HomeMy WebLinkAboutBuilding Permit 99-0897
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
ltt::;ln/BL-
ADDRESS
L{ Ljlt~ (' J.v,~"'V\.uT l /1 ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
c;q - fjCl'7
/
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
cg / _ "Q> V-~'"1,1 C(Cy~-
\HttO-<~I~j4 V~f~
-t - ~
rY. - ,~/9t0 ~ \/)0 /, -
V - - "'--. ...
~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~"
Inspector:
Owner/Contr.
'--'
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
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{?r,ey LK"
ADDRESS ~L-A5 ~"'\J\.l....""" /..rv
OCCUPANT. C, T2. O-'^' 1'..., ~,\,,-
HEAT LOSS PATE HTG. INST._
SOLD BY <:::'\,>r,,-_ \.\,-,
Electrical Warle By
TYPE OF HEAT
HOUSE HEATING TEST
I\>L
RECORD
APT. _FLboR
,OWNER
CITY
SU~
INSTALLED BY Rn'h 1:-
/ - Gas Line By A..r, h .::1... .
GA - FA L...HW _STEAM _SF-ACE HTR. _UNIT HTR. _OTHER
GAS DESIGN CONVERSION
MAKE
ModoJ
Serial
INPUT
('/~r"';,~,...
c:.."'1<CA\, n"'\o - \'-1
-s; ,afcry A \ "*9 <; /
<,("f",~
,MAKE OF BURNER
. Mod.1
. Max. BTU Rating
, MAKE OF FURNACF
Model
"
~ /
X
\
THERMOSTAil."i(,,1--\ CCONTROLS
Valve "LJ t< Heat Plug
\")0
\ 30
T, _ ~j\
(... \ \-''-..l
C:;-). ~ - \J ~:::.:'
Vent Size
, KIND OF LINER
Limit
lirrylt Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Mod.1
Pilot Timing
L. W. Cut Off
.
Pressure ~.< \ I '-
Input CF;;- "'i("'i
Stack T omp. :'::l. '\"')
- SIZF NONF
.R.gulofor)--./.......'X.' ""\~,-,
Num~er ,
Out.id.
Draft Hood
Filter.
s;zell, )(~~)( \
Chimney Location
Chimney Construction
Inside
~.L...,,.- 4
y
~ .....~t"~'X(
~-,-<~,-~
Smoke Bomb
Draft __
Door Pressure
.Wiring
.Te.t Tog
lighting Inst.
....
"v--/
/ \
"I
/ "
~
P.rcent CO -, \ ~
Percent 02 -15- I q
Percent C02 ex
/"
Date T estod ,- 1 ;;;,J... - l) D
Company Testing,_ <:;: )....._ r~ J.-t.t'~
Nome Dr Tester ~_ _ ~.:_
For," 235
, ,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
I (-v.. ( 0() I " 30
ADDRESS
44 crSc. H~I\lUT ~c
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
)(PLUMBING FINAL
~MECH FINAL
9'1'.897
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAsLINE AIR TsT
o
COMMENTS:
(J~ /. s...-"p.o ~+.." ,.l,.."....
O~ ;Z . Slle""" ~,J \-"0.; \ -+0 Skr~ 1;:"\.
)(, 'S. 'lJ{ Sl2. \"- <" \.-.<.. lAc;) .cJ.......,(' ./-,., 'J"'-='t.....
~I.\, lli)tr\f.<>.A \:=""A.C. ^--
<'), )?,^""",,,""'t,~ o..flCl,HtlJr. t r"? ~.~ .f.\h'...h
en. ~)jJ.. -.L.. ~ 'ppt- \)o'~du..f-..P~
'f. ,"/, .St,n\ P.o""~'A. J4~\'"' \ \1\ ~'l'V\Cu'...Jl toOVtA
o~~, S~r"l"{l 111r&r...l-h>q:\'"",,- v~ C('\)A.,,{.,.,.,...
c>*-~_SortlK' $.1 ",'-'-~(\r<;( c.~
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Ok\ I ~,:~ ~:~ ..y~U~
tG . ~~
~Q('lI'Ph O/U t").\-C.a.~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
)\ CORR'f"'lW ~RK, CALL FOR REINsPECTION BEFORE COVERING
Inspector\ --U ( ) Owner/Contr:
v 7
~
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
II
._-_._--_._-~----_..__._--,----,~---
, ,
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
9,;/(J,M
31ao
ADDRESS
L/*1s:- t!-#6S71z/C/T LAJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99- 8<;7
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RJ
A 0 MECH RI
'MWATER HOOKUP
SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAsLINE AIR TsT
o
COMMENT~: '\
(" S\~&.g. 40 P\fr..,.. .
~ lltt ftJtr0:k ~,~
V G"..J r~ ~ dwM ,\Nc..u
(
~ <t ~ ~ be "k ('~..ek..
~ ~ GI<......---
ED
EINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CAL 447-9B50 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
"
CODE
'MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
II
'I
CITY OF PRIOR LAKE
INSPECTION NOTICE
, SCHEDULED
DATE TIME
t/2.2.(Cl, p.. T:
ADDRESS
~~9S-
~A-
OWNER
CONTR.
PHONE NO.
PERMIT NO,
o FOOTJNG
o FOUNDATION
o FRAMING
o JNsULATlON
~FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ~ t--t.....JZ.J
,/,~
....,.;
r A
\p
'"
Cj1~J7'7/
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAsLlNE AIR TsT
o
,,-'
~/:..
"~
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<',-..._,~.'.. .,,-c.'_.....,-'w.'.'< ..,~.:.__",....-,-,.. ,.. ,---..~
"-,.....;.,,._.
~ORK SATISFACTORY, PROCEED
(DV CORRECT ACTION AND PROCEED
o CORRECT ~ALL FOR REJNsPECTION BEFORE COVERJNG
Inspector: ~ r Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
II
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CITY OF PRIOR LAKE
BU~ING PERMIT,
TEMPORA Y CERTIFICATE OF
ZONIN COMPLIANCE
AND UTILITY ONNECTION PERMIT
r 1,DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 7 -'2-3 -9. 9
2, SITE ADDRESS .....t 1.. \-r:.
4t\-9 ~ ~.o-.. \ . ~ u.::x- ~ I'\J t:.- ,e..r
DATE RECEIVED
1. White File
2. Pink City
3. Yellow Applic;
1 h-3(i1
Permit No. 1 7-817
DIRECTIONS
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT I BLOCK 4 ,
CJ>....\Z.~'A(oc- 1-\\L-\..5
12. NO. OF STORIES
ADDITION
PID 25 -3 \~ -03z-o
4'~~,::>
13. TYPE OF CONSTRUCTION
4, OWNER (Name)
"-"~~ <k.l\~.',,;.,j
-5. ARJHITECT (Name)
6. BUILDER
(Tel, No,)
K-.~ \., .. ':/ 1+o.1\"'T"1"""".
(Address) '(Tel. No.)
~ o-r--I...\<-A-. n-..", ='372
(Address) ( _%.1. No,) fG;. 15,NUMBEROFOCCUPANTSORSEATS
(p 'Z- - 15 OCCUPANTS
\. ,ck. ~ '. b.. .4$ I '-H.. 9 b L--A-r\. ~"~...J JI\. ~<.."i"'""" \~ '""- SEATS
~ Fireplace 0 Septic 0 Deck 0 Rs-roofing CJ Porch 0
Alterations 0 Addition 0 Finish Attic 0 Rs-siding 0 Finish Basement 0 ~ PROJECT COSTNAL~
~ ~s;- 'eO-O -
17. COMPLeTION DATE
(Address)
~'K.("
14, FLOOR AREA APPORTIONMENT USE
(Name)
~e.I'-
---'-,~'.!
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
''"''
""l
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished i. ,;...., .."'.:......, 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
bUildin~'t""\":~it to~t caus., Furth.rmor., I h.r.by agr.. that th~ cjty ojf;ci~r a d.sign.. may .nt.r upon the prop.rty to p.rtorm n.ed.d inspections,
x~\,p!..." :.0-'(. 'T3(,.'1' "'7~'Z.~-GQ
- Signature \ license No. Dale .
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FJLED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
BUILDING DEPARTMENT VALUATION
~F-D
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION It".r;; ,C'),O t>
~ /
SURVEY
PLOT PLAN
o COPIES
o
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
DMsion 1 2 :3 4
Permit Fee ............................... .... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ...................................,..,., $.
Collective Street Fee ....................... $
Sewer Tap ................................... $
, $
Pressure Reducer ..qe,.................. $
Meter Horn .................... .... ........... $
Water Meter ....f8-~~...................... $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
P.fiO.cn
1 r.J 50 .or")
Plan Check Fee ............................. $
---
1.'212. ~..,
"7R,?"'1Cn
P>2.S0
State Surcharge ............................. $
Penalty ....................................... $-
Plumbing P.rmn Fee .~1,~,$tL..... $ 1 eJQ. 00
Mechanical P.rmit F.. . '~:'~1"'''''' $ I~ we, m
S.w.r&Wat.rP.rmit ..1.:.!l..~...... ~ S5' .00
Gasair. P. ,Ft..j'j.:.f!:f.1.......~ 4~.DO
This catio eco uilding Pennit !lthe~proJrb
By Date ~~
Certificate of Occupancy
liS. ex>
I :;;25',06
1.200.De>
'i
"70t') .<90
Water Tap ................................... $
Build.rs Deposit ............................ $ I. &f""Ot) . (9.eJ
Oth.r ..TpeR.,~d-:.......... $ , 5 CO,DO
Total Due ........................,..... $ P, 2<93,2-1
# -
Paid ~ ~(n.;;rt R.C.iP~N~ 0~f?J()
Oat. J!J7/4q By 1M"--
est in the above application and accompanying documents is in accordance with the City Zoning' Ordinance an~ may proceed ~-requested. This document when
on~porary Certificate of ~Oning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
CRy Planner ~ $pecial Conditions if any
Issued
24 hour notice for all inspections 447.9850
I r
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White . Building
Canary . Engineering
Pink - Planning
Th,('tnIUof th, l..ak,Country
BUILDING PERMIT APPLICATION DEPARTMENT CHEC~L1ST
NAME OF APPLICANT
APPLICATION RECEIVED,
d
.....
<;
t i
1,,- i /\.1':""1 f /)l
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(".... -' C( "i
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: , /
i / A / l---..'
4 4 1 -' , ~ ~ I ! \f "
.. ~... ~ \...__,1 i\., <:...:. [ /0....; / l_~A,''''..i i",' I . L_, ,
~
Denied 1\ A ,
Reviewed By: f.A ,t);, ~
Comments: *!Je.' U~i t- t:on/1()f be, /~c:v,;kcf l/l
Accepted
Accepted With Corrections
Date:
<i/1 {1~
5/dLlu,d~
"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."
71-397
Tht. C""tll'r or Ih" uk" Co.nlT)'
White - Building
Canary - Engineering
Pink - Planning
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
d /) :-> / J
. K. rA(Z..ir2(/)(~,,-""' t-J()".'h~:S
7/7. 3 /qc,
,
APPLICATION RECEIVED
The Building. Engineering, and Planning Departments have reviewed the building permit
application for construction activity ~iCh is proposed at: / ' \ /
44cr~ CHcsr fJU T LAAle- N,&,
Accepted _ ./
Accepted With Corrections
Denied
Reviewed By: WALT':' E"'fJ€';"'III11/IJ
Date: X/'O/"
.
,
Comments: R."...o~ "'lor. lSE l'oNvEt'EO 1C> "'ND ,'!LONe,. DIUt/",Ar.E ~ r.)T'<lrY
_E.A'iFIIM~&JT'I:. ,Q<: Muc.w AS A?Ae.~A(_
5E.E JNFDAM4T\ON 1")41 RF.rm.<E Sl~
SFe "'rr"lc"'''''f"~: I. t..u"L IJ.....AE 1.0<"'<:,,<>0., I NF"o"'''''AT",AJ Z. atll9DINI!. R...,v
3. E:'ItOSIO........ I' ~uITttD'- t11~ t:'C'
<I u.a<:,n,u C"......,.".OL R...-'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."
. ~ T';<"""~7-'-'~'- ..,''''.......-.._.~.~,.~..-
-' -- ~;......."....-..,."..,~.~.,--'_..-.....~,....,...._.~..<"-,.,-..-,_.......,.-'.-'
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it
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71-1397
Tht' ('I'IlIt'f of lhl' tab Counlry
White - Building
Canary - Engineering
Pink . Planning
BUlJ-DING PERMlI.APPLlCATION DEPARTMENT CHECKLIST
NAME OF APPLICANT d. - f!... PAA.i,zt/)6cf- ;JCW7Gs
7/'Z3Iq~
. "
APPLICATION RECEIVED
The Building. Engineering. and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: J 1 /:
4--4C(')" CtfGsr fJ() T LANC' IV,&-,
Accepted
Accepted With Corrections oZ
Denied
Reviewed By: G2 j) ~_~
1
Comments:
Date: "1- ~ '1- <=t,cr
t. eQr>r.l -H-o a.\:1e..c.k....<"l ~"uk-
"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."
II
,u
.. ..... .........".,-..--
GIIE~N - F"~
YELLOW - APPLICANT
GOLD - CITY
CITY OF PRIOR LAKE NO. '1'1- 897
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the city.
APPLICANT: /~ 'C!.4f1>lV1 ...l.,)~
ADDRESS: ~~1,r J}tJiA A.y4- ./Jp
SIGNATURE: k{~~.... a
SITE ADDRESS: /.file> '"' ~7 --t:...
PHONE: '17)-,\,//4
063'&ATE: <l- l,~- 7' oJ
BLDG. PERMIT # "?CJ'i?97
I< I PID# 25 31 '+,. 032...- 0
, .
FILL IN THE BLANKS
1. Estimated length of water service
S6
feet.
2. Size of water service /
inch(es) .
3.
Location of any couplings
Type of sewer pipe. ABS
from structure
PVC y-- Cast
feet.
4.
Iron
5. Estimated length of sewer line ~V
feet.
6. Clean out (if required), located at
structure.
feet
from
==================================================================
===========C======================================================
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
Fee for either sewer or water individually is $t~.50 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
AMOUNT PAID
-PAlt' WITH
REC'D BY ,BUILDING PE',:;:,;:IT
RECEIPT #
4629 Dakota SI. SE, Prior Lake, Minnesota 55372 / Ph, (612) 447-4230 / Fax (612) 447,4245
AN EQUAL OPPORTUNITY EMPlDYER
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Pormit No. CjcJ - 0q 7
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Dalo II- I(A-{''-] PID. 25-3/4-- 63Z-C
Sito Address l;Vr, ,- (i, I' ,':l"AL.r I.';AL- 12. /
Lol I Block 4 Add~km (~A.e/O /16[. II /L-l 5 47H
Owner's Name
t ''k a...JAdo___
{)
Address
Healing Conlraclor ALLIED FIRESIDE dba FIRESIDE CORNER
Address 2700 N. FAIRVIEW. ROSEVILLE. MN 55113
Tolephone' 651- 6 33 - 2 5 61
FIREPLACE
illJmIIl.IJl Mako & Modol 11....1 A) C I.
Model Sizo,
.<V' 7~ 71"
TYPE OF SYSTEM
Warm Air Planls
Gravity
Mochanical
Air Conditioning
VenL Syslem _
Conn. Load
Fuel &1
Flue Size
Supply Openings
Relurn Openings
Input OUIPUI~J.>
Edr.
HEATING OR POWER PLANT
Sleam
Hol Water
Radialion
Special Devices
Other Devices
elm.
TYPE OF WOnK
Alleralions
Replacemenl
y
New Construction
Repair
Est. Comp. Dale
11,)3-4'>
Est. Cosl $
Ilrx' u--,
c; 9- 89'7
r p~'O WITH
\ BUILOING pj;,r,"in'
Building Permit ,
HEATING PERMIT FEE ~
STATE SURCHARGE ~
TOTAL PERMIT FEES $
.50
Receipt #
TYPE OF STRUCTURe.
I.rin"
2. GfUII
J. YC'lIuw
Fit.: 2
Chy 0
CnlllUtlOf(
,
...
en
I
\D
\D
o
"
..
111
\D
~
Single Family
Muni-Family
Olher
Two-Family
Commercial
Public
Industrial
Fee Schedule
Industrial, Commercial & Mulli-Family
Residential, Healing & AC
Residential. Healing Only
Residential, Gas Fireplace
Residential, Addilions & Alleralions
Residenlial. AC Ollly
1 % 01 job cosl ($39,50 minimum)
$99,50
$64,50
$39,50
$39,50
$39.50
"
....
,
III
III
....
a.
III
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,
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III
,
Remember 10 add Iho Slale Surcharge on Ihe bonom of this application.
The price or your heating permit includes one rough.in and one final inspection.
Addilionallnspeclions will be billed at $35,00 each.
House Healing lest Record must be submiued wilh 11Ilih1iM llmIIIiI ",...."p.. belora buil
in9 cerlilicale of occupancy win be iS$ued.
l:!fAI CALCULATIONS RFOlllR.~ with number of supply aod return openings listed
room with CFM's per openin9, New slructures or additions aend noer plan w~h auppJy
and return locations 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,
en
111
...
City Hall business hours are 8 a,m.' 4:30 p.m.
en
IN
IN
III
III
I hereby apply lor a mechanical systems permit and I acknowledge Ihallhe III
informalion above is complete and accurate: thai the work will be in conlormamoPr.
with Ihe ordinances and codes of Ihe cily and with Ihe state building/mechanh
codes; Ihalthis IorIO does not become a permit unli1 signed by the BUILOIN
OFFICIAL; Ihal lhe work will be in accordance with the approved plan in the
case 01 all work which requires review and approval of plans.
An"nv, )),,7'_ 1//II.I~r
APP~.7Ji~ ~rature ' Dale
.J;!Ijltl.~,---- /1/16/9<7
Building ONicara Signalure Oal.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
"
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...
Oct-11-99 08:11
D&D MECHANICAL INC.
612-890-4650
P.Ol
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Quantity
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3
C ITV OF PRIOR LAKE
PLUMBING PERMIT PPNo, 99...P;q7
Applk:" .1: D1-D rru!.~~~;,..f) {Ie Phone:---4'.....<?" - '8":J-gL
Addre'i' 7111 0J, ldJ-t'- a. .....I-1J . - - / . ........-;; '" 55:5 7.17
Signall e:~... , . 0~
(/
Legal!. 3scrlplion: Lot I Block 4- Sub l'.^~IM~ H/I j$.. 41li
SileAd ress: ~~t?_~ f"111~:5rAJ~ ~ R./
Buildi". Permit 1/ qq - 'il"97 PID It, zs,-314- 032.-0
NOTE: This permi! will not be processed without complete in'ormation,
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FIXTURE UNITS
Type Lit 'ixlure
Quantity
Type 01 Fixture
Bath Tub wiLh or wilt'; out shower
Rough-ins
Warer Healer
Dishwasher
I
I
W:llor :..'Ilillll
Fh"'\\H ~r:1in
Lavatory (bathroorll ink)
Laundry Tray (lor 2 :ompar1menl sink)
Shower Slall
Stand Pipe (washIng machine)
Sewage Ejector
Backflow Assembiy (RPZ, Double Check. PVB)
Backfiow Assembly T esl
lawn Sprinkler
Sinks
Bar Sink
Water Closet (toilel)
/
Olher
5" "".fJ P '-"""P
FEE SCHEDULE
Industriai, Commercial i, "'ulli-Family
(1% 01 job cost, $39.50 I Inimum) $
Residenhai. New Qne & wo Famiiy $99,50 S ttt:t, 5(J pd. ~U~
Residential, Additions & Ileratlons $39.50 $
Slate Surcharge $ .50
GRAND TOTAL
\N~ .
$ ~ PER.t-A\1' ,
, e\l\lO\NG
"I 5 pemlil is graJUctJ upon the C.ll.prC1S condition Ihat s3id
\ tractor, shall cumply iOn all respecls ilh Ihe: ordinallccs
he SI'lC~ ins CotJc d the an mJIfI us thereof.
C 0, · DATE
h TITST
_. ,
all for all inspectiuns 24 hours in advance.
16200 Eagle Creek Av, S,E.. PI r Lake, Minnesota 55372/ Ph, (612) 447-.~:::30 1 FAX (612) 44i-,L45
An Equai OppUrlUnilY Empluyer
, I
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. P",mil No. qC; ~ &97
Prior Lake, MN 55372
HEATING APPUCATION I PERMIT
Dale 1.0::1;).. -Cl~ PID II 2S ~ 3/4- - 032.- 0
Sll9l1dd,ell!l JLL/:ct5 Chpqfy,!A+ LflYIp> NF. k.1
LuI l Block 4- Addlllon C-AfZ.I'C.lA,66 rllL.L.S 4- TI+ AD D N '
Owne,'sNam" c.R.. f11ririrl(}fO, /-Irrnfq iN,
Address ILi/otj/ J IMr!('J/J...., I1U1l~.J dt-j.lJr' LiLt!} ~:~ tB..
Healln;ConlractoT ff/lf-e.l HrfJ.1tno,
Address il3b3 0,
Telephonell ~ - 'I) 1../ a. - !l1o.../b
'~r\i..\'" '
Furnace Make II. Model ~V ()qn.illL
Model Size
Conn,Load
Fuel
Supply OpenIngs
,-1/
Flue Size .,
Ralurn Openings
Inpul8Z": (XX) OUIPut-=z.t: or::xJ
Edr.
Clm. J~
1)'5lILJ
TIPE Of SYSTEM
Warm AIr Planls
Gravily.
Machanlcal
Ai, C<>nd~kmingQM-;lPr . ?,KtJl..CJl!)p
Vanl. Syslem
HEATING OR POWER PLANT
Sleam
Hot WalaT
Radlallon
Spacial Daviee s
Othe, Devices bel') Fi~f{Ar~'/
Allelallon~
Replacemenl
TIPE Of WORK
Naw Conslloelion
1/
R..palr Est Compo Dale 1- /8.. - (')0
Est Cost $ 115,9)0- (50 lluildlngPermU 99- <A9r'/
. I
HEAThlG PERMIT FEE
STATE SURCHARGE $
\'it\ TOTAL PERMIT FEES ~
.....::..:
~.:.~l:~::.p~,..
.50
,,~\O VJ\i'\-\
Re~\.D~g.~'t.
1. \iu't"lI
J. Ydl~
[i'f
I:DMraC-tl;ll1
TYPE OF STRUCTURE
Single Family
C<lmmerolal
)(
, Two.Family
Induslrial
Mulll-FlUlllly
Public 01he,
o
n
-<
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...
f\J
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Fo.. Schedule
Industrial. Gornrnerolal & Multi-Family
Residenllal, 1'leaUng & AC
Resldanlial, Healing Only
Rosldenllal, Gas Fireplace
Re&ldenllal, Addlllons & A!loraUons
ResldOfllial, AC 0 Aly
I'll. 01 'ob cosl (S39.60 minimum)
$99,60
$64.60
$39.50
$39.60
$39.50
..
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...
...
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m
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m
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House Hanllng Tesl Aecord musl be swmilled wilh bu~dina IlmmiI number boloro bulle ""
ing C<llllficale 01 occupancy will be iss\Jed. ~
;0
HEI\I !;Al.CIlLATlO~ m:.QUIAED wllh number 01 supply and ,alum o~onl"1ls Ilsled ~
room wllh GFM's pel opening. New slrucluffie or Rdditlona sand 1I00r plen with SUl'pty
and relulI1locaUons shown, HEAT LOSS CALCULATIONS, PAYMENT AND
APPLlCATlONS MAY BE MAflED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CAEEK AVE. S.E. PAIOR LAKE, MN 55372.
Remember 10 add lhe Slalo Surohargo on the bollom 0111111 appllcalion.
The prlco 01 your haalln; parmillncludes one rouvh-In and ona liAallllspecllon.
Addll10nal inspecllons will be bllied 01 $35.00 each.
City Hall business hoors are 0 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH.IN AND FINAL) . CALL CITY HALL
441.4130
I hereby apply for a mochanlcal syslems permit and I acknowledge lhallho
Inlormallon above Is complol.. and accurale; lhal II,.. work will b.. In conforman.
wllh the ordlnollc9s end cod..s ot th.. city end wllh 1110 alala building/mechanIc ~
codes; Ihallh!s torm do..e not become a permit UI1111 algnad by lhe BUILDIN f\J
OFFICIAL; thollhe work will be In accordance wilh Iho approvad plan In \ho ~
case of all work which requires rovlew and opproyal 01 plens. S!
10 -f} .qo, :u
Dal~ is)
f\J
/0/12./99 d
A
Dela
Building Olllcal'. Signaturo
, ,
.. :.U"'~UII:UII"=-II'MI=r...".,
::4 Building Tradition Sinc. 1934"
\0 - -Z-""Z... -O~
C-l~ e..s;=- ?Me-r- ~AY "" '
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Ct If
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T\-.. -<2- ~ 0 y--, ~.......r V l1\ - t L ~// O~
~, {\ / r- '\. (J/fl
R-Q.......Q, '^-\. ,~O.. -:r-.s. '\..::. - ~ '-.."'Z-.-J /' q1
1?- #-
'r~ p~ ~ \, "2--$ ~ Lf.'fCf S--+-- Lfq.cq ~
C-t--e-s:~u..::r. ~€-/' ~(~
cn-1 (-'2.-(-00 ~ iO-9~oo ~
''is a -0....:",\ A-t:::,. \:-\ ~~ -\:-0..
C-.t<-.t'>Ar \-\~e. ~S
~~ K.'?~e
Chuck Partridge · 14696 Landau Lane, Prior Lake, MN 55372
Office # 447-1846 . Fax If 447-1846
I r
"
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ljyC,S- (l~~vh_A.. L."''-''--I
NATURE OF WORK l\\.p""~~N&,~
USE OF BUILDING Sf'-iJ
PERMIT NO. Cj'<J -'?-J'ff DATE ISSUED ~-L'" -'i i
CONTRACTOR (\. ((. J?c..r~,.,,--A...,sz-- l-b... '\ ___
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
JNSPECTO~ DATE
I FOOTING l)'fu I B - 2."? -"!<t
I I ___.
, FOUNDATION (Prior to BackfillH~lol-,,~4-~ 6(.. N.t,Hi fI1' 9/3/1r
PLACE NO CONCRETE UNTIL ABOVE HAS 4!EEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC if I ~4A. "'1 ~
FRAMING V....... I
INSULATION ~ "/'VIII."Vr'l l
ELECTRICAL 11
PLUMBING I Vb /pI"II",
HEATING (if required) I /j/j1 N J~hcJ
FIREPLACE I U (;_1) ,~:i1h 'J
GAS LINE AIR TEST I V
ll--~~ql1
~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding) I "if!. e".,
BUILDING ~ c~~~\-oO I &fp,.'
ELECTRICAL I _
PLUMBING I (J:JlJ ..
HEATING I ~6 .
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
-
'-~/tq/~o
~ .. I Ie!ir-;Y/Ol
I
I /-""21
I I -""2 (
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 inspections
FOR ALL INSPECTIONS (612) 447-9850
II I
"
DATE TillE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
'I"30-d/
PHONE NO.
'119,1:) Chdriu+ L.Vl~ AI!
CONTR. c..l fe;'; 0'4 ~
PERMIT NO. flJIt:1-li/C; ')
ADDRESS
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
dii'....'~L
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/
n(ElCI8dbIFILLING
DCO~T
o FIREPLACE RI
o FIREPLACE FINAL
o GAsLlNE AIR TsT
o
COMMENTS:
nil (? c.
~_J~
e
,
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINsPECTION BEFORE COVERING
Inspector: #?~ _ Owner/Contr.
--=-
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI