HomeMy WebLinkAboutBuilding Permit 95-0450
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HOUSE HEATING TEST RECORD I.
ADORESS -1.% b ~ ~ Ll..ItASI Ul /7L- /'II, IQ. APT. --nFLGq.R _ CITY ~Y&UR.
OCCUPANT OWNER ''-0''1 ~ll&MMb
HEAT LOSS DATE HTG. INST. .
SOLD BY INSTALLED BY ~ttL U....!-A-n-
Electrical Work By ~ Gas Line By i^P~ IAfJot-'
TYPE OF HEAT GA _ FA HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
~."V GAS GESIGN
MAKE ~
~~:: ~ L ~ ~~ b
INPUT _ - . ~I~ ~T\A( pfl..
CONVERSION
MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE
Model
,.1..'" ~l
Vent Size r 1-0 S-
KIND OF LINER SIZE
Draft Hood ~/l. j)M ~, RegulaTor
Fi Iters Size ~mber
Chimney Location Insid,. II Outside
Chimney Construction lJ V bl\}r
~CONTROLS
THERM~TATJ ! Heat Plug
Valve ~r:~
Limit _5
Limit Setting Jrsb'
Fan Setting ~~ Id
Pilot Type ~ N\c.. SL
Pilot Make -
Pilot Model -- f
Pilot Timing ....l\ ().fJ:...;
L. W. Cut Off ---
r /)
Pressure 3 .U t;Jc..-- Percent cO2 ~.O
Input CFH I D() Percent O2 ,0
Stack Temp. 3,JO ~~ercent CO f'J
Form 235
NONE \/
Door Pressure
Wiring
-OIL. Test Tag
Lighting Inst.
/ /
V,
V
Smoke ~mb
Draft ~IL D(tArT
Date Tested 3, b .g,
Company Testin&t.t~~6~ WVk'-
Name of Tester M
1-"
CITY OF PRIOR LAKE
SEP 2 11995 BUILDING PERMIT,
TEM~.9R~flV ~IE!lTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
i
1. White
2. Pink
3. Yellow
File
City
Applicant
1. DATE
Permit No. c;~~SO
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
-r Ittl~
12. NO. OF STORIES
LOT
'-I-
PID jS J/~ - OJ9-b
BLOCK
J-
ADDITION
.... ~
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ESTIMATED VALUE
1: (J 000
17. COMPLETI N DATE
/J fc...5J#1 ~ Lt. IS" 199
7. TYPE OF WORK
New constructio~
Chimney D Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft. 000
S (Address)
r/4tJ 1"1 AI. 6-
(Address)
m~f"
r (Address)
~rtZo h1;1'1,2-
Septic 0 Heating 0
Addition D Finish Attic 0
(Tel. No.)
...3 Y'l-S23
(Tel. No.)
Reroofing 0 Porch 0
Finish Basement D
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
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 autho ized 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 voke this rmit for t use. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X - U - Z1-ar
License No, ,.. Dele r
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Side
MATERIAL FILED WITH APPUCATION
SOIL TESTS D ENERGY DATA
Back
Side
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET ~:+ ~: ~ ~w....\k.'O
USE OF BUILDING
-r. ~
TYPE OF CONSTRUC ION: I II III IV @
Occupancy Group A BEl H~ M
Division 1 ~4
Permit Fee ................................... $
PILING LOGS
o
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION _i Ic.jO,ot"'lt'\.Ot"lo
PLANS & SPECS n-- SETS
SURVEY
PLOT PLAN
~ COPIES
o
City:
Amount Brought Forward .................. $
Park Support Fee ...... ..................... $
SAC ......................................... $
Collective Street Fee ....................... $
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
11 O<?, '1 "'2. c;
lDlD.'17~
70.00
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer ....~C>::............... $
Meter Hom ......... ......... ........ ......... $
t;/ .'
Water Meter ..........y.l!l.................... $
D Sewer & Water Connection Fee ........... $
o
Check if
Deferred
Water Tower Fee ........................... $
Subtotal............................... $
I,B(p~. Cj7
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
By
ecomes Your Building Permit When Approved.
Date IO'3-Cj~
Certificate of Occupancy
Issued
Paid
Date!
in the above application and accompanying documents is in accordance wfth the City Zoning Ordinance and may proceed as r
ftutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of
10 -7., -q~
Date Special Conditions ~ any
24 Hour notice for all inspections 447-42309:00 a.m. . 10:00 a.m.
PERCOLATION TESTS 0
'/~(Il~ .CJ7
l)'i'O . On
~ C:;t\ . t"'I ('")
4 00 . Od
4<<0.00
/fC:; . no
, ( 000 . bf')
'700.00
1,t::;()C .1"'\ 0
qS-L(S]
~')-
~rN NOV I 5 19"j
CITY OF PRIOR LAKE
PLUMBING PERMIT
1. Blue
2 Gold
3. Yellow
File
City
Applicant
#~
Applicant: 869-7517
Address:
Signature:
Legal Description: Lot
S~eAddress: 14663 Blue Bird Trail N.W.
Building Penn it # qS-- '-IJo PID# ~S'- 310 - 039,0
NOTE: This pennit will not be processed without complete information.
FIXTURE UNITS
Unit
Quantity Type of Fixture Amount Total
2 Bath Tub with or without shower $ 6.00 12.00
1 Dishwasher $ 6.00 6.00
1 Floor Drain $ 6.00 6.00
3 Lavatory (bathroom sink) $ 6.00 lA.nn
1 Laundry Tray (1 or 2 compartment sink) $ 6.00 6.00
2 Shower Stall $ 6.00 12.00
1 Sinks: $ 6.00 6.00
Bar Sink $ 6.00
3 Water Closet (toilet) $ 6.00 lAnn
1 Rough-ins $ 6.00 6.00
1 Water Heater $ 6.00 6.00
Water Softner $ 6.00
Stand Pipe (washing machine) $ 6.00
Sewage Ejector $ 6.00
Backflow Assembly (RPZ, Double Check, PVB) $25.00
Backflow Assembly Test $10.00
Lawn Sprinkler $25.00
Other $ 6.00
Minimum Fee $25.00
SURCHARGE
.50
GRAND TOTAL $
96.50
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
o~ the State Plumbing Code and the am~dmentsJ!1ereof.
27b85 ~o.!!:/L/qJ DATE
~ ~ ,;; AITEST
Call for all inspections 24 hours in advance.
4629 Dakota St. S.E., Prior Lake, Minnesota 55372 I Ph. (612) 447-4230 I FAX (612) 447-4245
AN EQUAL OPPORTUNITY EMPLOYER
--~.~.."._------_._,~._----,._>--_,__,_.,^. "_~..e.__~_..~_
'.'.".0'- ~'__"."'"'.'~'~"'_"'~""""'~~____"~~"________,_.~_____.___,_________._,__.
Th. C.nlff of Ih. Lak. Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLlCANTcI<7-~-'/
APPLICATION RECEIVED tI/27/tfS-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~ . ,(L,;
/ if' tJ ~,(JbhJ./,- '1kA
Accepted
Accepted With Corrections
x
Denied
{2; 6,. -7-1:,
Date:
t,-,~s.~
Reviewed By:
Comments:
I. Ndt-c. a. \l Cotr>e.d,'1n\g
"2., Re0c9. _\ \ 0I..-\tQC.WuJ. v\~o...~
3. t\a.l\A\-~...... ~\~ ~~~_
~. Sd q. --n-u.c::. ~ r- ~ dev~~~ pl~
"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."
White - Building
Canary - Engineering
Pink - Planning
TIH C.nler or Ih. Lak. Co.nlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
j) {
NAME OF APPLICANT ~j(" l' t:' _ -.)~I ,.
APPLICATION RECEIVED j q II 7/15""
>. ............
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J d I I, 'i; - L ;-:/ / 1
'1 t ff,J 1:;'111 c {t, -/.. II /1 o..J:~ (~~I/I NE.W
Accepted y ~~s". Accepted With Corrections
Denied
Reviewed By: .4 ~~~
Date: 1(lIn/19C}5.....
Comments: ) "
,> , ^
'c. V'At ,/ ,,1.,/ "" ...'.<- '...,[
~ At. .J;;~L 9/29/9~. 3 ';3:sT. k1) ~ /~~
~ ~'
~ ;/~A~~" ~"/~~/L/.
/ ' /
tqvJ _ ~29/9o
~" :a;~ 09
I) d.f~yb..L # A-L-/.HAj~ .A/./~7 A 1Q<'~\99S:
"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."
"i,C. t,
p~ Chu.rn - ~Ot1eL("
c-~." ;I'....-.!If(...p.
,')1-."-
'78~ l't,f() ~
.
"~:. ,
CJ5- 4 50
Thr Crnl., or lhr Lakr Counlr)'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT J, 1-.,,-)r4r- _./ ~"'7 - 5..<~'
APPLICATION RECEIVED 4/2 7 /t? S-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ 1 t, t.3 /!)~l O)H!~ j ~, t:" lib
Accepted
V'
Accepted With Corrections
Denied
(d.
~
Reviewed By:
Comments:
Date: /t1;/a/1s
. JM~mllR-
"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."
GREEN - FILE
YELLOW . APPLICANT
GOLD. CITY
CITY OF PRIOR LAKE NO. q 5' - / L 7
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City.
PHONE:
869-7517
APPLICANT: Richfield Plumbing Co.
SIGNATURE:
ADDRESS:
DATE: 11/1/95
BLDG. PERMIT # '15'- '1sV
PID# O/S -...JIb - AJ~- tJ
SITE ADDRESS:
FILL IN THE BLANKS
1. Estimated length of water service
feet.
2. Size of water service
I"
inch(es) .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
PVC X
Cast Iron
5. Estimated length of sewer line
feet.
6. Clean out (if required), located at
structure.
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This application becomes your permit when approved.
BY Jt,~--,j.t k'Jt( DATE: II/t-/9J
====== ======== ==================================================
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
*
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 jJ/2-/1(
RECEIPT # ol..7c S /
AMOUNT PAID JS.5V
REC'D BY~l/
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 553721 Ph. (612) 447-42301 FAX (612) 447-4245
An Equal Opportunity Employer
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