HomeMy WebLinkAboutBuilding Permit 03-0196
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QIerfifitafe of <ID ttup aUt}!
CITY OF PRIOR LAKE
~epartttt~nt nf ~ui1~ing c1fnsp~ttinn
~ Final Permitted 0 Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code certifying
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
SINGLE FAMILY
Bldg. Permit No.
Occupancy Type
R3
Type Construction
VN
Fire Zone
N/A
Zoning District
03-0196
PUD
Legal Description L35, HI, STERLING ADDITION
Owner of Building
Site Address
14985 HILLSIDE CIRCLE N.'V".
Contractor'sName&Address MCDONAL CONSTR., 7601 145TH ST. W., APPLE VALLEY 55124
-
Date:
RQ~ERT D. HUTCHINS
rflt. Building Official
. Ul-~D b~
( . '
City Planner
DON RYE
Date:
--...-..,
,~:''f-.>_-.r.~ 'y
-".~,--:-''':'; ":-"..."
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
ADDRESS
/4-Cjf)5' jllL-{,Slu6 U//
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
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
S/;ECH FINAL
/
COMMENTS:
:5 - /7'0
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
I ,
DK~ ~(~- +L~ ~.~V
-...I' WORK SATISFACTORY, PROCEED
~CORR~ET TION AND PROCEED
o CORi/ T: ORK, ~ALL FOR REINSPECTION BEFORE COVERING
InSpectt~: I:(/) Owne~/Contr:
~~985!0 FOR THE N~T INSPECTION 24 HOU~I~ ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
IliSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
.L.,U
ADDRESS
/I.{qrr d-,I(<;,.r'~ ~-'_
OWNER
CONTR.
PHONE NO.
PERMIT NO.
-:?-/9!:-'
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: I
.r J\ n VI" I " __a ele a fP /Ova!
~IJ~ ~v !~).(l-- ~I?~f
'FffFr x rp~QA+ ~II f ~,..... UIIl/-! I s.or1 r.r
v
, III .
---- .
( I --e j,N<{? Wl-h- L. ~ -(-O~
O/SG\?r f'f'CklJt <2..
~~ SATISFACTORY, PROCEED
~ ~~~~~CT ACTION AND PROCEED
o CORRECytitCLL FOR :'NSPECTION BEFORE COVERING
Inspector: - ~ 7 -0 ) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
(p--t7-fJ1
./
ADDRESS ! Ll 'a5'
/,l/[Mo (L,.-
OWNER
PHONE NO.
CONTR.
PERMIT N~- /9t;
r
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
)( PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
,. ~\Ml1\U ~ OOf>~
2.. ~\ k C\.\\ -t=:~
.,3. OtJ..l\ t(.,'r MTl)
ti\l~-'~~ ~4A_
o WORK SATISFACTORY, PROCEED
1< CORR9~1 AND PROCEED
o CORR..:.CT K, CALL FOR REINSPECTION BEFORE COVERING
Inspector J Owner/Contr:
CA~ ~7~850 loR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
C~MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
III
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
Jc,tct f:>b
OWNER
PHONE NO.
o FOOTING
Ii! FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
/'
I
~.w ~-
DATE TIME
SCHEDULED ~~l~~
~ CWJk
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
I! WATER HOOKUP
V SEWER HOOKUP
n PLUMBING FINAL
o MECH FINAL
'\_ A_,.
(~u c..-
(~
-
~/'
3 ..( 'ib
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~)~
Inspector:
OwnerlContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
I_'
DATE nilE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
11-A3 ()3
ADDRESS I~~ /-I('/l~/~/'/
OWNER cONTR. Mc.DoYf4k1
PHONE NO. PERMIT NO. -1) 3 -/7 j,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
(,'4 cU -' I] I(
C.p!b i3IJ / -' D It
lNSNOTl
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InSpectOr:~~ Owner/Contr:
~C-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
.1,
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please,!VDe or orint and si2ll at bottom)
ADDRESS
/4Q!?', I-I:/l S:rl<:..
Date Rec'
1- 30 -05
;~i~~ ~:~ I PERMIT NO. Q'?-Olq'A
3. Yellow Applicant '..;J LV
(1:11 e (~ ~1. W
LEGAL DESCRIPTION (office use only)
LOT 3'LOCK I ADDITION Sioe. /2/ : z,c-
~':e~R /hp(}~~J ("D~-t
(Address)
A. rJr),' t: D--
ZONING (officeu,,)
P{/o
Sf,--ODJ-1O
PID2.5-~- G ~
(PhoneW$":t- t.d ").-7 /..1:, 7
BUILDER J1/J ~ V1 ( ) /:) 1:
(Name) jr relvlr:;,..tu /. Lli> ~ r
(ContactName)::S~.l1~ ~..,I2L.r_ ~_Ii./]OI-&:J,J.t 4
(Address) t') foo7eAJt.lf""'f.~ "j.L-c;~.
I TYPE OF WORK
~ew Construction
~ireplace
PROJECTCOST/VALUE (exdudingland) $
l2$.ck
o Misc.
DLower Level Finish
(Phone)('......:1~ 4T~ -1' 0 L
(Phone)9S1.~9f}.1 OG. {,
JPJI"I!,. Ve..J~ /ht-l -. ..s'"3'" /~4.r
~rch
DAddition
ORe-Roofing ORe-Siding
DAlteration ~tility Connection
9.'J&. ~ctJO_(!)O
/ .
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 wilI proceed in accor~ce with
submitted plans. I 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 upo the ~ r' ~O to perform needed inspections.
X ...----.-.----
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
.,.~S 7 ooo.oal
$
$
$
$
$
$
$
$
l~{"a.qs-
I {4".(,,2.
{IP"50
I
/()(),() 0 I
100.00
3S.5tl
*.00
This Application Becomes Your Building Permit When Approved
_~ .:f~/-I
Building Official
~h3
Date
I Park Support Fee
I SAC ~
I Water Meter Size5/8'~
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
I TOTALDUE ~ '240-03
---l3e - ~'3? (p
Contractor's License No.
I Paid ~r /0/4.5 '1
I Date . 7-.,P- -G.j
#
#
#
#
I)
I ReceiptMo.
Bv _'
{;
/.30- 0 ~
Date
$ .RSO.OO
$ IL7S .00
$ .3on.oo
$ i(}.OO
$ IZ.OO.DO
$ 7(JO .00
$ I~OOIDe
$
I
I
I
I
$Q44-.5:zl
4-.39Z t- I
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. Tbis 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
u~ ~ ~443 ,(/U/4L-f ~~
Planning Director I . Date Special ~,lditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
I"
Thr Cf'ntrr of thl' takr Country
White - Building
~ary - i:n~ineerlng::,
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t,if C. [) () J\,j f\ L [) CY) t\J~';ITL .
f -:,.7, ("-, ,/......, "'2,
_" ',r) _ ( I _
->~' J ,_.~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,i c:L CI tA r:::::.: L..} ii, I C I () l==- /') ,II'? li JC~ t,,} I l'\/
i J I l/......,/ I ; i V L/ --' :-"..../ \,._... L,., !",./ v L,. I I;
I
Accepted ,A
Accepted With Corrections
Denied
Reviewed By: ffJ4- r<;
Date:
2.../o-c]
Comments: See Reverse Side for Additional Information!
See Attachments: 1) Grading Plan. 2) Erosion Control Measllr~~
"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
/
II c
White - Building
Canary - Engineering
C!::.ink - Plannlnse>
Tht Ctnlt< of tht t.kt Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
fvlc- [)C; Nf\L D CC}tJ(=~-
- ~C) - C3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4CIS~ F1f~l-CIU~ Gl/(:C/G~ NvJ
f
Accepted
Accepted With Corrections
/'
Denied
Reviewed By:
Date: c:2/ t, /03
, .
~ ..~<1 ~~ ~ ..a.-o'Jl?J 4d-~
0-0 ~~.
, ,
A'~ ~ ~Ad-~
17
2' i 101 i4 ~o ~~ '1 8'~
~ ~ ~ ...J& ~~ a~.
, # ..J
&.J. ~ &;..d-~ ,,'-'2~ {) -, -h ~ 1'2. I ~ ~
B..e..c.e. ~..JL tYJ w-o-lL ~% ~ 5"0' ~ / 2.'. ~
U - - U- u
~ AM d)" ,aAA ~ d'"JXA.
~
,....
'7? ' , tfl C-J
Comments: A, e.
~~.~
I
uJ~1 tJeR.O.-
~ w...-
"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."
,-.....--.- T T
'"
Job Address 1'fJ~1Ii/4t~
. Heating Contractor Controlled Air
Name of Tester pt)
Date p~3
Percent O2 7(;,7
Percent CO2 7,?
Percent CO 0
Stack Temp. I~()~
"
Ii[ i[1 I
<:::White - Bui~
~ry - t:ngmeering
Pink - Planning
The Cf'nlrr of Ihe' t.kt' Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
tbDONALD COl\lsIr2--
- 30 - Q3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4-q6~ H(~0SIDc CAe~ N vV
- ,
Accepted
Accepted With Corrections ~
Denied
Reviewed By:
Comments:
<<.~
ff~
"1-" , ~ Date: ,2/ ~ It!) 5
, ,
CJ.-IL( ~...h - 12 ~ '
"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."
Iii
1
!, I
From : JECHEE>-<C
PHOt.lE r~o. 612 8926396
Mar. 18 2003 7:46AM P01
'I' " .'
CITY OF PRlOR LAKE
SE\VER AND WATER PERMIT
/ . I . ,
Dllte Rel1'd
\\
)
1,0- PII.
, ....110.. tllr
S. Oold ~pll-
PERMIT NO. 3 ~ I q /p
l
I ZONING (O/&t uu)
(Plel\~ I:'fP! or llrlnt and ~Ip.n. Ilt bOllum)
ADDRESS
l~:l q C(s .JJJ1J s ) 'd (-'
n~, I
l) LV'L ~"..,
JJUvI
AI.
'.' I
LEGAL PESClUM10N (olller me only)
LOT:) BLOCK ') ADDITION
';;''1' 0.11'11) ~ (I
~":e~R If\1.ro ClcnI1 ,\ ~()J1.&"~.- (Phone) ~ f':l ~:l '1jp 0 I
\~)~I - l~:I!jn'<Jr I\..~,^l. \/~~lq:..~"" , '
'l/~""'.~I"":!.;'~" !:', "". (AddltJs~ _~g:tY~'I!i' I : ", . . '(Znl Code)
PIO
-~.f.t(~/~~;,::''';'~'';,~ 1-/ ~,:, . ;,;', .
':APPUCAN'1'-r-
; (NAmc:)'I"I;J,.IV ~ ~~ t.VQ.. (Phone) ~ I;) ');;JO 7c.rn .
~!(~~tdaL1) :r ~ eLo r.J €--- 81 {)()tf1 ;~-f()J1 M1J 6l~4 :::f !
~'''''r{;>:~~''';I'';, . (Address) ( Ity) (ZIp CodC)
!~d~~~~ ;erson)~) ~ -t:t 1_ . (Phone) t& 1f} C ?V:~~
:APPLI2ANrSIGNATURE~ rJ,Q " .- DATE ,-
APPLICANT }'!.,1EASE COMPLETE BELOW
- ~
Size of water service inches.
Location of any coupliJlg~ [rom structure feet.
,Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if I"c4uired) located at _ feet from structure.
R.esldentlal sewer and water line connection $35.50
Sewer connection only $17.50
DstimatcJ Co:;t $ ex :,/)
FEE SCHEDULE
Industrial, Com 'I & Multi-family 1 % of Job cost with a S39.50 mlnlmwn
Water connection only $17.50
Building Permit #
SEWER AND W AT~R PERMrr FEE
ST A Tn SURCHARGE
TOT AY. l'ERMlT I'-1m
$
$
$
.. ~~Q
" PAID WITH
BUILDING ':'ERMIT
(Orne. "'.. Only)
Tbl. AppliCAtion Bocomes Your Building Permit W'hen APpr~~~d~ },:i1 "\
. . ~) ~ ~ 0 Ifl-..[t 4 - By
Bulllllnc Offiel.1 -'.' I)Ale 1 II
__ ._ 'M h^... ..^"..... r~. .111..........11"". ",,,,,. (....~~.~ '~r"~ .~~6.~.J.~
III
Receipt No.
(it
\{I ""
FROM WENZEL PLUMBING & HEATING 651-452-0367
(THU) 3. 27' 03 14:IL/ST. 14:10.'NO, 4860053371 P 1
Date R<<'d
LJ J i OF PRIOR LAKE PLU~ING PERMIT
1.8_ ",.
I. Gold Cill
J, ToI_ "J>II'4''''''
PERMIT NO.~ -I q to
(Flease: l\1)e or print md Jim ltt. ..."J
ADDaESS
/19rs .,.JI,u.s/~ 0,12. N, W.
ZONING (olllu we) .
UGAL DESCRIPTION (cilia we only)
LOT3 BLOCK' ADDITION 57€J2UAJ, ~
~:~ frl~O~l..O CoNS-r.
(Address) , 7~1 11~7J:I ~T
,
APPl.lCANT I ~ I 11.1'1
(Name) wEAJZ~ I'(~AAJI<AL (Phone) ~5/-4SZ- '~b~
(Address) .)7/0 4.~~ ~ I E:A6AN
(Address) / (City) {
(Contact Person) fYlll~~ / Rt.c.J.J (phone)
APPUCANTSIGNATURE [;~~_
Quantity
I
I
I
3
I
/
J
2-
PlD
952..-1~2- ~I
M~
(phone)
I1PAL ()Au...~ _
. f
frW
~/21
(Zip Cock)
DATB
3!2?~
APPLICANT PLEASE COMPLETE BELOW
Q..ptit}'
_=.- 7-~
Type ofFbtan
Type of Fixtare
Bath Tub with or without shower
Dishwasher
Floor Orai"
Lavatory (Bathroom Sink)
Laundry Tray (l or 2 compartment sink
Shower StaU' ,-
Sinks
~ar sink
Water Closet ~1'oilet)
Rough-ins
Water Hum
Water Softnar
Stand PIEe (Wa.shing Machine)
Scwa~e Ejector
BacldlOWAsscm bly
rsaclcflow Assl:UIbly Test
Lawn Spnnkler
Other
/
FEE SCHEDULE
Induslrial. Commercial al Mulri-f&/1lil)' I % of job cost witil a $39.50 minimum Residenti.l, New One!. Two-Family $99.'0
Ra:sidential. AdditioN &. Alunrlon' $39.50
(Oflice UU! 0111)1)
".
Estimated Cost S J~I '111f) -
.uIlG'. OIrlri.1
Building Pcnnit #. 03 &. O~
PLUMBING PERMIT FEE S 'U11..DI. ro
ST A IE SURCHARGE $ .50 ,~
TOTALc~FEE $. VJ fJ
IiJUflOl!Jv'" is;..j Jlecciptl'lo,
! nil Ll:, f, il
L [paftlAR 3 1 Z003 II) lBY ()J
U (/.
::4 hou," uotic:e for .n ioapcctiol' ~; 44 ~ lo {9Sl) oU-;-4Z43 .
This Applic:atioD Becomes Your Bujldin~ Permit Whln ApprovCld
D.lt
I Ti T I
--~ ~.. r",J.V.I( LAKE
I4JOOl
CITY OF PRIOR LAKE
HEATING/AlR CONDITIONING/~1l{EPLACE PERMIT
Date Rec'd
1. r'lblt ~.nc
2. Or... City.
1, V.I1_ Ap,ll<....
PERMIT NO.
CPlezse rvtle or or'..nt '-D.r1lii~ :at bottom)
ADDRESS
Zo~G (o!5t;c Ult)
/;jq R'.<
.M;h.r~Qe
c01r, AJI U,
I LEGAL DBSCRlPTION (office u,eonly)
LOT
BLOCK.
ADDITION
PID
OWNER f'\ [)
(Name) .P?t('1~ )~fJ- 'J(lJc
(Address).A. 1/,.
(An1 ~ ;..,
(I'honc:) 4;<:,9 -' 7~n I
APPUCANT 1/ n
(Name) r/Y!),t/'o.&~
(Addrcss)DJ/ d I 6 'COL~A.J
(^&Ir~s)
()l ,/1,
At J-e. ,
(phone)
4bD .- ~c? 6l .'
5~ ~ J../
(Z~ Code)
(Conta.c~ Pason)
?;d
7~~
~.
(; (CitY)
. (phone)
DATE
3 ~ &7-0~
Al'PLlCA:N'T SIGNATURE
. j" APPLl~ANT PLEASE COMPLETE BELOW
...JdNt. w CONSTRUC'l TON . 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL ~~ .' C9/pPj) /00 FUEL _ AJ9 f- _
FLUEsrZE $/' PUt., RE~~GS .!J INPUT ~9 6CO~ OVTPtTTq.~e,o~
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plnnts
~jt)'
~x:r~Ch t"a1 .'
~?ir onditioning
ent. System
o St~am
o Hot Water
o F,lldla.tJon
o Sp~cial Dcvkcs
o .QlhcrOevfces
PLEASE NOTE:
All Conditioner Units
Ca:nnot Encroach into
Required Side Yard
Setb~cks
FIREPLACE MAKE AND MODEL
:FEE S~J:1l!.DULE
Industrial. Comrriercie.l & Multi-Fa.mily !'Yo ofjob ~o~t Residcntie.l. Gu Firepl~ee
$39.50 minimum
Residcl1tial, Heating & f.JC (New Construction) . $99,50 Restdential,_Addltions &. Altcrations
Residential, Heating Only (New Construction) $64.50 Residential: AC Only
S39..50
.$39.50
$39.50
Estimated Cost S
Buliding Permit "#
REA TlNG PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(orne: US( Only)
Tbl3 A~plieatiot1 Becomes Your Buildil1g permit When Approved
Paid
Receipt No.
Date
By
Bllilding Ol1W".1
D3te
2.4 hour notice for aJllnspeetibnJ (952.) 447,9850, fu (952) ~7"'Z45
too~
HIV G3110KLNO;)
9lZ909ttS9 XVd It:60 rrH~ cooz/li/co
I r:
04/10/2003 THU 08:02 FAX 6514606276
CONTROLLED AIR
~~~ CTY PRIOR LK
~OOl
@OOl
--~=- ~.' r.ruu.K LAKE
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGI.t.f.l.l:<EPLACE PERMIT
Da.te Rec'd
.!It FAXED
;: ~~~~ ~I~..I PE:RMIT NO. /) -' (A )
1, Y.U_ Applin., :J <.// (,.P
(Plusc tYDe orinint tnd nl!:!1 a.tbottom\
ADDRESS
#;h,~Qe
ZONlN G (oIM: USIt)
/~q R'<
u~ , AJ ,t~.J t
LEGAL DESCRIPTION (office USe only)
LOT
BLOCK
ADDmON
PID
OWNER cQ
(Name).Y71r. (\)b,.'Jn leD
(Address) A 1/,
("Air1 ~ f-,
(phone) /1';<;,9-' 7C,n/
APFUCANT ikD
(Name) (.QlJ ,1/'0
CAddTCSS)DJI d I t'J l:;(JL~1U
(A6dre.!s)
a ,./'0.
(Phone)
~t) __ c..~.;;) ~ .1
.~~J./
(Zit' Code)
A(l~'
? r::. (Ci~)
(Phone) _
DATE ;5 - <97-0~
(Contact Person)
d~ _7~~
.
APPLICANT SIONATURE
. /' APPLICANT PLEASE COMPLETE BELOW
, ,.01ffiW CONSTRUCTION 0 REPLACEMENT 0 At'TERA Tlm-lS
FURNACEMAKEANDMODEL('~~ .' C9~P~/OO FUEL ~r-
FLUE SIZE ~ RETURN PENlNGS ,5' INPUT ~a 6CQ ~ OUTPUT (}o>. OO~
7' ,
!i"PE OF SYSTEM HEATlNG OR POWER PLANT '
OWa.-m Air Plnnts
~i1Y
E...er~Ch . ic::al "
Z6i" onditioning
eDT. System
o Steam
o Hot WI'ter
o R.lIdilltlon
o Sp~c:lal Devices
o .other D~yices
PLEASE NOT~:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setba.cks
FIREPLACE MAKE AN"'D MODEL
TnduSlria.1. Comm.ercial & Multi-?amlly
FEE SCHEDULE
1% ofjob cost ~sicl<;ntiel. Gas Fireplace
$39.50 mini~um
, $99.50 Rlls1dential, Additions & Alterations
$64.50 Resid~ntia(AC Only
539.50
RlUidc!\tial, Heating &. }.JC (New ConsTli.lction)
Residential, Heating Only (New Construction)
S39,50
$39.50
Estimated Cost S
~uilding Permit "#
Building Officilll
~ .50 lJ(JIl.~AID WJ"rH
$. . 1NG p~
\ ~ @ ~ n nn !~ '\ I . FlMI7'
~< PailfJ b L; G b ,) j Receipt No.
~ oli~ 1 U LUUj Jl By (/r
i; lJ
2.4 hour notice for all inspecti6n$ (.952) 44 8;850. Cu (9S2) 447-4:245 j
HEATJNG PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
COmet U~ Only)
Tbis Apyli~tton Becomes Your Building permit When Approved
Da.le
HI
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
L Pink File
2. Green City
3. Yellow Applicant
PERMIT NO.,S/ /q ~
-...
(Please type or Drint and si~ at bottom)
ADDRESS
ZONING (office use)
14985 HILLSIDE CIRCLE NW
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
MCDONALD CONSTRUCTION
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
(Phone)
ROSEVILLE
(City)
651-633-2561
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone)
651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
3/29/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Steam
D Hot Water
o Radiation
o Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEAT N GLO 6000TR-OAK
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
(Office Use Only) ........ ~ ---.:::-
This Application Becomes Your Building Permit When Approved ~~ II @ ~ G \!! 'eceipt No.
Date 1\ . teAf'R U ~ LUGj J y ()/~
Buildin!!: Official V
24 hour notice for all inspections (952) 447-9~axJ9"1)4471i'~ -
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
9utL6A1D fNrrH
1NG PERMIT
.50
Ii
I..., ,,,. .
PRIOR LAKE
INSPECTION RECORD
SITEADDRESS ~~8S HiLLS;))€' ~ ~.IU.
NATURE OF WORK ~ W Cc~StItU4t' '6~
USE OF BUILDING S.F:O # _ _
PERMIT NOo,l ()3-0/90 DATE ISSUED 'L/~C3
CONTRACTOR ~AIJLCDt-lsr · PH<3NE~ - "132. -71.07
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PER~IIIS BY S~RATE DOCUMENT
L L f2- J... ft'1/ t.;. 76 ~ j\ INSPECTOR DATE
I FOOTING I I/cV f?'-Lj--ci)
FOUNDATION (Prior to Backfill) I M/ Q.J h
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~
DEPARTMENT OF
BUILDING AND INSPECTION
SEWER I WATER I SEPTIC
FRAMING S ~{J~... 'I
INSULATION v
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE 1 c,t ~\ rT7 tS~)
GAS LINE AIR TEST
3 It4.- h3
j/Vf/
11j </ - J
If-t . -. (7)7- t
~
6Jf> ~ 4-(,
...5~c -~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
fiLJJpIJJ"./~~TII~~ ~11JN6' I R0i I tW~~
. ~ . FINALS
- /1/1/ 1.~3:f)]
<6/147 liS
GRADING (Prior to Sodding)
BUILDING (\.-tWl(? lft,\:rt
ELECTRICAL
PLUMBING
HEATING
DO NOT
/ l/ -2./
~t' -r; - /?
IW (9' j., 1 ~cfJ
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
III