HomeMy WebLinkAboutBuilding Permit 99-0981
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~ .~1a CITY OF PRIOR LAKE
mepartment of ~uilbing 3Jnsuf
J~i ~inal Pennitted D Conditional C.O. Expire~
-~a This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
f:' i ~ certifying that at the time of issuance this structure was in compliance with the various ordinances of the
~! i: City of Prior Lake regulating building construction or use. For the following:
~:'
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_..~t' ;:
,~ ,
Use Oassificatior
Sin"le Faro! Iv
Bldg. Pennit Nr,
99-981
Occupancy Type
R3
Type Construction
VN
Fire Zone
N/A
Zoning District
R1SD
Legal DescriptiC""
L1, B2, Raspberry Ridge Third Addition
15098 Appaloosa Trail NE
<:itcAddress
Owner of Building
Robert D. Hutchins
10d~~
Carabec ~omes,
~.
7844 150th St., Prior Lake, MN
Contractor's Name & Addres~
r,ty Planner
Jenni Tovar
Date:
Date:
DATE
~)~
~/Jsa ?;,
CONTR. {],.rdj,~C fh"l"$'
fY-717/
~GRADfFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
1,;1
('j
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
j5tJ 2t'
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRA NG
o ULATION
FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(:. r'd';/,)/(~ / <:
J
tltdh,u" /5
~
(/'~
NU
TIME
ct1
-"
/
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR . CALL FO REINSPECTION BEFORE COVERING
Inspector:
ner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
II
.-. "--~I-..-~-
1 II
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
/(/P/71 Z:3R).
/S?Jq~ I:;PPrJl-005fi 77C-
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99-9BI
o FOOTING 0 PLUMBING RI 0 EXlGRAD/FILLING
o FOUNDATIO~ 0 MECH RI 0 COMPLAINT
o FRAMING" 0 WATER HOOKUP 0 FIREPLACE RI
~NSULA T 0 SEWER HOOKUP 0 FIREPLACE FINAL
FINAL 1 0 PLUMBING FINAL 0 GAS LINE AIR TST
o SITE INSPECTION F\ X MECH FINAL 0
COMMENTS: Rl "" ~T( 0 ~1L--~.;5' oIL-
(I) hV.~^ O~IlQa'V'^""" 4"'~
(~~M_W) tv~ ~t d.e1k]4., FW\r~
1t~<>- &oI(,o~s+r':: cl,L.,)
:(iJ U!.d;"t'\ ~. ~'CL ~
. ~ '6c+OC".or ~
."0 ~'.U ~()II.J- S~ .--- _____
8vw\(J.D>_ sw- ~ ~ '\
~J~rr~ U~ )
OS~ <7"--V ~ O~ /
~
ORE COVERING
C LL 447 9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
UlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
, ,
I II
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 150Q B
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED IIJ'::;~~
twaksa-ll
CONTR.
TIME
1I:1Io
PERMIT NO.
qq - Cjf /
o PLUMBING RI
o MECH RI
o WATER HOOKUP
R HOOKUP
PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
~FIREPLACE RI
FIREPLACE FINAL
GASLINE AIR TST
o
--
,Jj'
.2.1/bS.
Ok
COMMENTS:
~ F.f~ + 9r-lWt- +- ~hvc.
0) /io.JJ ~>4-~~
-#< C-AA.l.lJ ~HA
.8) ~Ao Atr7>r.i J/..,d ~
-# ~ (~ rJlf
o WORK SATISFACTORY, PROCEED
';t1. 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
I il
I:
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ISo<le
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED
"'~<A T.
CONTR.
PERMIT NO.
o PLUMBING RI
to MECH RI
WATER HOOKUP
SEWER HOOKUP
f PLUMBING FINAL
o MECH FINAL
DATE TIME
'111'1/'1'1 JO:(Jf)
't~- /:f8t
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTr;: "
50'_ ~&....)L. 4<..> Pv,-
tk T~ k. ~""
/ tj) eCA.& if'r,
6r~~~ ~~~ h~
(~ C:m~. (1V\ 1(1 rc..ch +rk.
(r; - O-Y&c-.k. ~k-
U
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-h:,
G-vc-clc.-
/
/'
/
o ~K SATISFACTORY, PROCEED
j{ C~~~EC CTION AND PROCEED
o CORRE 1\, CAL~FOR REINSPECTION BEFORE COVERING
Inspector: / Owner/Contr:
CA ,L 447-9 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE;,
REMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
II
INSNOTl
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
QATF RFr.EI~
8/lo/qq
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12SITEADDIS()C\~ 'Ao()()J{)O~ \Y'o.:,l
3. LEGAL DESCRIPTION
LOT I BLOCK
1<aS(tPrf'4
14. OWNER (Name)
~a.1 * ...\i,Ji-e. ~()\\
15. ARCHITECT (Name)
6. BUILDER (Name)
c.o.J~\:>>...c. ~fMD J \ f)t,
ADDITION
Z
R1clCr"- ,~rc(
(Address)
12.'SiU:ler\trllN .
(AddressP
Fireplace)f
Alterations 0
DeckLJ
Finish Attic CI
I 'cJ'&:05 -91
1\Jt.- ~/5D
PIC 76~342. -IJI/-O
Add,'fjnl1
(Tel. No.)
L.j Lj C\ - t..L( ~/-
(TeL No.)
1)rife, ?,~
~l..jl-2J..j2Ll
(Tel. No.)
As-roofing 0 Porch LJ
Re-siding 0 Finish Basement 0
I. White
2. Pink
3. Yellow
File
City
Applicant
(Address)
i8L.\4 \'&~ U\. W
?riQr- \..o..\u.. ,_ \'-IN
Septic 0
Addition 0
7. TYPE OF WORK
New Construction)C
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished information on this application which is to the besl of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above m:~~~ property and that all construction will conform to all existing state and local laws and will proceed in accordance with submittad plans. I am aware that the
building offici~evo this pe .t tor j t cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X .oalur. -::tf- 2QQ5. ~ f..:::'N:=- D)? - ~.f ~ '1"+
Permit No.
qC;- qpy I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (DePlh)
12. NO. OF STORIES ~
~} TYPE OF CONSTR,I~T1ODr~
11~R A~~~OR?'ONM~SE
\
-
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTI'
-
SEATF
16. PROJECT COSTNALUE
-$ 100,000.
1i COMPLETION DATE
DO
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
BUILDING DEPARTMENT VALUATION
Side
Side
USE OF BUILDING
5F.O
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 14 \,I'ItY>. f'YT'o.
TYPE OF CONSTRUCTION, I II III IV 61
Occupancy Group A B E F HIM Q S U
Division 1 2{) 4 '2.
Permit Fae ................................... $ I. 1",;;::1. .,
'l~5.cr(,
74. tso
Plan Check Fee ............................. $
State Surcharge ............................. $
::n=~~n~.~~~~~~~j{~:1*C:::: : t 0 () . 6 ()
Mechanical Permit Fee . ~t. q~.l....... $ ( 0 0 . 190
Sewer&WeterPermtt "11.~~~!........ $ 35.5'0
Gas Rre ce P it ......tJ.I........ $ lfb . Oa
Th n ~es our_ PermttWhen !ll!Proyw'
By ... Date & -2"3-'1 7
Certificate of Occu cy
Issued
City:
~ ^~\q~
\{\~~,
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Amount Brought Forward .................. $
Pari< Support Fee ........................... $ A<:;O. (':lQ
SAC ......................................... $.j.j, c:;o . () ()
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer ...~~~~................. :
45. Of)
I ;tS.D<":l
"2 Of'> . CU2.
1 O/').t)C)
Meter Hom ......r;l.ii... ................... $
WalerMeter ....:ta........................ $
Sewer & Water Connection Fee ........... $--1..
.
WaterTowerFee ........................... $
Water Tap ................................... $
Builders Deposit ............................ $-1, '500. W
Other ......................................... $_
Total Due .............................. $ 7(pfj$ 7~1-
Paid // &- ~ .2./ Receipt No. 3~ 1'1
Datef!l~2" _~~ By (,Jh
l']iS~.S 'fy t th.~uest in the above application and accompanying documents is in accordance. with the City Zoning Ordinance and may proceed as requested. ThiS. document when
'0 by lann constitutes a temporary Certificate 0 ooing complianc.q ~f1~allows construction to commence. Before occupancy, a Certificala of Occupancy must be issued.
, . ~ ff"M r "f/L Ullii ~if vW'~~ In' ~li~
City Planner Date -.. Special Conditions it any
24 hour notice for all inspections 447.9850
-----r--.~------.__..__.-
.~. ';~"Ri.." .i';,~~-'
,,~_',. --,,,,,..-,:'<--01\' .~.......-+~ -..,_'!: ~~_-~~~--"~"..... ~,~~~
Tht Ctnltr of tht Lab Count.,.
~?:; /
White - Building
Canary - Engineering
Pink - Planning
BUILDINGYERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
;' // ,"/ ,
, ,-
/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,
! /" .,~'f
;'
-
/
.----
Denied 2 11 j
Reviewed By: < V)~ ~ Date: '6(19/9'1
Comments: AI Un, f ('QMlJT .t/VlJ'a,h /(j ,C:; j-de va,} s _
Accepted With Corrections
,
"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
9'1-1'11
White - Building
Canary - Engineering
Pink - Planning
TM CO'",t...- of lhf Lak.. Coltntl'}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
rc.rn.hp, t-Il'\lMes.
8~1O-9 q
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/C)()OfB
A ppCLlOr":lC,o.
lr-
Accepted
Denied
./
Accepted With Corrections
Reviewed By: sJtt, ~ EwDt3rt'iPAJN
Date:
. ,
!(J I''''
,
Comments: J?dAloFf . ",us,,"" ~E: C.oAJ\)f'f'EJl
,
T. 1;,.,10 ALl""" f)MIAJAf..!:-~ IITiL'r'"
~~M.E,..,M1C id.<. 1"-'l&JC.rof ~~ P~Ac..r.("~L.
1?..)ItJD~F
OAl "'-H~ J?€'A1t. poll-ria""'"
.flC -r-J.I ,<.
'0"-
M u s"r
13E:
C.O,.,J.JEf.Jrf) 70
'f'Hf AJoff:rHUAJ "'0<1'
,
I'ftMa of -r...lS
LoT
S~ J,)~6fl~A"T'o^-J .....\,.1 -r,./E. REuEAS~ StbE.
:or.- lil'l'fArtol"'€>I,S, I. p,"'Il<- Q'UIOf. JAl<PE.a,o.u },Jf.n......Ti",u Z. aIlADIAI/:. P.."'N
~. .f:n~slo...J - ~tJJ4-rR..D'- JA1e:A-5.ul'lLc::.
4. Dlo<",'" CO,.,JrA.oL P....t"tU
"The issuance or granting of a permit or approval of plans, spedfications 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 [
! ;1
~1
q9- 913 /
Tht Ctnlu of lhe L.kt Counlr)'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEeARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
C/1~r11!3 6C- .HOM6S
~/ 10,/ qq
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/50913
/}P'??/lt-OO$;/1 77C- /1/5
Accepted
Accepted With Corrections /.-.
Denied _
Reviewed By: ~r-
Comments:
Date: (3 -2'5 -'7 <=j
I. f?aMiaUJ /J-f-lu.c~
U~
"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 I
--- ~----r----~--~---_._---------_.- ._~_. -... - ._-
CITY OF PRIOR LAKE MC .
16200 Eagle Creek Av. S.E. Permit No. qC; - ?f3;
Prior Lake, MN 55372
Date 10 .
HEATING APPLICATION I PERMIT
J~' Cjq
PID" 25 - .342. - (j i 1- ()
S~eAddress 1 ~Oc; >< ItPftLon~A 1/2 n~ r< ISD
Lot ~ Block 2. Add~ion RAC;PE'E.RR..V !2.1D6E. 3 R.D
Owne~s Name(' A-f.?AM(l' ./-J..c,fYJES
- .
Address '7 f 44 -(:FO n+ s: '/ W
Healing Contractor .At.-a71/l'Ho/T/'C (J,~e; DooRf AWJ"a[S
Address 'id)1O u.J'f ow> LNG 1'\V'i. IV ~ 1Jt<>:>/2./.J..j J<lP~ Mtv Sf~
Telephone" ~a - 3JS- ),Ud
Furnace Make & Model I>tJ ::. '/ 13"u~PE OF SYSTEM
/)7A:J""if1C A"";' Warm Air Plants
21 al>///<#<' Gravity
Mechanical
Air Cond~ioning
Vent. System
HEAllNG>OR POWER PLANT
'Steam .
Hot Water
Radiation
Special Devices _
Model Size
Conn. load
Fuel 11/ M
Rue Size
Supply Openings
Return Openings
Input :J.7.6VO
,
Output
Edr.
Other Devices
Clm.
TYPE OF WORK
Akerations
Replacement
New Construclion
Repair
Est. Comp. Date
Est. Cost $ I ':Mtfj nO
qq-QSI
Building Perm~ "
HEATING pl:HMIT FEE $
~ PA\O W\11-\
\. e\J\LOING' PE.\,,~;,\T
STATE SURCHARGE $
TOTAL PERMIHEES $
.50
Receipt"
I. Pink
2. 0-
J. Yellow
TYPE OF STRUCTURI;,
Rio
Cloy
Single Family
Commercial
Two-Family
Industrial
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Add~ions & Akerations
Residential, AC Only
"'
o
"-
"'
....
"-
co
~ .-
Public
Multi-Family
Other
"'
o
'"
"'
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
."
>
...
'"
"'
'"
'"
"'
'"
o
....
o
'"
Remember to add the Slate Surcharge on the bottom of this application.
The price 01 your heating permil ineludes one rough-in and one final inspection.
Addilional inspections will be billed at $35.00 each.
House Healing Test Record musl be submitted with bulldinn Illl!!I!iI nllmbRr before buld-
iog certificate of occupancy will be issued.
>
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"
HFAT r.AI r.11I ATION!lIlFOIIIIlFn wilh number of supply and return openings listed per ~
room with CFM's per opening. New structures or addnions send floor plan wnh supply i;
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND '"
APPLICATIONS MAY BE MAilED TO THE CITY OF PRIOR LAKE, 16200 EAGLE ;:J
CREEK AVE. S.E. PRIOR LAKE, MN 55372. .' "
[;;
><
City Hall 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 for a mechanical systems permil and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
wilh the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUilDING
OFFICIAL; thaI the work will be in accordance wllh lhe approved plan in the
case of all work which requires review and approval of plans.
1"/1 .. l'I
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V'-}[i.,UUJ 1:1 rrLJ.JI..)/1(tb
cNRJ~
Building OftIC8I s 61YllcduI6
. ../ ~(2
/(/-/'1--7 (
Date
/O/;<I-/q'1
Date
I
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o
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"-
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CITY OF PRIOR LAKE
PLUMSING PERMIT
AppliC8l\!: 5 Q.\\a..\'iLY" Q\umo(()Q
Add_: ~A\\"\", (\ ;...1"1", ~c;
Signature: . ~ ~"'" .
Legal ~: i . Block;;z... Sub /2/1sf'eGl'?I'?'" I'!IOt!f!,6 3"<'
SI_Add,..: \'50q'1. ~XQ\~'Sc. Ii'l'\;l l.lLJ Ji!/sn
BulldlnlilPemlll. q9- 9 / PIOe U;;-34z.-0Jl-O
NOTE: Tl'lle pemUt "'"'I nat be P''ll . . .-ed without c=omplete information.
"uo,. .JRE UNITS
-~
-
n. c..... fit _ .... ~__"
~().{().~~ ~
~O" ~
Quantity Type of FIxture QllIIF1l1ty
I BaII'I Tub with or wllhoUl Ihower .3
\ DIehwuh.r I
\ Floor Olllln
1.- Lavalory (balt1room sink)
\ Laundry Tray (, or 2 COmpartment sink)
2 SIIo_r Stall
\ Slnlul
liar Sink
d- Wa.r Cloul (Ioilel)
.... '~HeDUU!
Industrial, ~ommen:ial. Multi-Family
(1% of jotl coet, 13&.50 minimum)
FI_ldenllal, New One. Two Family
l'Ie.lanllal, Addl!lon. . AIlerallons
.... Sureharge
GRANO TOTAL
"... ....
'- ""'" Q.,
), YeI..,. ~CMI
PP No, qq -98/
Phon.: ~(j f') --{" '73'-1
\Jr,']... '...~..,
Type 01 Fill'lure
Rough-Ins
Waler H.aler
Waler Softner
Stand Pipe (WaShing _chine)
S.wage Ejector
Bac!cftow Assembly (FlPZ. Cc>utIle Ch~ PVB
Bacldlow Assembly r.st
Lawn Sprinkler
Olher
s
s
s
.50
./-~
tK~Mp' ~ E\;MI\
l5\JIl.OINU r
'ni. pamj'iI ..- ._ tIItJ "pmu c:oacti.ion thaI said
.""'" "" . Ma.l1 CDIbp.,. ia.. n::apectI wlrA die ordinances
of tIIe..)J- C.... l.,. ", ". _to
. ,-. - ~/~DATE
ATTEST
-C::ull'orilllinspectiOftl 24 bouq in adVlUlce_
16200 Eagle Cl:I:ek Av. S_E_. Prior Lake, Mianesola 55312/ Ph_ (612) 447-4230 I FAX (612) 447-4245
J\A Equl ~.,. Employer
" ,
CITY OF PRIOR LAKE MC
16200&gIeCreIkAv.S.E. PermbNo. ?t?- ?t3/
Prfar LaIIe, MH 55312
HEAnNG APPUCAnON I PERMIT
DaIa 9-24 -~C4. PID,...25-3t..1-2.-01/-0
S_Addrus Il",t)~~ ~~..lnnt;,.c. TO'\. tJiE R..ISD
n
Lol L Bbck 2- AtI4iDn.I<ASPD€7<!.1&f 1e106€ 3 t<o
Owner'll Nanle L I...N.1o r. "- _ 1-l~ _~ '"
"
III
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101
101
III
(1)
00
N
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AdelI_ '7<:(44 I c~'D~"" S~ LV
Heeling Conlraclor U" Il~.... A ~ r ~ T oAt-
J
Addr_ ') \I \ W 1'1.c, \- L S t-
Telephone' C;C-'10 - 4-lo1
Furn..... Make & ModlO1 L L "'.... C1\r C.2]
Modo! Size. ') ~ QDJ
w
~
....
~
)-
W
..J
..J
~
>
Conn. Load
F""I rJ~1 FkI. Sile S-"
-
Supply Openings I~
Relwn Oponi~. _ ry
Inpul '7 s:. 00 Olllpul_ 6 0 ni:)(J
.
Edr.
Clm. LODj)
,
E
(l
..
b'J
TYPE OF WORK
Almalions
Rsplal:emllfll
Ell Comp. Dale
Building Permill
"
III
(1)
(1)
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Repllir
Est. Cost S
HEATING PERMIT FEE S
STAlESURCHAAGE S
TOTAl PERMIT FEES S
.50
---.
TYPE OF SYSTEM
Warm Ai, Planls
Gravily
Mechanical
NI Conditioning
Vent System
./
r/
HEATING OR POWER PLANT
Steam
Hal Waler
Radialion
SplICial Device.
Other Devi:..
New ConslnK:1ion
,/
Recelpl .
91-98/
~~;r'
TYPE OF SlltUCruRIi
J.li~
. .-
CIl,
c_
Silgle F.....V
Commeltial
v
MIAti-F8mily _
Olher
Two-FwniV
Industrial
Public
Fee Schecklle
Induslria~ ClII1Vn9ttiaI & MulHamly
Resid9n6el Healing II. AC
Residenlial, Healing Only
ResidIlOlliaI, Gas FlRlp1ace
Residential, Mdilions II. AIe.alions
Residenlial, AI:; Only
1 % 0/ job cost ($:19-50 mWmum)
199.50
564.50
$39.50
$39.50
.39.50
Remember to add Ihe Slale SUldlarge on lhe bolIom ollhis applicalion.
The price 01 )'OlIIl>ealing permb include. one lough-in and """ liKIl inspedion.
Addilional inspec;1ions will be blled al $35.00 each_
House HealingTesl ReconI "",51 be subm~led wilhbuikliDllllllD!il"""~"" be"'"' build-
ing certilicale 01 oa:upency wi. be issued.
!:!flII ~ r.1I1 ATIOIII~ pc", 1'00=" wilh I'IJmber at supply and "'lurn operings filled por
room w~h C FM's pOI opening_ New slrucl\lnls or additions send noor plan wilIl s"",tv
and .eturn localions shown. HEAT LOSS CAlCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED 10 THE CITY OF PRIOfllAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE. MN 55372-
CIy Hall business hauls al8 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-lH AND FINAL) . CALL CITY HALL
447....230
I hereby apply lor a mechanical syslem. permi! end I adcnowl&dlle Ihallhe
intOfmelion above is complete and aeanal.; Ihalthe work will be in c:onIormlnce
wilh the ordineneas and codes 01 the clly Ind wilh the _e buIkIinglmechonicll
codes; Ihallhis lorm does nol become a permll until signed by I~ BUILDING
OFFICIAL; thai lite work will be in accordance with \he opproved plan in !he
ca~~ WO:k whleh require. nMew and appro~at 01 plans.
'l//:;;;k~ /4. "Ih.,.ktq
/1 ?,4~9
Dell
~ OlIlcaI'sliV1_
"
. LP Gas
Job Address
Name of Tester V
Date ~ 1<)( - '7::t
Percent 0, 0..~
Percent CO ('\
Percent CO ;"J.e
, l~'\O~
Stack Temp.
Pressure _g-6-
Input fJC:-, Wt-
II
I-----d
/~IOR LAKE
'NSPECTfON RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS J5"O'iR J\P.p,.,J ..,0<:>..... \fi::a;.\---
NATURE OF WORK 1)...., rrivo..tJ,.
USE OF BUILDING S~f'\
PERMIT NO. 00- '18r DATE ISSUED ,{3-2'?-OU
CONTRACTORCar-o.L,,~AU>
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING ;2l:J - I {3 ISJ 1,;
I FOUNDATION (Prior to Backfill) Cvl f/aft1 I
PLACE NO CONCRETE tfNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
ff '"pl /9'~
Jh,
~.
SEWER I WATER I SEPTIC
FRAMING (~) "'"".
INSULATION 00
ELECTRICAL
PLUMBING VP /o/;/!r,/
HEATING (if required) I ()1) /-vl.r/c; "/
FIREPLACE t~ I t/6:t. /trf'i-91
GAS LINE AIR TEST 107 10/1"'/"'''' I
COVER NO WORK UNTIL ~BOVE HAS BEEN SIGNED
I I
FINALS
6 [',
In.
/~ -I/-'I'l
/f)~ /'1-'1'1
,. ,1.1:1..&.. . f ;'....lJ!.~'
GRADING (Prior to Sodding)
BUILDING f.c.,c;-.v 1~ \~OO~. Jd,1f,,1
ELECTRICAL 1
I PLUMBING
I HEATING
DO NOT OCCUPY UNTIL ABOVE HA
NOTICE
i/ I o/~
1/.9-5"/ de
". "..-
.. · tJ."III
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 ALJ..INSPECTIONS (612) 447-9850
I i I .