HomeMy WebLinkAboutBuilding Permit 98-0328 � .
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DATE ��1�,.--..�—�—.i'� ;�' _ `
CITY OF PRIQR LAKE . . � � , j ', .� ! �� , �: -
/ � _ .�
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INSPECrTION NOTICE SCHEDULED Z3 �� -- �":;''� • 4 « a ,''„� .,,,; �' , ,,r * � ,° " "` _-
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ADDRESS t�lOSD n1� � _ +._�
OWNER CONTR. n/L� OS. C.e � n��y � �
- " � � � �, x .� � �; �!1 '! � '�
PHONE NO. PERMIT NO. � - Zg � ; � � �. � � � � � �
❑ FOOTING ❑ PLUMBING RI �, EX/GRADIFIL � . + p � � �. a � � � �; `0 � '
� FOUNDATION ❑ MECH RI � COMPLAINT '`' � x � o. � o �� Q � �
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI -: �' e� �"�, a Q � �, =' -
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FI ` rt � � �. y � ' �.
�FINAL ❑ PLUMBING FINAL O GASLINE AIR {: �a C7 y N w �,�,, �� a P. � '
❑ SITE INSPECTION ❑ MECH FINAL ❑ ... �, � �i N � � � 'C� I� +
�* � C� r F- � �' o� l �y ` 1 � rt '"
COMMENTS: :� o � ue ,� �° � y y r+� ,�••� :'
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�WORK SATISFACTORY, PROCEED . � �° r.� � � O � � ,��,
❑ CORREGT ACTION AND PROCEED �� A� �' �
� � tti o0
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ' �� � '� � �..°,� ('� +-
V� C) ^ 4�3, a
� ' O p et ee
Inspector. f,� 1. �_ n_er �� a, 4 +�
�
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOUR3IN ADVANCE. �.. � � `w '�
( * " � ' :'�- „ ' M - � , � Y/ ' I�� �,, \
CODE REQUIREMENTSARE FOR YDUR PERSONAL HEALTH & SAFETYJ ` *.. / �. � . •4„ � ,�' 4' � , .tY , � ,� -- �
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DATE TIME
CITY OF PRtOR LAKE CALLED-IN
INSPECTION NOTICE Q� SCNEDULEO �� ' U
PERMIT NO. � " 3 � " COMPLETED
ADQ�� t�� �I ;���(s� � �
OWNER CONTR.
� TELEPHONE NO.
t� D FOOTING OPLUMBING RI ❑SlTE INSPECTION
� ❑ FfUMiNG /� ❑ MECHANICAL-RI ❑ EXCAV.IGRADINGlFILLING
� ❑ INSUtJlT10N �`'� ,0"WATER HUOKUP O LAKESHOREMlETLANOS
Q❑ WALL 80. O METER SET/TURN ON � COMPlA1NT
Z❑ FINAL A gSEWER HOOKUP ❑ GAS LINE AIR TEST
Q � FOUNDATION ❑ SEPTIC INSTALL. � SEPTIC FINAL
_ � ��-� 0 �� ��• ❑ FIREPLACE
v❑ FIRE PREV. ❑ PLUMBING FINAL p MECHANICAL FINAL
� COMMENTS:
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p " � til.._
�
W ` t `' �
a v S
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0
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¢ �
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W . n.. UGc�
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Q �Ne��a�
W❑ WQRK SATISFACT Y:PROCEED ❑ PHOTO TAKEN
Q�0'CORHECT WORK AND PROCEEO
�❑ CARRECT WORK. CALL FOR P,EINSPECTION @EFORE COVERING
O CORRECT UNSAFE CONDITION WiTHIN HOIIRS. INSPECTOR WILL RETURN.
O STOP ORDEFI POSTEO. CALL INSPECTOR.
0 INSPECTION AE�IJIRED. CALL TO ARRADKiE ACCESS.
cali for the n in ion 24 hours in advance.
Ownerl r. o e
Inspector 447-4230
r.wo»�ca�y� �n.cop,.n�o.cmr�ar�.
DATE TIME
CITY OF PRIOR LAKE Cnu.�o-�N
INSPECTION N a CE g SCHEOU�D q' �' �7� d= �
PERMIT NO. � Z c��o
ADDRESS I �(aS l � .� c�.. �N
OWNER CONTR.
,. TELEPHONE NO.
�j ❑ FOOTING ❑PLUMBINCi RI ❑SITE INSPECTION
� � FRAMIN(3 ❑ MECHANICAL-Ri ❑ EXCAV.K3RADiNG/FiLLfNG
�❑ IN3ULATION 0 WATER HOOKUP ❑ LAKESHOREIWETLANDS
0 0 WALL BD. ❑ METER SET/TURN ON ❑ CQMPWNT
2❑ FINAL O SEWER HOOKUP O GAS LINE AIR TEST
Q O FOUNDATION ❑ SEPTIC INSTALL. ❑ SEPTIC FINAL
_ � OEMOL. O SE�TIC MAINT. ❑ F PLACE
�❑ FIRE PREV. �,�,P'CUMBIN(i FINAL ECHANICAL FINAL
= COMMENTS:
Q � °''� �
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W O K SATISFACTORY:PROCEED O PHOTO TAKEN
O CORRECT WORK AND PROCEED
� � CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
V O CORRECT UN OITION WITHIN _HOURS. INSPECTOR WILL RETURN.
❑ STOP ORDER CALL ECTOR.
❑ INSPECTION R OUIRE . L TO ARRAN(iE ACCESS.
call for the next nspect ours in advance.
OwneNContr. on '
tnspector 447-4230
Y�Mow Capy/�NNoticv WIN1s Copy/Map�ctor's FNs
D TE TIME
CITY OF PRtOR LAKE
INSPECTION NOTICE SCHEDULED � f {9a
ADDRESS I � � �l � I � �SEj � �
OWNER CONTR.
PHONE NO. PERMIT NO. � —�� �
❑ FOOTING 0 PLUMBING RI ❑ EX/GRADIFILLING
❑ FOUNDATION � MECH RI ❑ COMPLAINT
❑ FRAMING O WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP � FlREPLACE FINAL
¢�FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
D SITE INSPECTION ❑ MECN FINAL �
COMMENTS:
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ty �+ �m i �.-,
a;,�
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�WORK SATISFACTORY, PROCEED
O CORRECT ACTION AND PROCEED
❑ CORRECT WOR CALL FOR REINSPECTION BEFORE COVERING
Inspector: � � Owner/Contr:
CALL 447-9850 FOR E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS' ARE FOR YOUR PERSONAL HEALTH & SAFETY!
rxsxor,
� O � P R/p�, �
�� CITY OF PRIOR LAKE �. w�,;� File
� ���� 1�'� BUILDING PERMIT, 2. P'°k c"
(� , '� '1 --� _--. -- 3. Yellow Applicant
, ��,1 (� � 3 � ,; � �TEMPORARY CERTIFICATE OF
,, , � ,, ZONING COMPLIANCE
�'�� ' UTILITY CONNECTION PERMIT Permit No. �t�" ��
��
DIRECTIONS _ - 1. DATE
SPACES NUMBER� 1 THRlJ.1�-M . FILLED IN ^
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 5 �aj � 9(� BUILDING INFORMATION
2. SI � ADDRESS / �, �� ��� 11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTlON 2 12. NO.OF $TO�iI�
LOT � fi�] BLOCK P!D 0��,,,TJ� � V�� � � �
� I S S (}��L �.-� �� 13. TYPE QF CONSTRUCTION
ADDITION v
4. OW ER (Name) (Address) (Tel. No.) 14. FLOOR AREA APPORTIOIYMENT USE
D� No �ac�.K 3� - (�5�
5. ARCHITE (N�e) ��� (Addres�s) /� (Tel. NoJ� - /1 �
v
6. BUILDER (Name) (Address) � su �ei Ng.) /,��� ��� 15. NUMBER OF OCCU �NTS OR SEATS
��y� „ , � ����� �. �� ', � � � � OCCUPANTS
� �,�, �� �.�
7. TYPE OF WO K Fireplace O Septic O Deck O R-roofing O Porch O SEATS
New C y struction� Alterations O Addition O Finish Attic O Re-siding O Finish Basement d 16. PROJEC��QS` �A�LU
Chimne O Misc. U V v V
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. CO PLETION DATE
Sq. Ft. //,.� � Width Depth Yes No �$
I hereby certHy that I have fumished infortnation on this application which is to the best of my knowledge true and cortect. I also certiiy Uiat 1 a e owner or authodzed agent for
the above mentioned property and that ali construction will conform to a!I e�asting siate and local laws and will proceed in accordance with submitted plans. I am awere tliat the
building official ca revoke this p it for just cause. Furthermore, I hereby agree that the c'dy o n ici / a , l or a� d may enter upon the properry to perfortn needed inspe �'o s.
X �.�/�-i � r���'i.-� �( JV�Y �� � ' -
Signature License No. Dete
FOR ADMINISTRATIVE USE
SETBACKS: Required MATERIAL FiLED WITH APPLICA710N
Actual SOIL TESTS O ENERGY DATA
Front Back Side Side
BUILDING DEPARTMENT VALUATION OFF STREET PARKING PILING LOGS O PERCOLATION TESTS O
SPACES REQ. PLANS & SPEC9�'�- SETS
USE OF BUILDIN�
S�=
SPACES ON PLAN SURVEY .A^'COPIES
PERMIT VALUATION I oZI� OOO •O � PLOT PLAN O
7YPE OF CONSTRUCTION: I II III IV Amount 8rought Forvvard $
Occupancy Group A B E F H I M� S U ���' ..................
Division 1 z a a qq Park Support Fee ........................... $ �'1 �.�i �
Permit Fee ................................... $ l t� Z. 'j SAC ......................................... $ l C9 OO � C, Z�
Plan Cheds Fee ............................. $
�.e t`I _ I� Collecdve Street Fee ....................... $
�a � �y Sewer Tap ................................... $
State Surcharge ............................. $ l0 � /
f ► ............. $
Penalty ....................................... $ Pressure Reducer ......J�f. $ • � �
Plumbing Permit Fee p.�. /./'• •3 �:� $ Jd � � �(3 Meter Hom ......... .. . . $
Mechanicai Permit Fea��. fT�..+7. �.$ / d�� D a Water Meter ...... ........... .. ..... S � O • D �
c � , �� Sewer & Water Connection Fee ........... $ . �
Sewer & Water Pertn(t .. d3. .w... � .��$ � S . �� '� � � d
-�(� Water Tower Fee ........................... $ .
GasFireplacePertnit ��.� :� $ - 1 �' �� WaterTap ................................... $
This li tlo Become Y ur Buiiding Pertnit hen Approved. Builder's Deposft ............................ $ ,r�C�l� . � E'�
YB Date � Q8 Other ......................................... $
Certiflcate of occupancy Total Due .............................. $ '�k 3��3_ 1.�
I � u � Pa�-r ,� Receipt No.
Date By
This � erti at tlie re est in the above application and accompanyirg documents is in accordance with the City Zoning OMinance and may praceed a u ed. This docurtrent when
sjgn b� tb Ci lann onsMUtes� porary Certlfic.ate of �' pliance and allows construction to commence. Before occupancy, a Cer6ficate of Occupancy must be issued.
C� [F L�t
C�ly Planner Da e Special Conditions if any
24 hour notice for all inspections 447-4230 p�,, � l
� 4�
O F PR/p
� �
U , r�T7
White - �uilding
C9nary - Engineering
Pink - Planning
The Cenler ofthe Lake Country
BUILDING_ PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT /�'►�-�� 8� � • ���'
APPUCATION RECEIVED 5 � / 3 " `� �
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
l b� 5 J C,� ► ��� � f� -�,t_._-�
Accepted Accepted With Corrections �
Denied
Reviewed By: Date: �'"���
Comments:
I • S�Q �....� �� � �ll .�..�...� �,,
2 , INt0.; � �e r,ns� � �v�i,�� -
,
3. K.ea� a�Q.. c�.�cc�-•a,r� �,�,.��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."
BUILDERS DEPOSIT/TREE DEPOSIT
CITY OF PRIOR LAKE
A$1,500.00 Builders Deposit is included in the Building Permit fee. The Builders Deposlt is issued as securtty to
insure compliance for a Final Occupancy Permit. (It is not an escrow account.) A$500.00 Tree Deposit may also
be required and will be refunded if specified trees are preserved for a period of one year.
DATE: � ' r ' � _
��
SITEADDRESS: IC�I[/� I �n���t'' �.�,� �V_ PERMIT# I�'.3Z�
REFUND TO BE MAILED TO:
� ���i!P�'� �.
��� � � �� ��
r�.,�e_, 11�� . �7� .
PLEASE REMEMBER -- TO AVOID PROBLEMS
1. KEEP STREETS CLEAN DURING CONSTRUCTION
2. KEEP EROSION CONTROL IN PLACE
3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR $500.00 WILL BE
FORFEITED
SIGNATURE: I �
�:�%.1�%98 WBTJ 10:11 k"A% 012947�1245 CI'T5' OF PRIOR LAKE ��100`l y
� , "" � ( ��
CITY QF l'1�tT0�. LAKE
�mpervious Surfuce Calculatians ' �
cTa ba suamistea riith Hu�ld►n� permn aP�ttcnaan� �
' �or .41.1 Propetties Located in thc Share�arid Dis�i,ct (SD).
The Maximum 1'mpervious Surtace Coveragc Permitted itt 30 �Percent.
Pmperty Address. ��o �,.�`�� �i�.Sc9�r` ��
�ot Atea ,� j� ��aS� Sq. Feet x 30°!0 � .............. � 4' s, .
•�*��w�*t�*+s�ss *s��*�s+�*���•s*aa*�#**s�+et�r*r�M+s**��+�,r�ry4#:�+r�r�hs*�ra��r*�►*s
LEYGTH WII?"fH SQ. F�ET
�OUSE - � $
x =
ATTACHED GARt�GE x = '�"
70TAL P�tIlVCIPL� 5TRUCTiJItE.._......,...»......
DETACHED• Hi,DGS x
(Garage/Shed) �
---�-- ��
Z'07AL DETACH$D �UILDIIYGS.........�..,,,.....,. 1-
DRiV$�VA�C/PAVED AREA3 x �
(Dri�eway-pavpd or nat) x �
(Sidewalk/Patking Areoa) � '� x � O
�Y � � P� T `/D ��S�N�i1�i�II�N������N�lN�YY��w������� O
����
PATiQ3rPORCHES/bECKS x =
(ape� Daoka %."•min. opcning boswasn � ,
beapde. witlt a pavioua suK7lce belo�r,
� noe aonaidse�ct.�a bo imPervious)
X =
?OTAi. DECK5........�,....---...----,......_�...,._...._.......
OTi�R x �
x =
iOT� Oa4f�I���N�Y���NY�Y��INr�w���Y�wAM��WN�/�M�
rox�, ilvarnERVtoUS sU��c� �`��
urrv�.x�ovER ---
. Prepared By Date J ,�=�
��
Company � Phone # ?, Ss� �. —� � g
Td Wti6b:0t 666I bi 'h�W 0£09bSb ZT9 :'ON �IVOHd I�I1�f1Zi1SND� S21�HJ.02IH J,��W : WO?!�
F PR/p
f
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U , m
White - Buiiding
Canary - Engineering
Pink - Planning
The Center o(Ihe Lake Coun�ry
�LDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT �'�'►�'-��r�r-� �'r= s �-�" :�'s�' �
APPLICATION RECEIVED S � / 3 `� �
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
l(,.a �./ � L.- '� -' r 7 f' j<''�J Y k�i °�,
Accepted Accepted With Corrections J
Denied
Reviewed By: • Date: /�
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."
OB/10/98 WED 10:09 FA% 612 890 275� STOChER E1CaVATING C�001
u�er • r�
O C P R JO� Tll.t0lr - aTR1GtR
�
COLO - C1T7
r1r �
� 7
� �
U � ���� C�TY OF PRZOR Z..a►KE N� •' ��
—'--- EWER AND WATER PERMIT
�l•v V E� � �
� g� i NOTE : Sewet and Wat�r
contractors mu�t
be reqistered
with the City_
� .
►-
APPLICANT' DC Mechanical/Stbcker �xcavating PHONE: 890-4Z41
ADDRESS: 8247 st 125th; St. Sava MN DATE: 6-9--98
SYGNATURE: "
BLDG . PERMIT n � (� 0
SITE ADDRESS : 16651 •ind�nr T ana S F pl�n-� :L�� �`��� y v
F�LL IN THE BLANK$ �
1. Estima�ed length of s�rater service feet- ��
2. Size of wat�r servic� inch(es). •
3. Location of any coup'lings from structure __ �eet.
4. Type of sewer pipe. : ABS __ P�C_g_ Cast Yron
5. Estimat�d length of ;sewer Iine feet.
6. Clean out (if reguired), located �t _„fset from
structure.
��...,._x���:�:���=�___=__--___�=____-= _=___�...���=N=����--
This a plic tio b es your p�=mit when approved-
BY DATE - �/� ' I U °� Y
s==�=�m_=��=��ea=�•==�...-.__�.��.._=-__-�.�� =.r.s�����-..�..,�rsa��___�=a
FEES: �$ 35.00 �Sewer and water lin� connection permit.
$ .50 :Surcharge
$ 35.50 :T02AL
� Fee for eith�r s�wer o= water individually is $20.0o plus
$ .5o surcharge.
� Secrer and water pGraiits issued for new construction must be
recorded on th.e building pe�mit card at th� time of issuance
to insure that no duplicate sewe= and r.ratez permits are
issue�d_
DATE PAID '� AMOUNT PAYD cJ� ._
.
RECEZPT tt R��n niNG p..F�� REC D BY _
. �
16200 Eaale Creek Av. S.E., Pnor Lake, Minnesota 55372 / Ph. (612) 447-4?30 / FAX (612) 447�245
An Equal OppoKUniry Emplaycr
�-��-����-�� �: -- 'CITY nF PRIOR LAKE 2 :�°° �r
�-L _ ' ` . '.. __ 3, YeUow ApplicaM
� � � � ^ ., PLUMB/N a� PERMIT � � �� �
�. f 4 l99� . �
,A ' IicaM Sc� '(1 e ��r P ��-11'( ( �'1 Phcne: �`� �� � - +:�� �� �
`� ��� 1 f�k.¢:
rt�e s�.�.. or �k 4.r. cor�in ��/4d �958: � �� C��' 10(1�. l�C�
�-------- ---- - . .. Signature: ' c
� Legal Description: Lot �' Block , Sub �.J� /,J,.� . � P,r,,, cf.j'
Site Address: 5 � ,�1 SG �'� �I �1 �
�� Building Permlt # � PID #�� 33 � - d �{ / • (�
NOTE This permit w I not be prooessed without complete ir�formation.
FixruR� uNirs
OuantHy Type of Fixture �uantity Type of Fiuture
� 8ath Tub with or without ahower 3 Rough-ins
Dlshwasher ' Water He�te�
� Floor Drafn Water Softner
Z., Lsvatory (Dathrqom sink) � Stand Pipe (washing machine)
� Laundry Tray (1 or 2 compartment ai�l� Sewage Ejector
� shower Stsll Baddlaw Asaembly (RP2, Qouble Chedc, PVB)
' Slnk& 8ackflow Assembly Test
Bar Sink Lawn 8prinkler
Z, Water Closet (toilet) Othar
FEE SCNEDULE
Industrlal� Commercial & Multi-Family �
(1 °�6 of job �st� �39.5Q minlmum) $ � 9 � s z}
ResfdentiAl� New One & Two Family $gg,50 -`
Aesidential� Additions b Alterations �39,50 a
State 8urcharge a .50
GRAND TOTAL $ � ' �
BUI L N P RMI'1'
Tlris pe�mit is grant�d upon the express eonditjQp that said
' �liractor. shall to�nply in dl respeca witb yfe ordioanees
o( thc Sn� PlumbinE Code apd the smendqnen�a the�eof.
RE�1PT NO. Dq'1E
1'AID �y T
�UIID�►�j� PE � �for all inspecqions ?a hours iti cc.
16200 Eagle Crr.ck Av. $.E., ptior Lakc, Minaesota 553�'2 / Ph. (612) 447-4234 / FAX (612) 447-4245
An Equal Opporcuniry Employer
�� c'�ti���, ��� � V L�,—� i r��� - r�� D
�� ' 9 CITY OF PRIOR LAKE M � � ' 1 �"n" � �'�r �
� J. Ycllow . Cancec�or �
� � rn 1 6 2 0 0 E ag le Cree k Av S. E. ermit No. _� �'�� � � E F T R TURE o
Prior Lake� MN 55372. � � �
HEATING APPLICATION / PEflMIT �� le Famil o-Family Mu1ti•Fami�y �
Dale /� ' � - y� PID R �'S � � � • ��d Indusl al Public Other
- O
�
Site Address /(� �-,�/ '� ; ,��4,� [t�. Fee Schedule �
10
lot � Block Addition 1 � Qo ,,,.,,, ��(� � n d Industrial, Commercial 6 Multi-Family 19�e ol job cosl (539.50 minimum) D
Owner's Name a Residenlial, Healing d AC 599.50 �
/�' r�,�„_ s.
�,'i Residential, Heating Only �64.50 �
Address /(o(o5i (.[J �,vG_�,n lv� Residenlial, Gas Fireplace $39.50 ID
fiesidenlial, Acldilions b Alterafions �
Flealing Conlraclor Allild FNlSid! 339.50 �,
a� � Flesidenlial nc o�,iy $39.50 , a
Address �0111tiCb/t LICl11S! N2�091� �
1700 N. �irvie�r ve. �
Telephone q__ RoSlviqe. MN SSI1� Remember lo add Ihe Slate Surcharge on Ihe bottom ol Ihis application. �
612/633•Y561 3
Furnace Make d Model �� � , TYPE OF SYSTEM Tlie rice ol our healin
Warm Air Planls P Y 9 permil includes une rough-in and one linal inspeclion. �
Model Size �/11 ef / Gravily �ddilional inspeclions will be billed al 535.00 each.
Conn. Load Mechanical flouse tlealing Tesl Record musl be submilled wilh � di
Air Conditioning �9 R.giIDll NuII�Bi betore build-
� ing cerlilicale ol occupancy will be issued.
Fusl �_Flue Size Venl. Syslem
NEATING OR POWER PLANT �� �`�`� T � - �� ��Q wilh number ol supply and relu►n openings lisled pe�
Supply Openings room wi11� CFM's per opening. New struclures or additions send Iloor plan wilh supply
Sleam and relurn localions shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Relurn Openings I�lol Water APPLICATIONS MAY BE MAI�EO TO TFIE CITY OF PHI�R LAKE, 16200 EAGLE �
Radialion CHEEK AVE. S.E. PHIOR IAKE, MN 55372. �
Inpul Oulput Special Devices �
Ci1y Hall business hours are 8 a.m. - 4:30 p.m. �
Edr. ,
O�her Devices ALL WQRK MUST BE INSPECTED �ROUGH-IN AND FINAL) - CALI, CITY HAIL W
Clm. W
447-0230 �
TYPE OF WORK 00
I hereby apply for a mechanical syslems permit and I acknowledge thal the �
Allerations Replacemenl New Conslruction �k intormalion above is complele and accurate; I�ia1 Ihe work will be in conformance
willi If�e ordinances and cades of Ihe cily and wilh Ihe slale building/mechanical
Repair Est. Comp. Dale ��/��R� codes: Ihat Ihis lorm does not became a permit until signed by fhe BUILDING
�'— O�FICIAL; lhat Ihe work will be in accordance wilh Ihe approved plan in the
Esl. Cost � ��(�C� Building Permh N �� • a�,�' case ol all work wliicFi requires review and approval of pla�s.
I�E�TING F=RMIT FEE S_�� � � -- ���/��
A licant' Si nat e �
STATE SURCHARGE � .50 PAID WITH PP ' g Dale
BUILDING PEHMIT °
TOTAL PERMIT FEES ; yd. �b Receipt � � 9 C fe _ '�' °��� Y
Dale
1. Pink - File
~ � �Rlph, � � 3. Ye�llav - C ntractor
� �.�� CITY OF PRIOR LAKE M� (c� � ��_---�i1 TypE OF STRUCTURE
� �, 16200 Eagle Creek Av. S.E. permit No. �
Prior Lake, MN 55372 `�� +
Fal�iily ' t1 � � Two-Family Multi-Family
HEATING APPLICATION / PERMIT � �
Date �s PID # �.S � 3 8 �(� I 0 Com — Iridustrial Public Other
S�i Address �� f GCJ/'�S!'lI2 ,�� ee Schedule
Lot � Block � Addition ��( J. f 1rn c� 5� � Industrial, Commercial & Multi-Family 1% of job cost ($39.50 minimum)
Owner's Name / r��A ) L� ,�/Q�'j _ Residential, Heating & AC $99.50
Residential, Heating Only $64.50
Address Residential, Gas Fireplace $39.50
L Residential, Additions & Alterations $39.50
Heating Contractor r � Residential, AC Only $39.50
Address � •
Telephone # � � g 3 Remember to add the State Surcharge on the bottom of this application.
Furnace Make & Model � TYPE OF SYSTEM The price of your heating permit includes one rough-in and one final inspection.
W Air Plants
Model Size o� h ( �� a�ity ��, �ldditional inspections will be billed at $35.00 each.
� � Mechanical «�'�
Conn. Load House Heating Test Record must be submitted with il in rmi number before build-
r � Air Conditioning 1 y ing certificate of occupancy will be issued.
Fuel – ��� — Flue Size S Vent. System
G� HEATING OR POWER PLANT –� CALCULATIONS AE�UIRED with number of supply and return openings listed per
Supply Openings / room with CFM's per opening. New structures or additions send floor plan with supply
Steam and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Return Openings � Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
Radiation CREEK AVE. S.E. PRIOR LAKE, MN 55372.
Input �� Output _ ��� Special Devices
City Hall business hours are 8 a.m. - 4:30 p.m.
Edr.
Other Devices ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Cfm. aa�-saso •
TYPE OF WORK 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
Afterations ReplacemeM New Construction with the ordinances and codes of the city and with the state building/mechanical
Repair Est. Comp. Date � ---- codes; that this form oe not become a permit until signed by the BUILDING
� (i � OFFICIAL; t t the r will e in accordance with the approved plan in the
Est. Cost $ �'`��v• Building Permit # � b 3� case of all rk ' h eq es review and approval of plans.
HEATING PERMIT FEE $ ��� S+� ,? T f�
STATE SURCHARGE $ .50 pAID WITH A c'�i � re �� + e
��� �/
TOTAL PERMIT FEES $ !i O. bo Recei t# BUILDING PERMIT � '� s" 9 r
/ P Building Offical's Signature Date
DEPARTMENT OF
, BUILDING AND INSPECTION
SITE ADDRESS I�o��l ��`�n�.sc�r L.r,��
NATURE OF WORK ►�1�� (1,��,
USE OF BUILDING Sf',�
PERMIT NO. 98 -3ag DATE ISSUED S-aO-qPti
CONTRACTOR �M .�
NOTE: THIS IS NOT A ERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOC ENT
INS E DATE
FOOTING r �� � -/
FOUNDATION (Prior to Backfill) 6 �,. , �
PLACE NO CONCRETE UNTIL ABOV HAS BEEN SIGNED
ROUGH - INS
SEWER / WATER / SEPTIC � -2 �9 �
FRAMING � �
INSULATION �
ELECTRICAL
PLUMBING � �� � � • � p
�iEATI1�G (if required) �.�6�9�
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
6� � �-e-- Gl'°� �. i � •9
�✓e PIaC 4 F I N A L S �� 31-9$
GRADING (Prior to Sodding , . _
BUILDING ��� �•�' q�' ��D� t t mo'3 �
ELECTRICAL
PLUMBING `- _?r - G
HEATING '� p
DO NOT OCCUPY UNTIL BOVE H S BEEN SIGNED
M NOTICE
' 7his card must be posted near an electrical service cabinet prio� 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 447-4230