HomeMy WebLinkAboutBuilding Permit 99-1432
ADDRESS
/447q
DATE TIME
SCHEDULED ~ I:IS-
j1/ 161fl7 /1/ CiA L- e
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9'9-11/-32-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
.1.1 0 MECH RI
vY )!f;WATER HOOKUP
~SEWER HOOKUP
<3> 0 PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
\.o~.w4 (jQ LV_ nA>.
,~~ I'~
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. ....
H.
'V
aLA ./taJ;{ --'f')'
~11 c.~11' .-- '/...5/.,;;"... JZe-:tdt!
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
,"11 ..?11
. 17' .
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ
-:'Sa-y
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
t./jl.J)& /:/ S-
ADDRESS /4479 N ic::Jl!4--i (\ c:f to ,
OWNER CONTR.
SCHEDULED
PHONE NO.
PERMIT NO. 99 - /4, z:;;;:(
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
~NSULATIO~~ 0 SEWER HOOKUP A
~FINAL ."' ~LUMBING FIN~r
o SITE INSPE TION ^MECH FINAL
COMMENTS: ~O\ \ 1\
(~~%l ~l'IW?J ~o
~dr: ::=>t..l1\...~(P , l\1jJ.. '^'4
~ e ;tr':?p A-r-fL';~
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INSNOTJ
...--....--. ,.-...._..._.,.._--~-._.........._,,~._.._-~-_...- -.-.--.-.-..---'"
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
f/IW1o :LQo1Z...
J..,.. J ~ () 0--.
oJ
....----.-
....'.. 'fV;~~. r_. '~'.lfflL.1\.'-'''''~'tl:'-~'~'''''~ '~,:"'''-"_'".:'" ~ _''''''_ E''''';' .,'~,;
~, .....- " . ',. . . ",. --;......~,,,',.'-,... "~"". . .-",'~. ""~-".'." '-""1'". . ".
BVRNSVILLE
Heating & Air Conditioning, Inc.
12481 Rhou IsltwJ A"". So., Sava,., MN SSJ78 . 894.0005
Orslat Test Report for Jobl If /
, J
, Addl"<''' Ii( t/79 ,r!h'I//If/fY,;d/,r ,,:.//(. CiWi!;''/til/ iAIC[
Occupant
_ Date of Instal/.
Type of HT. F/A / HW Space HT Unit HT
OIhec
'.. Make ~
I
Model.3R ::? K/lV(J<fc?o 9/
Serial 3t!?9A/7/'-'/9
Input ?k-/~
.1
Pilot Type. 1-15T
Pressure =? cj
Input CFH _ s:r ~/ I919V
S1aCkTemp _~;;Z 9"
C02 -;; ~
02 &1 I
CO 0
Date Tested. ~- / 7-(JV
CompllIl}' 6rV/C: /t'- /1/ ~
NameofTester #/lp
"J,~ ~
#
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 144 7q
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATION
INAL
SITE INSPECTI~ .
COMMENTS: M
1....._"'
~ 1~:EA. ~ TIME
SCHEDULED ~ q r7v
N/~~
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
av-& IV~
fJe.oo-U/
"
i.2i ,iNu.., ~ J&~ L...{- LUrcLRW
I
('.joM ft
- ~~
\ IYIA ~ (~-A' 0
\ ~ (' .A~-+,....~J .--J
~---
/~
~
--------~
--
qq ~ 1132-
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~
l:;t1J~1! I
\
I
/'
.MWORK SATISFACTORY, PROCEED
/0 VCORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ , Owner/Contr:
CALL 447.9850 FO.lTHE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
~~.
. I
\ .
1'--
(c 'I: -'" r; ,"
DATF RFr.~N~.~)
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
DEe - 91!Rl
Permit No.
qq-/4-32-
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS , (0:/;. I/), 17
JL/Lf fC1 /Yjvvd~ LA~-
3. LEGAL DESCRIPTION '"
LOT ::J. BLOCK ;:5
- )r ~ ;{j, '/I 7'<<"
1. DATE
/;;L-1-f.Y
~I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
~~ (~~
1:(NO. OF STORIeS
~
[,V~:s;~~~
I 14. FLOOR~ APPORw(ONMENT USE
(Depth)
L/"",
PID Z6 - S"G.iX -0.:<8-8
ADDITION
14. OWNER (Name) (Address) (Tel. No.)
15. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.)
fY/lifeI5f~!3hf//t~~. :2~,9ft{1$t bsjI-~d--177/
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 ~'roofing 0 Porch 0
New constructiO~ Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement a
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft 125;9'(---
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
170, 0=-
17. COMPLETION DATE
?-r~ -06
19. PR07ES~DIMENsrO;t?' 3~ 10. CULVERT SIZE
Widthrty_,- Deplh I~' t:3 Ves No
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 above mentioned property that all construction will conform to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
bUild~~n th' p st cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x_.'}~'; s ~:>'7"~ """eNo /;;J.-t;,.?l
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
LJ ENERGY DATA
o
,51="D
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMITVALUAtJoN.~:I'V"\I'). (9("")
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS LJ
SURVEY 0
PLOT PLAN 0
SETS
COPIES
TYPE OF CONSTRUCTION: I It 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 ....................... $
S U
City:
Amount Brought Forward .................. $
Pari<: Support Fee ........................... $
SAC uu....._._uuuu........uuuu..... $
9611881' i.... i1tf"ea 5./1.e.t........... $
R CV"l.~
I (; ~(') ""0
5TJ. 00
'll'l:> . 2 S-
f__~I~
<;-c., .SQ
Sewer Tap ................................... $
Mechanical Permit Fee ..................... $
1&0.00
/t:>6.(:)O
3S .2>'(')
<;[ " ~
Pressure Reducer ..-:m.................. :;:
MeterHom..........;Z.................... :t
"
Water Meter ......... 1;.................... $
Sewer & Water Connection Fee ........... $ I
,
WaterTowerFee ........................... $
(/S : 0 c:;
Sewer & Water Permit ...................... $
I "2S. CJCJ
20.....t"'l-t$
1011 ,...,.,
Water Tap ................................... ,If.
Builder's Deposit ............................ $ I. t::)/JP). /'170
,
:~~:r;~~~;;f~~:~~;~
Date ) By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zonin Drdi ance and ~y proceed ~"requested. This document when
s~~e:~:utes a temporary Certificate of Zoning complia;!!'ll and allowy\onstruction to .fOm"'lnce~BefOr u. .P<1ncy, a Certifi'1te of Oca.lpancy must be issued.
^ I?--PR~ ~,;> ~ ~CL"'k _ *r:.~>lITAo1~ _
& Ry Planner - .... Date - Sper:ial C diti9ns if any
24 hour notice for all inspections 447-9850
ur Building Permit WJ:!en ~proved,
Date / L -./J'J-~
Issued
/
"'--- ---.----..-,--
......,.,.
~9-(i!> 2-
The Cenler of the Lake Country
White . Building
Canary - Engineering
Pink - Planning
.BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT,
APPLICATION RECEIVED
/,; // -7'".T(~ l._
-1)'1"[ i '-T-
,._ .J .
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. ;
I '
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
N'-t 1&1 ~ ~ ~ CN.d..L.
. - u
Accepted
Accepted With Corrections
v-
Denied
Reviewed By: ~~
cOk2~e! ~ ('e-vl'~
. ~ :L?, le2f1'1..
Date:
/2---f-f6,CYi
b~ 4'UMjAPJ ve.te.;,IRe'~
"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."
~~
While . Building
Canary . Engineering
Pink . Planning
Thr ("""Iu of lht t.b Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLlRT
NAME OF APPLICANT
APPLICATION RECEIVED
HII It;..L.::::. tlt5u {
12/ q jqq
, (
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
Accepted With Corrections
x
:::::" ByQ C!l) D'" 1< - ?O-~
Comments:
/, ~~JQ A~W tL4-k~
"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,"
'iCf - f'-{ u~
lh.. C.....'tr of Iht' l.h CObnl!'}'
White - Building
Canary - Engineering
Pink . Planning
BUilDING PERMIT APPLICATION DEPARTMENT CHECKlISr
NAME OF APPLICANT ;VI I TTE... L ~ I 11 c Df
APPLICATION RECEIVED /2/ q /qq
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
14~1~
1\\ I Gl-llirJ (l,ALE.
erR
Accepted
./
Accepted With Corrections
Denied
Reviewed By:~.Jl F:I-/Il€SMAwJ
Date: d5/oo
Comments: -rut!. Pn.o p""El'> Bu,...l>,.II_
Foo7'" PItII\Tl""
UAS J4 DEP7U nF
sz.....-:t I="F<;;'7'", . 4ovJE'vEJ!.
-r"HIS t...,
~1'I:s I'l
PAl> DEPTr/ RE"s"'Il.,~nol\J
OF <" f'"E<:,... -fHEAEFoA.E.
1-\1\1 r:- .JJ~I.....E:Dl !.JILL UAJc' Tn ~I'~,:""
TolAT ,"'ERE.
IS
."",.....1I3/..f: PRoPFJtt -I C.....PAcrl'"1) .""'" ~ t'k,1J{I 70 P...a.'AlI.
:rote:.
Poo" '-S&.S
:r,..
/s
-rJ-4E RLJ'LOFJ1:~ RE:.Sf'nN<"~.rt 70 f'---u...tTJClfr
P.OLb N,Jt.,.~,.. 'lkvELOPME>lT ( Wa"o;, r.ail$EL I 1(, 5Cr" vP -n.E 'SDILS
- -
,ESr pRlg,,- 10 DIG.I.I~(;
(l-IOIl.~' I'1G..,.1\ ,n AG.a.roED "Tn "~He:::
~..- "f: lotIO It~~ SEE , l\lF'atl UItC1Dt.,I n.' 1>11:. RfUG1Hf:. StJ:IF
:o.FI'.. ~&m;. : I. F,,,,AI ~Il.AAE /Al~fJI<:Cr,o. \ /ut=.llJ4flma"j
1.. anA",,"'r. R..fW
3.. moSIoN CO'"'7tl.OL MfA<",,!,"<
'f. FJl..~....., r "''''''''OL ?..'"
"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."
Quantity
?:
I
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~
(
/
)
.. '-5
CITY OF PRIOR LAKE
PLUMBING PERMIT
APPlicant:,V/?/h/, fJ////J'V}/':~ ('1() Phone:
Address: ~?/'; ~ //> /.,("'/7 n /-".
Signature: /'/;9"/".-,\ /?7r'P/?/;;)
Legal Description: Lot 2- Block.3 SuI
Site Address: /,,1-/./--/ Jiq /,?;'1Ah~/) /r/> 1'7.4""/,,.
Building Permit # Cj~ J~ PID#
, .
NOTE: This permit will not be processed without complete information.
"'''
t\J
I. Blue
2. Gold
3. Yellow
File
City
Applicant
PPNo. CfCf-/4-32..
~/q7?J?/
I::. NOB HI u.... 4-f:+4
12./
/5- .3102. - 1Jz.f?-0
FIXTURE UNITS
Quantity
Type of Fixture
.':f
/
Rough-ins
Water Heater
Water Sottner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (lor 2 compartment sink)
Shower Stall
Sinks
Bar Sink
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
$
$
$
$
.50
GRAND TOTAL
'l'p.\0 \j\j\ I'~_.
\~\ \\\..O\~G "t::\-...,\\'t
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbini&de and the amendmeJ11S thereof.
- ~ 'Il~/OO DATE
;(I"" ATTEST
fEB22
Call for all iKspections 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 553721 Ph (612) 447-98501 FAX (612) 447-4245
An Equal Opportunity Employer
12/13/99 MON 13:15 FAX 8128902753
STOCKER EXCAVATING
1aJ001
QBU.......
"'1U.t:M' . ~.-r
GOLD ... aTt
CITY OF PRIOR LAKE.
SEWER AND wA'1'ER PERMIT
NO. QCj-/tf32..
I DEe I 3 I!&l
"
\',r
w'
:\
NOTE: Sa~ar and water
contractors must
be registered
with the city.
APPLICANT:
, ,
v,,
"'-"-'-' . . I'
--..--
,
,
DC Mechanical/Stocker
Excavating
,PHONE:
890-4241
ADDRESS: 8247,..West 125tJ! Sc. _ S:::..a:t. MN ~~l18_0ATE:
SIGNATURE: Jf..~~~rl{~)
SITE AOORE~t:inlZ"'P r'~.lp (T? 1>01
Knob Hill 4th Add
FILL IN THE BLAN}(S
12/13/99
BLDG. PERMIT # S?9~/4l~
PIO; Z5-~2 - tJ213- Q
1. Estimated length of water service
feet'.
2. size of water service
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
--=~=~=~==;===;======~====-==--~~=~~==;==~~~~-===-~==---=~~
BY
your permit when approved.
. DATE: / /7 lot)
, I
This
=:c:=;;;;===~~=:::::;:==-
c====~~:==_=____==========~--_c~~=
FEES:
$
$
$
35.00
.50
35.50
sawer 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 insurQ that no duplicate sewer and water permits are
issued. -
DA1'E PAID
RECEIPT #
AMOUNT PAI(;""'. ~W\i\-\ .,'...
"'0. t't;n".n
REeJ D BY t',U\\.Oh"
16200 Eagle Creek Av. S.E.. Prior Lab. Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Oppol'tUnity .Employer
~
~
~
,
~
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. QQ"";if3Z-
Prior Lake, MN 55372
~
~
~
HEATING APPLICATION J PERMIT
Date ;J-/-rOo PID' zS-3r..Z-()z.r-o
SiteAddres.s NV~ /}(clLh~ Cv/{I o/{".
- ~
Lot ~ Block L Addition plO" /I"''' <If;f
Ownef~Nam..1?J r~'...4L/S~__L~ ~a.r
AdMess ..2V.,1j- 7dJ.'I-f. S'7-!: ~.lA.-.:: ~
Healing ConlTacl1I t51u A..f',,;//.., rib(L~N1..fl)<. /I ht. v
Mdress/~L/b ~o& ':z:i la-r:I :.t r
Telephone# ~1"j.Piv tJOo r
FUlnaC9Mak8&Model~""'v~ TYPEOFSYSTEM
. Warm Air Plants
Mooel Size :3R~ lOW 0 1,/ ~~ q / Gravity
Conn Load '? / 0 0 a Mechanical
. Air Conditioning
F~e1 /1) ~ J Flue Size 5'1 Vent. Svstem
HEATING OR POWER PLANT
Staam
Hal Water
Radlalion
Special Devices
..
~
~
,
0-
~
~
~
~
..
~
~
~
~
+
SlJppIv Openings
/1
r
ReMn Openings
~
Z
0-
-c
~
""
~
~
~
,..
~
Z
Dr
=>
'"
,
E
~
~
Inpul
Output
Edr.
Ol~er Devices
Clm
TYPE OF WORK
NllW Construction )(
Aiterations
Replacem en!
. Est. Compo Da\8
Building Perm~'
CJ1-1 tf.3 2-
..
~
Repair
Est. Cost $
~
~
,
HEATING PERMIT FEE ~
STATE SURCHARGE $
TOTAL PERMrTFEES $
.50
( PAID WITH
lBU/LDING PEF;;,ilT
Receipt .
~
.,
.~
~
.TYPE OF STRUCTURE
I. Pi.....
2."-
3. Yelfoo..,
FOe
0"
a"""""
Single Femily .....
-.
Commercial
Two.Famlly
Industrial
Public
Multi.Family
Other
Fee Schedule
Ind~strial, Com""'rcial & Multi-Femily
ResiilenliaJ, liealing & AC
Residential, Healing Only
Residential, Gas Fireplace
Resid&nlial, Additions & Afterations
Residential, AC Only
1% of job cost ($39.50 minimum)
$99.50 . -
$64.50
$39.50
$39.50
$39.50
Remembet 10 add Ihe Slate S~reharg" on Ihe bo1Iom of this applica1ion.
The price 01 your heating permit includes one rough-in and one final inspection.
Adlitionallnspections will be biled al $35.00 eacl1.
House Healing Test Record must be s~bmi1led withl!llilllimlJlllIlllllll!lllblu before build-
ing certifica1e 01 ocoopancy will be Issued.
HEAT CALCULATIONS REOUIRED with nt.mber of supply and return openings Ilsblll per
room w~h CFM's per opening. New structures or additions send floor plan with supplv
and llIIum 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 Half business hours are 8 a.m.. 4:30 p.m.
All. WORK MUST BE INSPECTED (ROUGH.IN AND FINAL) . CALL CITY HALL
44N1850
I hereby apply for a mechanical systems permll and I acknowledge Ihat the
information above is complete and acc~rate; thai 'he work will be in conformanc..
wllh the ordinances and codes of the cily and wll~ the stat.. building/mechanical
codes; Ihat this form does not become a permit unlil signed by the BUILDING
OFFICIAL; thaI the work will be in accordance with the approved plan in the
cas~all work wh~lres review and approval 01 plans.
dkJ~( tV~ t..~<-f ;J-/- 00
AfJrirJ1fl ",.lure D~
){J~ Z/2..IOO
Bt!f'ng Officars S ignatu re Date
;.j~
@
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av, S.E. Po.mll tlo.
Prior Lake, MN 55372
qq -/4:32.
HEATING APPLICATION I PERMIT
Dale rJli'I/OD PI~' 2-5- 3{,,2. - ()zB-O
,
SkeAd,hss flflf,q AJ:'"U-;nC,cPf ~ g,
LoI 2.. Black ~ Add~ion U ~N 013 It I u.... 4- -nt
Own..s Name. m, ..ff-k...~f6".U "'1?.uJ,~
Mdr.ss
Heating Colliraclor ~LLIED FIRESIDE dba FIRESIDE CORNER
Address. 2700 N. FAIRVIEII, ROSEVILLE, MN 55113
T.'ephon.# . 651-633-2561
F1RI!PLACE
hltilll Mak. & Model tk rJ ,J Gu.
Model Sil.. c"a:x>iV_
Conn. Load
Fuel. (~
Supply O".nings
Relurn Openings
In"u!
Ed..
Clm.
Flu. Size
OUlptll ;;}i.o:D
TYPE OF SYSTEM
Warm Air Planl.
G1av'Jy _
Mechanical
Ail Condllk>nng
Vent. Syslem .
HEATING OR POWER PLANT
Sleam
Hol Wale.
Radialion
Special Devices
OIller Devices
Ake,a1ions
Replacemenl
TYPE OF WORK
New ConstrJclioo .lC:
Repair
Est Comp. Dale
Building Pe.mk 1/ .
Es!. Cost $
liDO. D)
HEATING PERMITFEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
;)Iff"
,
qq-/4-32-
PAID "Vi . .
laUILDING Pb':;"iiT
Receipl ,
TYPE OF STRUCTURE;
I. Pink
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Atr
aly
ClMMrKtor CD
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Singte Family
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. Two-Famly
Industrial
. Multi-Family
Public Other
CommelCial
Fee Schedule
Industrial, Commercial & Multi-Family
Residenfial. Healing & AC
Residential, Healing Only
Residential, Gas Fireplace
Residential. Additions & Alterations
Residantlal, AC Only
1% 01 job cost ($39.50 minimum)
$99.~
1641/11: V
$39.5q/ J '
$39.50 \': HB I 4 2000
$39.50 ; .
Remember to add Ihe State Surcharge on the bottom oIlhis epplication.
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The pliee 01 your healing permil inclucles one rougb-in and one Iflallospeclion.
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Additional Inspections wi! be billed al $35.00 each.
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House Heating Test Record mu.t be Sllbm~led wilh Ill!ikIiIlg llllIIU ~,'-.r". belofe buid. ':
log cl>rlificale 01 occupancy will b. '..ued.
HEAT CALClJl ATlON!; RFOIRRFIl with number 01 supply and return operings Iioled p.
room wilh CFM's per opening. New slfUeNres 01 additions send lloor plan with supply
and relurn locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED 10 THE CITY OF PRIOR lAKE, 16200 EAGLE
CREEK AVE. S. E. PRIOR LAKE, MN 553 72.
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Cily Hall business houlll are 8 a.m.. 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL). CALL CITY HALL
447-4230
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I hereby apply 10. a mechanical system. permit and I acknowledge that the l>
inlormalion above is complete and aecural.; thai the work will be in conlo.manelt '"
wilh Ihe ordinances and codes of Ihe cily and with the slale buildlng/machanlcal
codes; Ihat this lo.m does nol become a permit unlil signed by Ihe BUILDING
OFFICIAL; Ihallhe war. will tJe in aceo.dance wilh Ihe appTOved plan in the
case of all work which requires review and approval 01 plana.
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t:::Yi I-,J1. #1/."""'-
Appmfp're
BuildinlOll1car. Signalure
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- 'z-!(~700
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PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /t/l./~ N 1'6~\\V.5clo
NATURE OF WORK .Qv.i COvcs'!' .
USE OF BUILDING S Fe:>
PERMIT NO. 'i' QQ'/4-31.- DATEIS~UED 17.-70-'(7
CONTRACTOR M .-ricLto Co.~ Cr,~ .
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE P~RMIT IS BY ~SE;PAR~E DOCUMENT
Soi ~ e~'''~~I'~ ~,13'e~t-e... h::d,'t.;J ~s:.f' INSPECTOR DATE
FOOTING ~eN(] GPmwu 0.1<:.. fZ; ~ /2-?f- (t.
, FOUNDATION (Prior to Backfill) ,.--.i~ ~ 1/11/0) nuc.J.. 1/13/vO
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS f
SEWER I WATER I SEPTIC ~ / PI'{ I~o l I
FRAMING . ~ ZI m 07)
INSULATION (:9 tfs-!uJ j V
ELECTRICAL 1_ 71 _ . I
PLUMBING Ii IS (yjl z./JeA ~ CJ/51! I
HEATING (if required) f.{ C/j) zlQ(015 I
FIREPLACE I ~ ~/J 7/ ~ 0 I
GAS LINE AIR TEST I flJJ z/r.lo () I
COVER NO WORK UNTIL ~OVE HAS BEEN SIGNED
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FINALS
WI; 4/z~/UU
7J1'
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GRADING (Prior to Sodding)
BUILDING reAJ"TV g.f,((J'O
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
C-!/9!oo
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I eM.
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UNTIL ABOVE HAS
NOTICE
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.
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BEEN SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850