\) I fYf/
INSULATION I M/
ELECTRICAL I
PLUMBING ~ f l.. L J I tiJ. > :5.13/ /e::f
HEATING (if required) I "j,//If I ?(-~-C!J
FIREPLACE I /IVY I ~~J'-r&
GAS LINE AIR TEST ~I,^ + fP I tv(? I 2 - .2-ff-r(]
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
1~2 q -r/3
q-~-df
4-/I-cn
GRADING (Prior to Sodding)
BUILDING 1-ev11f (/vth!
ELECTRICAL
PLUMBING
HEATING
DO NOT
'6-(-"'7
rrrJ
;iy?
OCCUPY UNTIL ABOVE HAS
NOTICE
0- ;q-~
ro -lJ~c7'?
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.
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
f-II~
ADDRESS 17.3~ 'Aen;~1/ Pro
OWNER CONTR. P. (. M,,-4 'I
PHONE NO.
PERMIT NO. C2J-1 t..
Cl FOOTING
Cl FOUNDATION
Cl FRAMING
o INSULATION
[] FINAL
Cl SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
jjt EXIGRADIFILLING
Cl COMPLAINT
Cl FIREPLACE RI
o FIREPLACE FINAL
[] GASUNE AIR TST
Cl
COMMENTS:
6~- (Jf,
Cu(6~.. ~~
)(.wORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspect~ ___ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH &; SAFETY!
/NS/fOTI