HomeMy WebLinkAboutBuilding Permit 03-0473
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15/1t") J't.{:{l./Y"s {)c.u
CONTR. e..(')llr~ r:.I-J
PERMIT NO. _(;) ~ !: 4 7 ~ (
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,...a-ANAL
o SITE INSPECTION
COMMENTS:
!:.I'u "it -
~.,/b
OATE TIME
SCHEDULED
1-~J-03
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
c;s;TCYMnl...n~ 'NG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/'If-
'K/),(- ('JY
~
~RK SATISFACTORY, PROCEEO
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspedor.m~ ~~_ Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNO"
--_.,---_.-_._.~-..._---_.."..-
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
J S/I ()
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
I /
7'1< ~
v
SCHEDULED
~~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
I'
Cl<)<-0J
Jt
DATE TillE
(6 ~-07
.3 ~ lfl)'
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLIIiE AIR TST
z...5.l::...7
1
'-. ,( ,1
/'
~ORK SATISFACTORY. PROCEED
o CORRECT I AND PROCEED
, CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
41-1.4850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
co
EQUlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
/5:110 J(/.k/<. Po,5J, /" II L,lv HCtJID
l h//fc' ,
Ds-Lt73
CITY OF PRIOR' LAKE
INSPECTION-NOTICE
SCHEDULED
ADDRESS
--'
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
a;lLFJNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
/I.,. "
'\'
Gv. S 1),.)/
fl/o If/.., 17rvl/
-I,) &Jlud,
v
--.------ ..--..~-~.._.
DATE TIME
?/J 7hJ :n~
,
""''''''~LUNG
o COMl'D1NT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
I, l,/I-1 L, 6, "'~
J:? I/o -I 5ln ( h (1 'V
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~ORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector.$~ Owner/Contr.
:CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl ')(
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
ISIIO
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
;l!!:'FINAL
o SITE INSPECTION
DATE nile
SCHEDULED 6.2l,-o",? ~
\J:C~ ~~~
CONTR.
PERMIT NO.
3 -41?
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
::?:REPLACE FINAL
ASLINE AIR TST
o
COMMENTS:
I. l=:".,....J c:...... -1). ~. ~". /~~.P
'2 . /,U.o..;~c...:... -P\........lc>--- ~ U
~. ~,.,~ .+T~ .
'Se,,I/
~C' ~e-
IJ-I-CJJ
(I
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
X CORRE1]K' CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CAL~ - 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
C~UlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSI<<>n
DATE TIME
CITY OF PRIOR LAKE 8-'2.~
INSPECTION NOTICE SCHEDULED I O:~C)
ADDRESS 15\ \() ",-\;~tc; -U)...'> S
OWNER CONTR.
PHONE NO. PERMIT NO. ~- 4"\ ~
o FOOTING o PLUMBING RI o EXIGRAD/FILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: t~
I.~- (~...~
Gc.~ <
I_t \::'1
,
"'\ ?x...Lu.... J---1-.... :>
2. p,.1l\J~rL I ,.u .
~lA
k
b.R,
o WORK SATISFACTORY, PROCEED
,XCORRECT ACTION AND PROCEED
o CORREfV1~CALL FOR REINSPECTION BEFORE COVERING
Inspector ( 1/1 ) Owner/Contr:
CA. j~50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODUQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or Print and sism at bottom)
ADDRESS
\6\ \ () j 5~FE-\2-S ~c:;.S
I, White
2. Pink
3, Yellow
File
City
Applicant
I PERMIT NO'Q3-04nl
LEGAL DESCRlPTION (office use only)
LOT 6 BLOCK 3 ADDITION.J E;;f-Fta.-S n-:;: So
OWNER
(Name)
(Address)
Date Rec'd
3___;r1.--03
ZONING (office use)
Rt
PID~5~3q5- 05'l-()
(Phone)
~~~~~~ n\\~~-O \ ~ +\ lJN1 ~ <:.
(Contact Name) E::.C\d\ Eo: ~h\'/Y"'\n+ 2-
, (Address) 1t12/J ~\L~Vl.l' -:: ."'P,\ D0\ .
- .
TYPE OF WORK
o Misc.
~ New Construction
DLower Level Finish
ODeck
o Fireplace
PROJECTCOST/VALUE (exc1udingland) $ "3 \ O. q 00. -
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
..
'f311.e()f).DO
$ .2i75.~.
$ J ~ 1 3. 9'i? ..
$ 15c::.<5o-.
$
$
$
$
$
/OtJ,(J 0
/("),00
35,~o
LJ~,o()
This Application Becomes Your Building Permit When Approved
:3/~ ;7~ ~/'!,It,3
. Building Official Date
(Phone) t::J '32, \.!-l::?l. InC-l {)()
(Phone).Jp12> loBe;. ?>2DO,
( d ILf':1/ll \.~ m h 5504 LI
I
I
I
I
I
I
I
I
I TOTALDUEt~ 4-2~-a3 $~CJ90. 33 J
'2' ; <2
I Paid JR19~.. a3 I Receipt No. <littJ<;~ I
I Date tj-!)- C) -O~ By rt /' I
DPorch
ORe-Roofing
DAlteration
ORe-Siding
DUtility Connection
I~ 75'.{)O
,..;;, 5".40
45. ()O
/ZlJO,Oc:J
70d. t!JtJ
1$00. () 0
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
ffi'~ 7'~~
Planning Director
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 am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon e ro erty to pe needed ins~ t2QC1 312 r / S
Contractor's License No. f Date'
I $
I $
1$
1$
$
$
$
$
DAddition
I Park Support Fee
I SAC
I Water Meter C?~I";
! Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
#
#
#
#
~a.d~
Special Condi1i6ns, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
~?f!?
White . !;!uil~in9.
r ~anarv . cnqlneerln<f-::,
Pink - Pla"nnlng
TIM eml... of '1M L.ke C....nry
.f3!,!ILDlNG PERMIT APPUCATlON DEPARTMENT CHECKLIST
NAME OF APPLICANT ,jt!J--I:.~&1J :.itS lJC77JL.;'-4-
APPLICATION RECEIVED 3 - d- 1- '3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is propo~d at: r.
/51/0- (,i4f./YA0 ii--2i.(,1.~.
r
,:,-. u '-'
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
A IJ4 ($
Date: '-1-).3- 03
--"
Comments: See Rev.er!;F! ~irle for Additional Infnrmation!
See Attachments: I) Gradinl! Plan. 2) Erosion Control Measures
"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." .
~
~~
White - Building
Canary . EnQineering
Cf'lnk - Plann~
ThrC"l'nll',nf lhl' I..h("ounlry
6.UJLDING PERMIT APPLICATION DEPARTMENT CHECKUSI
NAME OF APPLICANT
/ Il' I /. i
. ,j - !
~
APPLICATION RECEIVED
3---:1~1 ? i
,:,,7- '.-.";
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
!
/"/1/)- ,.'
"-"")
_.
Accepted
Accepted With Corrections
I./'"'
Denied
~
~ ~o,fJ~
Comments: . A. e, tu' ~ ~
fa..J!- ~~.
Reviewed By:
Date: #9~ 3
~ 4J12~
>-~.
"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."
~~
LWhite - BuildTri!t::,
Canary - Engineering
Pink - Planning
ThO' (-..nll'r "r lh..l..k.. ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~J ~.~
APPLICATION RECEIVED 3 - d- {- "3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
ISI/O- ~ p~
Accepted
Accepted With Corrections
...----
Denied
Reviewed By:
~::f~ Date: 7jlQ;'3
~~ a-d ~~-~.
~ ~ ~~&?.,., ~ Pr_".'J~ ~
~,
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."
4. : 0 0 3 3; 50PI,1
GEN= RVAN PLUMBING AND HEATING
No.8m P: 6
e CITY OF PRIOR LAKE
REA TING/ AIR CONDlTIONING/FIREPLACE PERMIT
Date Rec'd
: ~~, ;fl~. I. PERJ.\1lT NO. 2.- '-I r{..::) I
) y"llow APl>'I~&nt ; J
(Please ~ OT tlrlut!J1d ~iY,n at bottpm)
ADDRESS
I t:) /I 0 "Teffe~ p~~
ZONING (office U!O)
. LEGAL DESCRJPTION (office use oo1y)
LOrCJ BLOCK ~ ADDITION (
~~R r.o1 le~ Cc
I
(Address) l1W I a.Ki
~~;,~~ANTqel'J:t- .~f1 (Phone) jllt/f/- L(2-3-IJ!{t.{_
(Address) /q1 tit:) J .f212izJzf TlzI ~j( }J10Ulti 0)Ua9
(Addrcs f (CIty) (Zip CoM)
II~ - - (""~) (hl- <{2~- t/Lf
ALVA A ~ 'fd.~/l- DATE LilY ~_
I
Jeffe~ SOWn.-
. _JiQrnes
PID
(phone)
Q'52, L!frL9--h 900
~1I1U~
(Contact Person)
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
ftNEW CONSTRUCTION 0 REl'L.ACEM"ENT 0 AL TERA nONS
FURNACEMAKEANDMODEL~4/r:;-/2t::; FUEL NJIff.C:7A-S
FLUE SIZE RETURN OPENINGS ') t..{ INPUT /2 ~ tJDO OUTPUT II~I ()()J.2..
TYPE OF SYSTEM HEATmG OR POWER PLANT
~arm Air Plants
OGravity
o MechanIcal
~ir Condiiloning
DVe-nt.. System
o Steam
o Hot IVater
o RadJation
o Special Devices
o Other Devices
PLEASE NOTE:
Air CondItioner Umts
Cannot Encroach mlo
Required Side Yard
Setbacks
FIREPLACE MAKE ANP MODEL
Industrial, Commercl>l & Multi-Family
FE.E SCHEDULE
1 % of Job cost Residemmr,-Gas Fireplace
$3950 mmimum -~
$9950 Re<ldelltl3l, AddItions & Alterations
$6450 Re~idcntial, AC Only
$39 50
EsllDlaled Cost $
Buildmg Pel1mt #
$3950
PAIQ$ttitH
BUIlDING PERMIT
ReSldenllal. Heatmg & AIC iJ'lew ConstructIon)
Re"dential. Heating Only (New Construction)
HEATING PERNITT FEE
STATE SURCHARGE
TOTAL PERJ.'\-IIT FEE
$
$
$
Building OMcilll
.50
\E@~~~~l\
I Paid ~~y r,PR ~ S 7r~C~:J
InM< ~ ~~ >J" j e-
24 bour notice for all inspections (952) 447-9830, fax ( 4245
Dat-c
10m" U.e Only)
Ai. Application Becomes Your Building Permit When Approved
APr. 4. :003 3:50PM
GENZ RVAN PLUMBING AND HEATING
11086:6 P 36
~~Pll~
""~~<
I-L "
- "
u '"
. ,''",."'..
~:~;:(~~.i;:~t~':~;"+'N' E' 0' .
....",;."
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
; ~~ ~;~ I PE.RMITNO.~_ J //13
l. C<,l(l Apphr..lllt J ~-I
()?lase tXDf: oronnr a.nd ~u~:n atbottrlm)
ADDRESS
161 In Jeffe~) R;L<)~
ZONING (affic~ u.~e)
LEGAL DESCRJPTION (ollice us< only)
LOTt:) BLOCK ,,3 ADDITION
PID
(Adclre,,)
qq2 ,l(~~ It?( IJD
5~
(Z.iu Codr.:)
APPLICANT L--.o I1V
(Name) r,l~ .h1.~ K. an
(Address) ~C; SjOlJef2:J ml.,
(Addre."~) _ J
(Contact Person) -Ct:lJe. (S: Is.
~LICANT SIGNATURE ~11/1
(Phone) ~t;I- t./2,-:1.,- JjL/4
J20KfYl0l1nf t:J<....D(t?R .._
~:::e) _ {PP)I-:<23-1l4t/~__
. DATE ~JA
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure
Type of sewer pipe. 0 ABC 0 PVC
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
feet
o Cast hon
FE;ESCl:lEDULE
Resldenual sewer and water Ime connectIOn $35.50 Industrial, Com'l & Multj-famlJy 1% of Job cost wIth a $3950 mffillTlUm
Sewer connection only $ ] 7 50 Water connection only $17.50
Estimated Cost $
BUJlding-J>errnit #
SEWER Al-JD WATER PERMI;r FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
PAID IAn
8U/LDIN r~'17-I
G P~RMrr
(Offict Uu Only)
Building Offltial
.l'.:uc<
j 2,(r~~D\~
0". ZfJeJ '
.J
24 hour notice for all inspectiOn! (952) 447- 1 fax (95.2) 4..t7-42,15
_.. < Receipt No.
~,\
i3v
r
- I
~_J
This Application Becomes Your :Building Permit When Approved
Bv__,_._.:;.._----
,.
GENZ RVAN PLUMBING AND HEATING
N0.8626 P, 46
APr, 4, 2003 3:50PM
~
€~~
,;.'\,.A,f/v. 0....,..
.:;{*~\~~~}/,' N~S
Date Rcc'd
CITY'OF PRIOR LAKE PLUMBING PERM]T
I Bbl_ [.i}"
l. Gold Cil}'
1 Yell"'" Ap;;>jiclZlt
I PE.RMIT NO. 3 -Lf13 I
(PJe::U:e ttPC' or DriDt md sls!:n at bottom)
ADDRESS
101fD0effe~ "Pas~
I ZONlNG (office,,",,) I
LEGAL DESCRlPTION (ollice u'e only)
LOT'J BLOCK3 ADDITION\jetfe~s :5;D1)3111
PID
~':~~()[IPr1V r,(
(Address) 70'20 La kt
e.s I [1C . . (phone) t{{)vL!-h9-ftq[)O
lH~kTJ\lllltj
~;:;~~ANT ~.fh1: ~ rh I an
. . I.
(Address).J!:tZ!:IC; \ L__~l'R{_[cl-.
(Address)
C (;1I?JSn F711U
APPUCANT SIGNATURE (~ "=frA1.(-<'.
(Phone) (fl /?) {- 42-3 - { I L/L/
l2Dif.VYU2~-L__ c:y:::; lJ _lp K
(P~~~:) ~c)l- L/ 2-3 ~li/44
L{ ill/ () :3
(Contact Person)
I Quantity
I 2-
I I
I I
I .,
I \
I I
I f
I 1
I ,
DATE
APPLICANT PLEASE COMPLETE BELOW'
Type oi Fixture I Quanti!)' I Type of Fixture
Bath Tub with or without shower I Rough-.ins
Dishwasher ( Water Heater
Floor Drain \l-~ L Warer Softner
Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Ejector
Shower Stall I Backflow Assembly
Sinks I Backflow Assembly Test
Bar Sink I Lawn Sorinkler
Water Closet (Toilet) Other .
FEE SCIlEDlJLE
Industnal, Commerculo! & Mull'1-famlly 1 % of job cost WIth a $3950 minimum _......--Re5;identJaJ, New One & Two.Famlly ,1;9950
Re~adentj:1l, Additions & Alterations $39 50
(om". u.. Only)
EstImated Cost $
BUlldmg Penmt #
8llltAID WI- _
DING ~.,,.,
'l:F1Mrr
PLU1vfBING PERlvUT FEE $
STATE SURCHARGE $
TOTAL PEAAUT FEE $
50
Building OCfie.isl
~ ~:@ ~ ~~oo~ 11}::CCiPt NO(jl'
Dm ~ll APR ? I !\
24 hour notice for.1I :n,pections (951) 447-~~~,_~~~~2)447-4245 j .
This Application Becomes Your Building Peroit When Approved
~
(;//\ v~
vL~~
~/t\'/If"O<"
APR 9
~~le Ree'd
; \
,
jl
I
.-1
CITY OF' PRIOR LAKE
SEWER AND WATER PERMIT
(Pic~c tV1>e or "tint iInd sicm &t botTOm)
I ADDRESS
I \5\ \0
~Pc~
--=-\j ~ ..~
~
! LEGAL DESCR.lP1iON(oftlco UIe only)
l..LOT S"BLOCK ~ :WDITlO~
d03
: ~t. ~i~ I PERMIT NO. ~/ J i1.,1., :
l. Cold A.~~ ;/ Vf } ~
I ZONING ,o,.,;;;;;jl
~ Sou.:tA PlD
U'
OWNER
(Name) r..lortLiw
(AOdJess) 79 ;;;2.S
~ \\~
/-'~6IuJ
(Add,..,)
A PPllCA>f,f, - A
(Nam.' Dac\~ r XC c< UC;XX-r--q
~ . ,
(Address) K~7 ~ w 70 'n--.. S-ty ~
<Ad4I<,,)
(Contact Perlon) ~clw S L ~ .
r APPLlCANTSIONATUR.E__d~~t ~0--
(Phone) '8t s-l- Vc"C(- r;, 9'0 ()
?~ SSVYC/
(CItY) (Zip Code)
(Phone) !;;07-7Ycr- S-sz;"J---
lcn.s.d~ S3Z:Jy b.
(City) (ZIp Code)
(phone) ,~1-7C(C/~ S~\'
t'lATl' v.7-o3
APPLICANT PLEASE COMPLETE BELOW
Si~ of WlLter service ...5:1- inches.
Location of any couplings from Structure -== feet
Type of sewer pipe. 0 ABC [2SJ1'VC 0 Cut Iron
Estimated length of sewer line 50 feet.
Clean out (if required) located at -- feet from structure.
FEE SCHEDULE
Residential sewet and Wiler line cOMeotion S3~.SO Industrial, Com'l & Multi.family 1% of job cost with a $39050 minimwn
Sewer connettion only $17050 Water connection only $17.50
Estimated Cost S
Building Permil #. -."..
SEWER AND WATER PERMIT FEE
STATB SURCHARGE
TOTAL PERMIT FEE
(omcr t'tt Only)
,.
$
$
S
:508lh,~DWI~
-.~ "E114ti-r
Thl. Application Become. Your Buildlne Permit When ApprQnd -,-,-...1';;'1'-' IS \\f1 ~ r;~. '~Retei~t No.
n, ~al~ ~. Q.. ~i 6y'
8uUdiogOmol,I Pllt '1 MO^~. cr-
. An~ ]. "LtJeJ 'J\ .
.4 hour notlte 'or IlIln.p.tlion. (~S%).4: SO,'" (lIS.) 44?-41~ .'
BY~. --I
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~: ~:~:w ~l~iCan{ I PERMIT NO. 3- Lj"7 3 1
(Please type or lJrint and silro at bottom)
ADDRESS
ZONING (office use)
15110 JEFFERS PASS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) COLLEGE CITY HOMES
(Phone)
(Address)
APPLICANT
(Name) AT-UF.!) FIRESIDE DRA FIRFSIDF HEARTH & HOME
(Phone)
/\51-/\33-256 I
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
5/9/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
o Warm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVent System
o Steam
o Hot Water
D Radiation
o Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
I FIREPLACE MAKE AND MODEL
HEAT N GLO 6000TRI X 2
Industrial, Commercial & Multi-Family
FEE SCHEDULE
] % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
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24 hour notice for all inspections (952) 44/-~t:')V' UIA. (",S2f Il . ,.~ I V
PAID WITH
BUILDING PERMIT
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Duildin!! Official
Date
PRIOR LAKE
INSPECTION RECORD
SITEADDRESS l!SJLo ~~If.S eAs~
NATURE OF WORK Na W · N
USE OF BUILDING 'S'.IC:'"l). _
PERMIT NO. 03 -O4-1? _ DAT~ ISSUED qjqJIJY
CONTRACTOR ~ CJ~l'J" p~.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I FOOTING ~ I"{ (?Ai /03
'FOUNDATION (Prior to Backfill) I ffi 1~;~3
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
_ tf/;}!7
Y!(
. Pb t; '/'7'
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
. ,
PLUMBING lj,b. (//gAL- 5!r"huiJi
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
{Z} ,,,,,-.0
yC-rt;
~-/~
P-ftY t; -/ C)
(ff r
IYf(I.
f/(J
G-~/~
b
g. zf"
COViR NO WORK UNTIL ABOVE HAS BEEN SIGNED
1J1!4~ /;:Z:? ~ ,<<-I
FINALS
GRADING (Pri~ to Sodding)
BUILDING (' ~ f.?:,.Jl!;iJ', I -I -{\"?:; I h } 0 -L
ELECTRICAL
PLUMBING ~JJ r7. Cs
HEATING -Pi) ~~
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
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.
FOR ALL INSPECTIONS (952) 447-9850