HomeMy WebLinkAboutBuilding Permit 99-1024
~~"""'~~"'''';l~llfii'l',~~,.~ '~~~"~~i__ 0-~",.~,.....;o,.1Ir';_ 'C"!"i''' "'\1- ,,,,,",ir:"",';,';"'-"";'::""""'"';';qo,,_,,:-<;.~;;:_'fi ,?!"W',~,;,; ....,JI"..,'F'~'''''.;-''-
"- - ," . ~
~~ J.....I~~I.~~XI
0-1 -d ,,-,d :~.-.I .::;il', Ji::1'~Jif..::!\rJa!
~tl.'~'''''~.~1'~~' ~'~.'mli..--.,~~
QI:trttfirau at (@cmpanry
CITY OF PRIOR LAKE
~ 1l9tpartmtnt of jSuilbinlI 3J n~ptttion
, i1al Permitted o Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
cenifying 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 Sin2le Famil V Bldg. Permit No. 99-1024
Ck:cupancy Type R3 Type Construction VN Fire Zone N / A Zoning District ! 1 SD
Legal Description L 5 & 6, Lakeside Park
Owner of Building !j Site Address 163';0 Park Avenue
I, \
Contractor's Gerold Btoth~rs, P.O. Box 128, New PraRue, MN
\ I
. ,
R City Planner Jenni Tovar
-
'1 . / Date:_
Date: ~
POST IN A CONSPICUOUS PLACE
"""'l'G..-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 1(.. 3 50 fw.A- ~
riJ;9
TIME
~:t5"
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
~ ~ECH RI
WATER HOOKUP
SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
qq- IOZL/
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~ f)~ ~ !/c.r " j.., / /1
~ r--:-- o..:f- ro-f~ I z' - t-" r--
~ ~+- ok> C!..Q.__~,
------:::J A . . , I ~ r-
'//~ L . .1. g. , ,6 "-- ~ '^-""'-' ~
;w...M~ .-f -.rt d"'.-f. AD -tLJ - .Ln.-- '-'F
L~' ,
...JP 0..... 0
<
i.ra.:IL...- ~ ~ - if!-
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~ALL FOR REINSPECTION BEFORE COVERING
Inspector: \ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 1",350 PAI/Jt.. AVJ;:
.J_D1E J TIME
2.~ C1: fItJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
~ 0 WATER HOOKUP
o SEWER HOOKUP
f~LUMBING FINAL
~ g,ECH FINAL
COMMENTS:
751 botf1.k "'r i,f~
~
tfAdr..
Ii. <"1.-,
'1<1- IOvf
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~~
r; ^-ct-s
to
(1<--
HI2..
10
, PROCEED
PROCEED
REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
E NEXT INSPECTION 24 HOURS IN ADVANCE.
CALL
INSNOTl
TS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
------.-----.-
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
-z.jJtt./no 3'.Ot)
SCHEDULED
ADDRESS
/~35D PI1R.!<-
OWNER
CONTR.
qq-/oz4-
PHONE NO.
PERMIT NO.
o EXlGRADIFtLLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL ~LUMBING FINAL
o SITE INSPECTION ~MECH FINAL
COMME~TS: . ~
~I~~t:
(J._.-r
Ins
Owner/Contr.
UlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
~ TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED lC:l:CO
ADDRESS l("~50 Pa;--IL L;\ VG
OWNER CONTR.
PHONE NO. PERMIT NO. ~- IO-z.y
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~NSULATlON o SEWER HOOKUP o FIREPLACE FINAL
FINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
() V--~
cn--...
c~ 5C.<e
Inspector:
PROCEED
AND ROCEED
FOR REINSPECTION BEFORE COVERING
Owner/Cantr:
R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
. - ,- ^~..,._----_.__.- ...-.-- -- ----.-- -...-.---------. --~~-
~\
DATE RECEIVED
8/ /e,/qq
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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
iP3
3. LEGAL DESCRIPTION
LOT LMs I) ..l(J BLOCK
ADDITION L-J,Jt.E '5/"AF_ '*PK..
(Name) (Address)
o Pn.;"... u..~
5. ARCHITECT
(Name)
6. BUILDER
(Name)
t:P&RDI.tQ
&Nd-
FireplaceJ!!!J...
Alterations 0
1. DATE
eJ 11 I q
.e IS.o
PIO Z5-09Co- 003-0
(Address)
(Address)
?O. 80>> 1Z8
IVi:W ~
~-
(Tel. No.)
'0-4/'11
(Tel. No.)
(Tel. No.)
~
SepticLJ
Addition 0
Dee
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish BasementJ(
Permit No.
I. White
2. Pink
3. Yellow
File
City
Applicanl
qC(- 102.4--
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
JH. t) H (Width) lO~) ".
z.;.-o '.' ~
12. NO. OF STORIES
OIJC,
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
Amount Brought Forward .................. $
D-R. of-
Park Support Fee ............................ $
SAC .....................Cre;\!:t-........ $
13. TYPE OF
~
14. FLOOR AREA APPORTIONMENT USE
ZIZ:Z.
NSTRUCTION
~
OCCUPANTS
15. NUMBER OF OCCUPANTS OR SEATS
c:9..
SEATS
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer ..t~...\.~.~.......... :
Meter Horn .......1'.......................... $
Water Meter ...1............................. $
Sewer & Water Connection FeQe,!,'~.. $
WaterTowerFee ............~,t... $
Water Tap ................................... $
Builder's D~sit .....t'\.:._.2.:.............. $
Other ......J~.~S.it...,i" $
Total Due .........~,(>3.yll~.~
Paid fL ~ 'i & Receipt No.
Date q f.
.u
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 off n r 0 is . r just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform ?bed~ inspections.
X III~ l1mnz
Signature License No. ' I Dale
9. PROPERTY DIMENSIONS
Width 100' Oepth 2.30'
10. CULVERT SIZE
Yes S>
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
.5 F.o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ...................... ................. $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
FOR ADMINISTRATIVE USE
Bad<
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN 3~o/oOC!).~
PERMITVALUATIO~ .-~
S U
City:
I. 9f3~.::2S'
I,~~I .'1\
I (pO . fX)
I 00 . ()O
1M .C>G
3S.$O
4C'l . rrJ(
M:f;:10Ifj~
tI/ JIY
G~SFir cePermit ........ ............ $
Thi A ca mes Y r B .. permi~en~rovr:::or
B Date - I,., I
Certificate of Occupancy
Issued
SETS
COPIES
P>:Y:> .B~'
76 ()6
112u(\.~l)
-1M__Ar
5 f) 0 .N"}
t:;"oO.6lC
3(poi)
"
in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed a quested. This document when
stitutes a temporary Certifi e of oning compliance and allows construction to commence. Before occupancy. a Certiflca~ of OEcupancy must be issued.
AII' 1/,,;1- ~ lbncw<<r~ It) ~J..p ~
o I ~ SpsClalCondrtlonstfany
24 hour notice for all inspections 447-9850
~~
99-/024-
Tht CC'nlrrof the L.kr Counlry
White - Building
Canary - Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
GereOLO t3,e'OS.
~//B/qc;
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/tb35V PrJ/<!.K- AVE: ,
Accepted
Accepted With Corrections ~
Denied ~ k-------
Reviewed By: ( 'j)~
Comments:
Date: 8 -7.. ~ -1'(
l. 30J Q.ll Bos-e. SOil ~'5
2.. f<...r>rl. aIL&Ctc~), f{,,--,,~Cn,~
"3. M.D.i...-I-cu-", ~t~ ~
"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."
1 r __-.M."."-..,.-------.---...,-~----..-.------.-..--+..-...-.---...--,------.----- . ----~_..----.-,-----~,_.--.---------~--
"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
Accepted V Accepted With Corrections
Denied
Reviewed By: q;:;r c
Comments: .~fC ()t')1 T C~
I.....
9ch~
Date: q/J./ 'j?
U1 CA.-De.m ) 01
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
NAME OF APPLICANT
APPLICATION RECEIVED
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
White - Building
Canary - Engineering
Pink - Planning
Thr Crnlrr of lhr Liar Counlry
.~
.~~
,,+-, .":."':',7",-~;,:::;~~-",J.,. - ,,-~"'~-
'". ,_,-[i;....,,~~
;'f.')l" -;,~",;"",l,:?'r';'_: .'~ ;";)f"''i:I\.'(,-;>>'-<(''',:,>~,
,j -",-'~.
08/31/99 TUE 13:56 FAX 6128902753
STOCKER EXCAVATING
GM!.UI - n.&
Ya.u..DW . ~
GDLIt . c;:nT
CITY OF PRIOR LAKE.
SEWER AND WATER PERMIT
NO. 99-/()Z4-
NCJ.TE:
Sewer and Water
contractors myst
be re~istered
with the city.
...
APpLICANT: DC Mechanical/Stocker Excavating
ADDRESS: 824r!i..sr. oi25?!." /~~. HN
SIGNATURE: ~
SITE ADDRESS: 16350 Park Avenue S.E.
PHONE:
890-4241
55378 DATE: AU011Qr ;0. ,QQQ
BLDG. PERMIT II '19-/024-
/e/>O PID# 25- O'9h- 003- ()
FILL IN THE BLANKS
1_
Estimated length of water service
feet". \"'\"\ ~
...~O 'l'I cX'-~~ .
~r ~'G ~""
, \\\\..0\''''
fe~-e .
2.
SiZQ of water service
inch(es).
:> .
Location of any couplings from structure
4. Type of sewer pipe. ABS
PVC~ Cast Iron____
5_ Estimated length of sewer line
feet.
6_ Clean out (if required), located at
structure.
feet
from
=========~~=~~===~==~==~=~=========~~~=~--===============~=~
BY
your permit when approved.
DATE: C7 /q /q'1
This
---------
-----....---
-=~~=======~===-~============~==~~==================
FEES:
$
$
s
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
AMOUNT PAl D, ,fI.\P 't-I~\f.\'t
~ p-~e'-
REC' 0 BY ~\\\.O~
RECEIPT #
16200 Eagle Creek Av. S_E., Prior Lake. Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employer
I I
9r:?-/C24
n,. enol", of II,,! uk. Co.nlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
GE-kOLO 01:!OS
0//slc;c;
/ I' I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/fr36-U P/i/<'/C /7(/(;.
Accepted
Denied
v'
Accepted With Corrections
Reviewed By: jJ14&..T~1t CH(l.E:s1f1,ewAi
Dale:
-, ,
'If 1/ '"
,
Comments: R VJo/~p,: ~vs-r OlE
PR..onR.l"f LI,.J€:,C; 04' "1.Jc..1
SEuJEt<. >(:'Itl.lICe:. :5J-./OI.JL.O
FLOOIl.. E (.WAr.oN RiEl4frtl..JS
REvE4'E s.OE.
I!e~vc.,.e:t)
'T""a AuO
/ft...oAJ(
-
AS.
rICAc:..'/lc.AL .
'HI!. EXIST'I..,J-r.
IA\oI1K
A5
tA,.J~
A<:
T>l1E.
/ ~..JFs-r
rHE
"'N<E: .
5H
IA.JFoA.......ATltIJl.J .:>i<.l "THe
sa A
r
(]R.AJJ".Jo.
CO....,Trtol... H..A...J
'3. F",H)'S,IDN r./j;JT/{~L. ME:Asl.J,(!<\
"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 r
'l""----~----
u
z
U1
f-
Z
a:
f-
--'
=>
U1
Z
o
U
'"
Z
-
f-
a:
W
I
E
o
'"
LL
STATE SURCHARGE
TOTAL PERMIT FEES
\
$
$
50
----
/-~~\~~~"^~'t
e\l\\.o\r"
AoeeJpi
/1
HEATING PERMIT FEE $
Repair
Est Cost $
Aftorations
Est Comp. Dale
Replacement
TYPE OF WORK
Building Permll'
New Con.lluclion
I hereby apply for a mechanical sy.tems permll and I acknowledge Ihalthe
information above Is comple'o and accurale; Ihallho work will bo in conformll\ce
wllh Ihe ordinances and codes of Ihe clly and wllh 11\8 .\ale building/mechanical
codes; lhalthis 101m doe. not become a p.nnlt unlil signed by the BUILDING
OFFICIAL; thaI the work wlll be In accordance wilh \he approved plan In the
case of all work which require. review and appr.val of plan..
ci
z
x
a:
LL
"
I'l
"
U1
ill
U1
I'-
N
.-<
lD
Clm.
Edr.
Conn. Load
Fuel ~Flue SilO
5 upply Openings
Return Openings
Input
L
o()
.oil
J/
Model Sile
Dill.. Oe.icllS
lYPE OF SYSTEM
Werm Air Planls
Gravity _
Mechanical _
Air Cond~iDning
Venl. Sy.l.."
KEATING OR POWER PLAKT
Sleam _
Hot Water _
Radlalion _
Special DeVicllS
441-4230
!:!E&: RFOUIRED wfth number 01 supply and relurn openings listed per
room with CFM's per opening. New slructurllS Dr addllions send Iloor plan wllh supply
.nd leturn localions shown_ HEAT LOSS CALCULATIONs. PAYMENT AND
APPLICATIONS MAY BE MAILED m THE CITY OF PIIIOR LAKE, 16200 EAG.LE
CREEK AVE. S.E. PRIOR LAKE, MN 553n.
City HaD business hours .,e B a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH.IN AND FINAL) . CALL CITY HALL
House Healil1\l Tesl Reconl must Ile submilled with ~ ~ II\llIlllII before build-
Ing certirtcale 01 DCCul'ancy will be issued.
The I'rice 01 your hea\lng permil includas one rough-in ""d one linal
Addllional nsJ>e<:lIDns win be billed al $35.00 each.
.-<
lL
E
a:
cr>
"
I'l
IS>
cr>
cr>
cr>
.-<
U1
IS>
:>
o
z
Address
Ownafa
Lol
L-/It:6SIOE. P/lRK.
:;l,;.,' C /,,'~?O .
",.
'iU" /'("'" /Pre-
Healing Contractor ~ /? 9 ~.5 (/~- "eJ;.
/
Address /~ " tJ.e.S -e- ~.". SI::;' ,eJ4I.
Telephone' ~/,;2 -~,p-- ~?...2?
FurnllCl! Make & Model ~e/?/?t:7
//~JCJ
Nam.
J"~
'e-~.~
Remember 10 add Ihe Stale Surcharge on
Induslrial. Commercial & Mulli-FamDy
Residenlial, Healing & AC
Resldenllal, Heating Only
Residentiel. Gas Fireplace
ReBidenltal, Additions & AltBrations
Residential, AC Only
insJllll:lion.
the bottom 01 this applicetion
1IN-5_
$39.50"
[g
.-'
~.
SI18
Dale
PERMIT
{Jq{c - 003, D
f.2 ( 5D
"""... 1lII"" . ...-..-.-.....- l\1C
16200 Eagle Creek Av. S.E. Permh ND.
Prior Lalle, MN 55372
FeB Schedule
Single Famly
Commeleial
797"~r
Two-Family
Industrial
Public
MuJti.Famlly
Other
FROM: HEATING CONSULTANTS lNC
FAX NO. : 612 758 5434
Nov. 05 1999 03:50AM P2
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: ~/1 &5 v. ~~ one: ~/-7 -?.57P ~Z2?
Address: ~ C &J/'"..."':-<.- -""'" _:rc;;",~
Signature:
Legal plion: Lot / / 131 k /
Site Address: /':;;357:' ~~ ~~
Building Permit II 7"9-/.::>.,2<;./ .., .. PIO# 25-0q0-{)O~~-O
NOTE: This perm~ will not be processed without complete information.
FIXTURE UNITS
t. B11M'
2, 0014
3. y.uo..
File
a..
AwIi-
qq- /()z4-
PPNo.
TlM Calkr .., 1.01' L..~, CelMl'"
'D... rn@~~ ~.1".
: .-~. I
I ';
.!
Sub t-,LI,k:.6SiDE P/iRI<-
Quantity Type of Fixture Ouantlty Type of Fixture
'1- Bath Tub with or without shower / Rough-ins .R.. ~7)
/ Dishwasher / Water Heater
P- Floor Drein (/.J---=> - - - ./ Waler Sellner
~ Lavalory (balhroom slhk) e::> I Stand Pipe (washing machine)
/ Laundry Tray (1 or 2 compartment sink) Sewage Ejector
.3 Shower Stall Backllow Assembly (RP2, Double Check, P\IB)
/ Sir,ks Backflow. Assembly Test
Bar Sink Lawn Sprinkler
.J Waler Closet (toilet) Other
Industrial, Commercial & Multi-Family
(1% of job cost. $39.50 minimum)
Residential, New One & Two Family
Residential. Additions & Alterations
State Surcharge
~i'l
FEE SCHEDULE
$99.50
$39.50
$
$
S
$
.' ::C::J:'?,'~~};'~
r /-- pto"ri, ~.. M\\ ~
.5 U\\.O\~~;,;-~ ... -
,',. " .:<
'-,-,'
GRAND TOTAL
This petmi[ is granted upon the express condition thar. ,aid
contractor. .hall comply in alll'C$l>C"'s "'lib lhe ordinances
of the Stale Plumbing ~e and the ami~ lhereof.. .
~ :;jJtJll //,~5/9'7 DATE
<- Ie ATl"EST
Call for all inspections 24 hours in advance.
..
16200 Eagle Creek Av. S.E.. Prior Lake. Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Equ~ Opponunity EmPI~~e.,.,. .. ..;,;~;d>:.i~~~I~.:;.
TOTAL PERMIT FEES
HEATING PERMIT FEE $
STATE SURCHARGE $
$
50
Asce ipl "
r;-----
PAID WITH
BUILDING PERMIT
/
:u
Est
Repair
Afteralions
Cas.
$
..0
Es\.
Replacemenl
Building Permft /I
Comp. Dale
qq-/(J2?!-
N 9W Consllllclion
~
I hereby apply lor a mechanical syslems permil and I acknowledge thai the
inlormalion above is complete and accurale; Ih.1 lhe work will be in conformene.
wilh Ihe ordinances and codes of Ihe cily and wilh Ihe stale building/mechenlc.
codes; Ihallhis lorm does nol become a permit until signed by lhe BUILOINC
OFFICIAL; Ihallhe work will be in accordance wilh the approved pian in lh.
case 01 all work which requires review and approval 01 plans.
t:
Clm.
TYPE OF WORK
Input
Edr.
OIher Devices
Model Size.
;;.
\f Conn. load
~
t Fuel (~, Flue Size
Supply Openings
Return Openings
-
\
OuIpUl
~
<>CO
HEATING OR POWER PLANT
Sleam _
Hot Wale' _
Radiation _
Special Devices
!:lEAl REQUIRED wilh number 01 supply and relurn openl"!l$ listed ,
room with CFM's per opening. New sllllclures Dr additions send lloor plan wfth supply
and relurn tocalions shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PAlOR lAKE, 162.00 EAGlE
CREEK AVE. S.E. PRIOR LAKE. MN 55372.
City Halr business hours are 8 a.m. . 4:30 p.m.
All WORK MUST BE INSPECTED (ROUGH.IN AND FINAlj
441-4230
.
- CALL CITY HALl
TYPE OF SYSTEM
Wa.m Air Plants
Gravity ~
Mechanical _
Air CondiUoning
Venl. System
eludes one rough.ln and one Unal fnspoctlon.
"U at $35.00 each.
House Heating Test Record musl be sul>milled with 1llliIll.iog IlIUDilIlWlJbm: befora bWIo
ing eerlilieale 0/ occupancy wm ba issued.
The ptice of your healing perml!
Additional [nspecllons....i11 be billn~
2700 N FAIRVIEW
Telophene' 651-633-2561
FIREPLACE ftw P 6(."
5mJe.1l!l Make &. Model
Remember 10
add !he Slate Sureharge on lhe
boUom of lhis appUcalion.
I'.ddress
ROSEVILLE
MN
55113
Healing Contractor ALL lED
FIRESIDE dba FIRESIDE CORNER
Add.....
Site Address
lol 5' Block
Owne(s Nam.
Induslrlal. Commercial I!. Mulli.FamBy
Residenlial. Heating I!. AC
Residential, Healing Only
Residenlial, Gas Fireplace
Residential. Additions & A1terelions
Residenlial, ~ Only
1 % of Job oosl (139.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Oa.e
HEATING APPLICATION f PERMIT
PID, .JZ-5-090- 003-0
St- /2IS.D
Fea Schedule
Single FamBy
Commercial
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. 8.E. Permit No.
PriQr Lake, MN 55372
qq-/02-4-
I.
..
J.
Pi..
G.=
Ydo..
flk
a.,
c.o...c
"Tl
AI
o
~
m
I
I
lD
lD
U1
00
W
'"
"U
~
Two-Famly
Industrial
Public
MliIti-Family
Olher.
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS Ilc"s'-<=)t) ~U\Je.
NATURE OF WORK f)e., O=f-
USE OF BUILDING S FD
PERMIT NO. '1'7 -/0 2'-/ DATE ISSUED ~ ''21.-"0'
CONTRACTOR G.p ,,.,cd. ~.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING (f0
FOUNDATION (Prior to Backfill)
PLACE NO CONCRETE UNT ABOVE HAS BEEN SIGNED
ROUGH - INS
r CZr, '11
INSPECTOR
1m.
DATE
I 1- 9-;'7
SEWER / WATER / SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I '.J. ~ I5iREl I I
FINALS
GRADING (Prior to Sodding) W&7 i.(/'/)
BUILDING Ii r; 7-/.1J.d?;
ELECTRICAL ~(/
PLUMBING ( ~/lI>llR
HEATING t1 'r e./Il>JOl>
DO NOT OCCUpy UNTIL it ~OVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in insi>ections
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
. . ----r-------"-'--~-