HomeMy WebLinkAboutBuilding Permit 99-1117
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BVftNSVILLE
Heating & Air Conditioning, Inc.
12481 Rhode IslDlld Ave. So., Savo8" MN 55378 . 894-0005
Orslat Test Report for Job' q 9156 S1
Address /5070 11f?t>AL{XJ)# licit-!. fli2lof? L,!1Ki
Occupant l-1i7kL57/VP7 [;fto5 0JJ.J5TPuU7~
Date of Install
Type of HT. F/A)C HW Space HT Unit HT
Ottier
Make 6fvt A.vr
Model '3 9J3 tA V () 4- 2. t7J I
Serial
Input 73 8 . OtJO
Pilot Type J..-I C 7 3vrt...fAU
Pressure -:s . )'
Input CA1 'Y ~,DOO
S1ackTernp . '350
I h)"1
....., ,
Company pv{21l.>U)ut tlo1Tl~.
NameofTes1er 1/ (.... {)()t?X~
C02 ,.7 ~'.
02 ~ 6.y
cn I]
Date Tested
'.J
~~
DATE TIME
Iq/~~1 1/;tJO
/5D70 APPALOOSA /72..
" PRIOR LAKE
"CTION NOTICE
SCHEDULED
ADDRESS
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
A ~WATER HOOKUP
J4 '~EWER HOOKUP
10 PLUMBING FINAL
o MECH FINAL
qq-/I/7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
_I, ~r;~ (\ ,,~1t,3'*'" Ifu,.,.. \.", Q..",h
X WORK SATISFACTORY. PROCEED
o CORRECT 10 ND PROCEED
o CORR T 0 ALL FOR REINSPECTION BEFORE COVERING
Inspect . I. 'j Owner/Contr:
v ../
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
IliSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
ADDRESS
/5V70
DATE
SCHEDULED .~;I~te)
/1P~/1 LOOS-r}
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
2' -WI
0.51</
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq -(117
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
------------
~'L-~
o WORK SATISFACTORY. PROCEED
~RRECT" ION ND PROCEED
~ORRECT ~ fO. L FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 44~-98~FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE~MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI
DATE TIME
CITY OF PRIOR LAKE 1-34 Io:GO
INSPECTION NOTICE SCHEDULED
ADDRESS 15C1o A oa?loosa ,k.-
I'
OWNER CONTR.
PHONE NO. PERMIT NO. ...9..9...=lLL7
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~ .e:1~~~TlON 0 WER HOOKUP o FIREPLACE FINAL
LUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION 0
COMMENTS:
~,tr~ (~"''-''
(0 I!t$ W
I
o'^---
f?\A ^~)~
Inspector: Owner/Contr:
CALL 44719850 FIIR THE NEXT INSPECTION 24 HOURS IN ADVANCE,.
CODE REdvIREMfNTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
V lNS/'IOTl
~-,_._---"-----
SCHEDULED fiJ ./s-()()
~PRUJOwq
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/5070
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)!I! FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
...A.J~ T. ~ -~
~ fb--- ~ . ..
~ .~'"<UP
'-
-
, , .
DATE TIME
q9-/117
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o SOt> t.~
~/~ ~ .I .
)! WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~.
Owner/Contr:
gALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTi
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
-8
It.' ,
0'."-
k.....h.J
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
15'(}~
3. LEGAL DESCRIPTION
LOT
i1P;xdrn>.f4-/ (;.v-! /III:
Permit No.
1. DATE
1-7-1j
1. While
2. Pink
3. Yellow
File
City
Applicant
qq-/1/7
/iCIS.o
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
AL-rJ . <:'4'1?
1ZNO. OFSTC~RIE-S
?-
t'6')
BLOCK .;2.. rP
/30 3_
PID
25-3L/z- 013-0
13.~CTION
14. FLOOR AREA APPORTIONMENT USE
I?-o-tf ffi>.t~
/3<> I Ii'
1(01 ~~
6. BUIW"ERLL, ,(NaJl'''L7(.J (Addre~.~r 'II L:: (fel.No.). .J.. '5. NUMBER OF OCCUPANTS OR SEATS
/flJ Tt'U.dtAUt1. Ui'Otun &1-:J;~;-'f0 'lt~,:70._.u c,!:~~>,;2.-I771 OCCUPANTP
7. TYPE OF WORK Fireplace 0 Septic D Heating (] Plumbmg.o. . Reroofing 0 Porch 0 SEATS
NewConstructionA A1terationsLl Addition 0 Finish AtticC! Residing 0 Finish Basement 0 16. E~TIMATEDVA~UE
ChimneYLJ Misc._ _' 180/000 ;"cl.d& l~(
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS -. 110. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. Wldth~O. '{SDept.h /{,f./'J--- Yes No 11~J--j-tJ1
I hereby certify that I have fumished 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 a~:~=ned property an t at 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~'l!AW n r his r 0( J cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X/lAw'! S;g ~ 'I :54Y't"OMNO <7-7;;'
ADDITION
,-<:
J!A~k-r",
(Name) ,Y
(Address)
(fel. No.)
4. OWNER
5. ARCHITECT
(Neme)
(Address)
(fel. No.)
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
:Side
Front
~ack
- PROPOSED GRADE FOUNDATION
IN RElATION TO CURB OR CROWN"
OF STREET
USE OF BUILDING SF D
::>ide
MATERIAL FILED WITH APPLICATION
SOIL TESTS LJ ENERGY DATA LJ
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN ( '5(". 000. CJ6
PERMIT VALUATION ~~rJ~"- v\; ~
PILING LOGS LJ
PLANS & SPECS 0
SURVEY 0
PLOT PLAN LJ
TYPE OF CONSTRUCTION: I II IIIIV~
Occupancy Group A BEl H1!Y M
DMsion 1 (jJ 4
City:
Permit Fee ................................... $
/0(".7.25
. - --
""7'" - -<;1:,93.7/
tv n~ ~ I
?V7tJ6
wi( . Gl) naH
~fw
p.p
Q'9-II17
11. 1/1'7
q1- /117
,/'1- 11/7
Check IT LJ
Deferred CJ
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ..:f.l~......................... $ I ('J t'l .00
Septic System ...~.!\~..'.............. $ (,S'-(90
Other .........S.t0..................... $ 3S,SZ)
_..E~...~IMI!........... $ Lj O. M
This 4~e6ke7SYOU llding Permit~hen Approved.
By C&fbc., Date q-("S-7Cf.
Certificate of Occupan .
~
Issued
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
CollectlveStreetFee ....................... $
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer ...~l................. $
Meter Horn ......sJ:.'.r........ ......... .... $
Water Meter ......~........................ $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
W~erTap ................................... $
Buildsr'sDeposlt ............................ $
Other ......................................... $
Total Due .............................. $
Paid '7 S'3 t: ~ C.
Date q////~.,
PERCOLATION TESTS [j
SETS
COPIES
RG'J~r?6
10 <;n .190
t!f:"CiO
I .2b' - c>o
/.7_00. C>b
7t'Y?60
I c;Oo. c9Q
By
reque t In the above application and .........,"1'''", ,ying documents is in accordance with the City Zoning Ordinance and may proceed requested. lhis document when
r stitutes a temporary Certificate of Zon~ compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
:d) e;-c, - 1
.city PI er Date Special Conditions if any
24 Hour notice for all inspections 447-4230 9:00 a.m. . 10:00 a.m.
ThISiCfCS ifyl
signa By .
---r, .
1/
CITY OF PRIOR LAKE
PLUMBING PERMIT
APPlicant:m/./",/~ . #/~~/"m7
Address' ~ /M,...,;/,..(.u ////
Signature: (2./?; JH /FJc/Z./2;;!. .. .
Legal Description: Lot 3 Block:;2... Sub~PBeli?t<.V IeloC1#6
SiteAddrBss:!5V;t'/) r:?/j~.I?/7M/' ,.P? 3111.0
Building Permit # /4<:;- /117 PID # 2.6-30.1-2.- 0/3-0
NOTE: This permit will not be processed without complete information.
10/21/99 THU 13:14 FAX 6124474245
C1TY Ur PK1UK LAlU;
Ill. ("ftl~r.., ltoe' I..... ('nu........
FIXTURE UNITS
Quantity . Type of Fixture Quantity
c: Bath Tub with or without shower .q
J Dishwasher /
/ Floor Drain
.~ Lavatory (bathroom sink) /
/ Laundry Tray (lor 2 compartment sink)
I Shower Stall
/ Sinks
Bar Sink
::::5 Water Closet (toilet)
FEE SCHEDULE
Industrial. Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
GRAND TOTAL
~UUJ.
I. Blue-
2. Cold
3. Yenow
rite
C;ly
^rrliCMI
#
C?9-///7
Phon..'
Type of Fixture
Rough-ins
Water Heater
Water Sollner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
$
$
$
$ .50
/--....~O WI'.'ri I
t~\EO\NG ft;.(.
OCr 25
I99g
This permit is granted upon the express condition that said
conlrnctor. shall comply in all rc~pccts with the ordin:lnccs
of the St:ltc Plumbing Ct lh en men~ thereof.
RF. a ~./<9"1D^TE
, -
. A nEST
Call for all ij{p:tions 24 hours in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equol Opportunity Employer
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E, Permit No. qq - / 1/7
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date IO/'>~/'7 S PID# ~f';-3I/-Z- 6t3- 0
. /J '--' .
Sfte Address I.s-e:; 70 N '!2.+l d./ ~u / hI' .1 II!!. 15[:)
, I -
Lot .3 Block 2- Add~ion RAf5p15F;!I?J<..V 12/D€tF.; ,"3R.O
- . I
Owne(s Name ~ 7f;/~..I- ~'
Address ,:;.'1 d-r 06!!::J ,9- 5 J1.-<-<J..-<J ~d4
Heating Contracto-;::B~~/. ~ uIo,'-(> ,..... ;lite.
Address J X K I -<zL", ?i:;J.A.J -1 cP ~ s.;-
. .......
Telephone # . S?7 V 000 r
Furnace Make & Mode~.t......r3.f.~.e,q~~E OF SYSTEM
" Warm Air Plants
Model Size q / 0 c> 0 Gravity
Mechanical
Air Cond~ioning
Vent. System
Conn. Load
Fuel/7d ~Iue Size
Supply Openings
Return Openings
17
7'
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Input "'}/aot' Output
Edr.
OtheYgevices .tN'Il rH'~
eJ.-.-u ~ ~-~
Cfm..
TYPE OF WORK
A~erations
Replacement .
New Construction
Xi
Repair
Est. Comp. Date
Building Perm~ #
qq-//J7
f'/>.\O W\~I4-."
6U\\.Olio..\G r ,;;;.,-\..,;'
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
Receipt #
rYPE OF STRUCTURE;
I. Pink
2. Green
3. Yellow
File
City
Contractor
Single Family
Commercial
)<J
,~
Two-Family
Industrial
Public
Multi-Family
Other
Fee Schedule
Industrial, (:;ommercial & Multi-Family
Residentiai, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
. -
OCT 2 11!H1
~-
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with hlJildina oermit number before build~
ing certificate of occupancy will be issued.
HEAT CAI ClJLATIONS REOIIIRED wilh number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
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.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-9850
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with 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; that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
./7 /?
/oh~hq
I Dafe7 /
09/09/99 THU 08:44 FAX 6128902753
STOCKER EXCAVATING
@9~..
GIIUJI ~ ~
YIlLI.DW ~ ...uc.....
caol.D .. CIT"
II I I
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. tJ9-//17
NO.TE:
Sewer and Water
contractors must
bQ registerea
with the city.
APPLICANT: DC Me.c:han1cal/Sc:oc:ker. Excavac:1ng
_PHONE:
890-4241
ADDRESS:
8247 We.st 125th St.. ~5""e.uMll.. ~~;78 DATE:
SIGNATURE: q Ja..... ~tfl J/~ BLDG.
/ - ~~ ~
SITE ADDRESS: ISD"10 AfOo.(OOiY>, Tr. PID#
I ,IiZ/SD
FILL IN THE BLANKS
Cf-q-<f~
PERMIT it qq-///7
25-34-2- D/3-0
l~ Estimatea length of water service
feet'.
2. Size of water service
inch(es).
3. Location of any couplings from structure
feet.
4.
Type of se~er pipe. ABS PVC-x--
Estimated length of sewer line
Cast Iron ~
~\OG pf.?J.'li
feet. e\J\lOIN
5 .
6. Clean out (if required), located at
structure.
feet
from
___:l:f.!i!!!I!!l!====-===-__
#r----------===~~==----~=======~--~~=~=-=======~~-
BY
our permit ~hen approved.
. DATE: ?/Z. z.../91'
This
=========:;:1:13_
~======~=======~==========~==~=;==============:::==---
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or ~ater individually is $20.00 plus
$ .50 surcharge.
* Sewer ana water permits issued for new construction must be
recorded on the buildin~ permit card at the time of issuance
to insure that no .dupl~cate sewer and water permits are
issued. .
REC'D BY
~~p...\t) 'J'l~:>,WS~
._,~\G
'OU\\,v'
DATE PAID
RECEIPT it
AMOUNT PAID
16200 Eagle Creek Av. S.E., Prior L3ke';'~nesota 55372/ Ph. (612) 447-4230 I FAX (612) 447-4245
.AD Equal Opponuniry Employer
:~"
),
II
H
!:c.
t'"
.,
J... "
,
\
\
u.
qCJ- ///7
Th.. ('"nttrof Ih.. LlktCounlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING peRMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1'-1// I c: L STA E;OT f3r<.OS
q/S/qCJ
f I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/5070
APP/l L-OOS/1 / /<... AlE'
Accepted
Accepted With Correction~
Denied
With
/'
Date: 7'-1".5 -"7<;
Reviewed By:
Comments:
f2Qc..ct ~ll ,,-~c.W I~=- fl<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."
--.'.--r------'.-~'~~..--.-----~-'-'---,.-'---------..-.--___r_--'--'--'-'-~~
.,
".
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Pormil No. QC1-llll
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
/.J .
Dalo 11f/ J?/<;C;
. ,. - /
S~o Addross 1::Sr77o 11~~Au '/);tJj
'II
v
lol ~ Block z... A dilion R/15Pt5BR,el/ ;eIOq&
Own or's Namo
IJ7dIIMliY./ .,...
PID' 2S~3o./-Z.-0/:3-0
/Z.1:sL)
3RL?
Address 2700 N. FAIRVIEW. RDSEVILLE. MN
Telephono #. 651-633-2561
FIREPLACE rLI _
1\lJmQ~ Mako & Model ::JJ,;Ul"./',J C,t"
Model Size.
[m:; TR:-
Conn. Load
Fuel r,::;,.,,,
Supply Openings
Relurn Openings
Inpul OulpUI .:J7r))'L-
Flue Size
Edr.
Clm.
TYPE OF SYSTEM
Warm Air Plants
Gravity _
Mechanical
Air Condilioning
Ven!. Syslem .
HEAllNG OR POWER PLANT
Sleam
Hol Water
Radialion
Special Devices
Olhor Oovices
^/leralions
n.placement
TYPE OF WORK
New Construction
>0
Repair
Esl. Cosl $ /ltYJI 1)
Est Comp. Dale 11/ <;
'1 .
Building Perm~ # qq- / / 17
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMITFEES $
.50
( , p,b.,\O W\,\-I
eU\\.OING PERM\T
Recei~1 #
TYPE OF STRUCTURE;
I. Pinlr
1.(~fI
l Yellow
z
o
rile (
Cil' I
Conlllctoo
(Xl
I
IC
IC
o
(Xl
..
N
~
'11
Single Family
Commercial
~ lwo-Family
Industrial.
Public
Mulli-Family
Olhor
Fee Schedule
Induslrial, Commercial & Mulli~Family
Residenlial, Healing & AC
Residenlial, Healing Only
Residenlial, Gas Fireplace
Residential, Addilions & Alleralions
Residenlial, AC Only
1% 01 job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39_50
$39.50
~.
,
m
III
~.
a.
m
l"l
o
,
~
m
,
Remember 10 add Ihe Slale Surcharge on Ihe bollom ollhis application.
The price of your heating permit includes one rough-in and one IInal inspeclion.
Additional inspeclions will be billed at $35.00 each.
Hous. Healing Test Record must be sub milled wilh /1uildinn l!eIIIIiI ~..""'~. befora bund.
Il1g certiticate 01 occupancy will be issued.
l:iEAI CAI r:1I1 ATlnlllS flEQUIRFn w~h number ot supply and relurn openings lisled pt
room with CFM's per opening. New slruclures or addilions send Roor plan wilh supply
and relurn 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.
(!I
UI
"'
Cily Hall business hours are B a.m. . 4:30 p.m.
All WORK MUST BE INSPECTED (ROUGH.IN AND FINAL). CALL CITY HALL
447-4230
(!I
W
W
(Xl
(Xl
(Xl
~
I hereby apply lor a mechanical systems permit and I acknowledge Ihallhe
informalion above is complete and accurale; Ihat Ihe work will be in conformBnce
with Ihe ordinances and codes 01 lh. cily and with Ihe slala building/mechanical
codes; Ihat Ihis lorm does nol become a permil until signed by Ihe BUILDING
OFFICIAL: Ihal the work will be in accordance wilh Ihe approved plan in the
case of all work which requires review and approval 01 plans.
;J 1/
I:J.tRA<.12 Ii 11~_
Ap~Jr~ Signature
0I:;;Pf'(! f', ~
B!!!Jding Ollicars Signature
1//1/7'1
I ' Dale
il
o
"'
/I/e/qc;
Dale
/~~
r:lq I 1/ 7
Th~ C"rnlrr of Ihr L.kt COllnl!')'
While - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
ILl/TIE [
9/8
~?77}t- Of
I
/ClC)
I
0/::':'C~
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/.5070
/-/;JP/lL {; O,~r/ TlZ /\IE
"
Accepted
,/
Accepted With Corrections
Denied
Reviewed By: lJ.6..c.,.rFf2 EJ-l~~~.qNN
Date: 9//5;"
Comments: }<o.>AJ<>FF M""r
13,
(2. 1...h'~'r'CO Ie 11 NO IlLON(~ Otl..A/AJIl(.,/E:
.
<i:.. U"-ILlrY F.-A-<..FM~~
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"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."
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White - Building
Canary - Engineering
Pink - Planning
Tht' ("t'ntt'rof lht' L.k, Counll'}'
,BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
i
;
The Building, Engineering, and Planning Departments have reviewed the building ~mit
application for construction activity which is proposed at:
f,' /""'
1;'- /
t:,
Accepted
Denied
\/
Accepted With Corrections
Reviewed By:
(J~.~
-f
Date: q -9 ~
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."
i
PRIOR LAKE
INSPECTION RE'CORD
DEPARTMENT OF
BUILDING AND INSPECTION
(' ~
SITE ADDRESS Isn'l() i1.Ma.I'-'/"f'Cc",~(r.
. ~ 1
NATURE OF WORK NFl'\ (lon.v...k.
USE OF BUILDING SF'D
PERMIT NO. q9- / I J{ DATE ISSUED q-/3- <fer
CONTRACTOR ,Aj: !-LOP" "l--a.J2-.d ~JS. ~ . .
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
_ I..~ (\ INSPECTOR DATE
I FOOTING !'Jli.Y:ivM"1' (/;J/'~ I &=r, _ 1- ,)3-11
I FOUNDATION (Prior to Backfill) {~) 1m. riPfh,?9 liD-I-C)?
PLACE NO CONCRETE UNTIL ABcWE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC ~ ....0 ~
FRAMING ;\-0
INSULATION (()l~,/"
ELECTRICAL 'lj'
PLUMBING ({/) 1j/<//f'3
HEATING (if required) (/ ';\D ~l- 'ir / q or
FIREPLACE" . (/[) /1);' N" ~.
GAS LINE AIR TEST V v D J ( ~ t'- '1Q
COVER NO WORK UNTIL ABOVE HA~ EEN SIGNED
l.or;l;~C J.<Q-\o I I
FINALS
G e.-- f -1<lrOlJ
~,
ll,~-q~
GRADING (Prior to Sodding)
BUlLDING1.C..o.riUtllloo {fp I/J/,O
ELECTRICAL
PLUMBING
HEATING
DO NOT
JY / /'t,/ tr6
(
~) r
OCCUPY UNTIL ABOVij HAS
NOTICE
\- 3-Ob
,- '!,- 00
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