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Home My WebLink AboutBuilding Permit #99-1426 ~'~-~'--"':K~:"""",,-"__:__:~_.-.;__-r.__T ~.:"":---:'-"~<r'-'-""''''-~::.,:<-:'1:~~''~;:v:''' ....~ --.-?--....,...--;l"~ -.-r:r:,;'~.- -.l:""lF:- ----:.~ -......,-;:0;: ?7"'Jl1r"-"'7 ~_n,;rr--':. . . m_", -;' ~,/ -. ,--" - ~trtificau of (JDccupanry CITY OF PRIOR LAKE I.ltpartment of Jauilbing 3Jn~ptttion )&1 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 a/the City of Prior LaJce regulating building construction or use. For the following: Use Classification SINGLE FAMILY ~ldg. Permit No Occupancy Type R3 Type Construction VN Fire Zone Lc al De .. L2, B5, KNOB HILL SECOND ADDITION g scnptlon N/A Zoning District 99-1426 Rl Owner of Building C;ite Address 14350 ROBIN ROAD NORTHWEST 55044 Contractor'sNarnc&AddrcsSBR.r.J.'UAA CONSn., P.O. BOX 1314, :I.Akr.vJ.LLE, MN ROBERT D. nU.l.CHINS t1:1. City Planner DON RYE B,ilding Official &/ :; f;:, /tJ'O Date: Date: -iiIili;--~' "<'k' ,_:~. ',:;_,,;-~~.'i.i:<; '1 i>.F~>~~~I!1- -,i:.,'>.:li > ~~" \>:.t~~ :.~~~ ,;~~~~-~- ~ ,~~,\ .~; ;j~;~,j,. ~i;~--"':~'" '~'L2,:J:~~,{;..::i ~\fL:~: j;.i.;~-:'~~.L.:'~J~H<)r~"~"I~~~~i~,::.;-:;;(,;l,..... ~';'~;';' ',:l.l:;;:i,:~n:.:~ '~~~~,\~ ,)''''~i&;;;~'~;.u.;~l''''::~~'' ... CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS '4350 Rob.), 12d OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI ~ECH RI ~ ATER HOOKUP SEWER HOOKUP ~ 0 PLUMBING FINAL o MECH FINAL COMMENTS: I )::7 ~ TIME ff L 1.~(Jo ~- 14z~ o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o ~., aM' ~'-')_i(r cYA i:.M".. ~~. :6.""1'1.'\ r ~ ~ '. . f~ () I /J 7'# IJ Ll r; 14 i~ r~~-7f1~ --1aV 2~ , : "<.::.:1:l--1 ,~.. At-rtJJAO ~rJ ~~~,,~ , t A3' J'?'~'" / V ~ORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: /--1\ /:J , I ~l 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 SCHEDULED ADDRESS 14350 Rob,VL Rd 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 A ~EWER HOOKUP . PLUMBING FINAL f4 MECH FINAL COMMENTS: ~\J~ - ~ 0' (? '~0 DITE TIME ~~ tL~ Ciq - \4-U:. o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o (' fl VU~ - t%.~ ~ /II' 60~Slttflrt LJ~ ~U-- 0Y ~~Q lI~i 1fAAf \~O~ ~ O~ ~ A ~K SHTIS 0 Y, P OCEED -bRREC C ION AN ROCEED o CORRE OR, L FOR REINSPECTlON BEFORE COVERING Inspector: Owner/Contr: CAL~447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE ~QUIREMEN; ARE FOR YOUR PERSONAL HEALTH & SAFETY! ~ lNSNOTl ADDRESS /4350 DATE TIME SCHEDULED ~ 1-30 to-b7'f\e ~)aJ CITY OF PRIOR LAKE INSPECTION NOTICE OWNER CONTR. PHONE NO. PERMIT NO. 99-/4d6 o FOOTING 6V 0 PLUMBING RI 0 EX/GRAD/FILLING o FOUNDATION . A.,.. 0 MECH RI 0 COMPLAINT o FRAMING r, 0 WATER HOOKUP 0 FIREPLACE RI /JjlNSULATION \ 0 SEWER HOOKUP 0 FIREPLACE FINAL (FINAL ~- 1 ~ i'S'PLUMBING FIN~ 0 GASLlNE AIR TST II J SITE INSPECTION J/' MECH FINAL ~ 0 COMMENT~: ~ IfT'lY\.- ~n/""'" ((J) Amg 'i' ~ o.<l ~ ~--Q- c1) ~:~~ ~~aJ1 ~~, '\;c.o ~J) -!?> n 1-00 o WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED fi CORRECT W~, CALL FOR REINSPECTION BEFORE COVERING Inspector: f2IT. Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI INSNOTl DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ~/I1./bo ADDRESS I C/350 A'OSIA.l ROM\ OWNER CONTR. ~ CAAJs-r.. PHONE NO. PERMIT NO. 99-~ o FOOTING o FOUNDATION o FRAMING o INSULATION J<.FINAL o SITE INSPECTION o PLUMBING RI o MECH Rl o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL ){ EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: {JItAtL \5; ~U.~R t.F L.uaM I!u~ So ",.. IS KUSH wi"" 1He. PlAltf<- ~e.. - U~ - <' V~ ~J4'1toJ SK.-r-' ~ u.u1lc- ~E.D o WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED )( CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: J.L..:> ~ ~Contr: ,. "- CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI INSNOTl CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS 14350 Rob, YL ;e.tl OWNER CONTR. PHONE NO. PERMIT NO. o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o FOOTING o FOUNDATION o FRAMING @) ~SULATION J!. ~~NAL o SITE INSPECTION COMMENTS: ~ .r .. Jre.t:S ~/z2~ TIME A-T qq - 14U o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o ~~ ,i." t.J.e ~ . - . V ' ~- .:2-~tt~ 01 ~~ ~ ~ ,aL-- . ) J~~ ~ .~, ~ ~.. ~ ~ o.-lt 4 Po ~~~ ?;il.. (~~' ~ ~ ) ~p~ ~~.- ~WORK SATISFACTORY, PROCEED ( ~ ~ORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: ~ ( Owner/Contr: / CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNOTI CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! .,--- ,-, "'1'"'-'-'" .-"'...... .--.. 7. TYPE OF WORK New constructio~ Chimney 0 Misc. 8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS / 10. CULVERT SIZE ,. /LLJ Sq. Ft. /3/ 330 Width gr..,1 Depth ISS- Yes No N/77 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 " ,,,,,,.. "'~UfJ~rtY. d th II construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildin i an revoke e' f just cause. Furthermore, I hereby agree that the city official o~~J9I)1l~aynter upon the property to perform needed insp~~s. X ~ ~5 , Z-a:>7 f( 'I () ~ / z...--Z/ -r / J Signature License No. Date DATE RECEIVED \ Li...._~ CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE . _~iAND UTILITY CONNECTION PERMIT \ i DEe!,. . DIRECTIONS SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 1. DATE Iz~Z/-rl 1<./ ~Z533 702-'10 2. SITE ADilt350 )(c){? IN ~rJMJ ,A/ 2,., 3. LEGAL DESCRIPTION ~ LOT Z- BLOCK":::::> PID J(JJO L3 fit t&J Z/VO 1!tJL1 m tJ;J . / 4. OWNER (Name.!.. A "" /J (A~~~S) /J .d c / (Tel. No.) c5IfWlL /P DcJlt,{}""i<.. - /..... V{t>t7 CA- _ 5 AR"III=FES:j; (Name) .,-JA~~ess) . ,-Vel. ~~ I "iJt./t-mMtW Il..-I/71.lcO~. &;:)(-,/.:; ~ -tJ7Z/f 6. BUILDER (Name)' . (Address) (Tel. No.) },(~ctws/(/k '~JJ!~~ 6fZ.-R'?ISfg''j ADDITION Fireplac~ Alterations 0 Septic 0 Addition 0 Deck 0 Finish Attic a Re-roofing a Porch a Re-siding a Finish Basement a 1. White 2. Pink 3. Yellow File City Applicant Permit No. 99-/'fZb BUILDING INFORMATION 11. SIZI; OF STRUCTU8E (~1))f ~i1l1 (037 / 12. NO. OF STORIES 7~IO 13. TYPE OF CONSTRUCTIOti. -^ tVOtJO ~ UJ 14. FLOOR AREA APPORTIONMENT USE 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS SEATS 16. P~JECT COSTNALUE -f' /7ff( 3 J U 17. COMPLETION DATE FOR ADMINISTRATIVE USE SETBACKS: Required Actual Front Back Side Side BUILDING DEPARTMENT VALUATION OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMIT VALUATION 17A, ~.t9C> USEOFBUILDING _5Pp TYPE OF CONSTRUCTION: I II III IV V Occupancy Group A B E F HIM R S U MATERIAL FILED WITH APPLICATION SOIL TESTS a ENERGY DATA 0 PILING LOGS a PERCOLATION TESTS ~ PLANS & SPECS a SETS SURVEY a COPIES PLOT PLAN 0 Division 1 2 3 4 I a ").17. zs- R~. 2l 8(]. ClO Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ 66'"Mti..n il~881 r_ <::" AA . $ ....~/.~....... 8S'6 . CO , 0 ~ .GO ,50.00 Sewer Tap ...................................ll'. \' $ Pressure Reducer ..?i.e.................. $ Meter Horn-\................................. ~ Water Meter ~:-;._......................... $ " Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ City: Permit Fee ................................... $ Plan Check Fee ............................. $ State Surcharge ............................. $ Penalty ....................................... $ 16(? . oC> lOt') . 00 "3~ . <<0-0 GaS~ir cePe ~... ................ $ t./o .t!)O This .. co Yo r Building Permit vy~ A.I:lQr~d.oC\ By Date -1-L~j c:;,-C L Certificate of Occutcy Issued Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ Sewer & Water Permit ...................... ~ _~ S; c:e J ~6.CJO /, ~(9G .d'O n 7fJC) .e6 WaterTap ................................... $ Builder's Deposit ............................ $ .I .' h-e>O . ~) Other ......................................... $ Total Due .............................. $2 qCJ/. r t;? Paid 719 /. 96 Receipt No. ~ '74-r:1J Date By ~__ This is to certify that the request in the above application and accompanying documents is in accordance with the City Zonin Ordi nce and may proceed.(s requested. This document when Si~C' P ner constnutes a temporary Certificate of ~~ compliance and allows nstruction to commence. Befo e ~cu an a Cert~icate of Occupancy must be issued. l-'i-G7IP <,p ....~R"""~fr City Planner Date e:..> Spec I Conditions ny 24 hour notice for all inspections 447-9850 / Th~ Center of the Like Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED "j") , ,-.- L~,/" L ' /\~'~_. / ::,. , " 1/:.. ^; .,c.'....~ l ,/ .,/ .,,/ The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: r ..._... ,',' /i" '1/' /" t. ___, I \, "L_) ,i (- .,~~ ---/ Accepted Accepted With Corrections ~ Denied Reviewed By; ~ L~pv\ Comments: Date: l "t.-J - 60 AIL- ~~ ~~~~ ~~~ !j,-vv/~ ~o ~t~~ Se.-~bL~. ;J-{ f'\. W\r.o<.~AM ~ ~ I~,clxv-. "iT ~k \~ l>>-<{ (~9/iMA~ 'R. e,vj;- . '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.1I -,.---~-~--oifI-"-----.--_.~- Th~ Cf'nltr or Ihf' L.kf' Counlry -", /' ..' 1'7 ( (fc/-I/-r/ ,r-:; /1 .L-~_ White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT 310:::. 6/\//\/ 6 ~ /Zj/Z I/'lq APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: / /1 -;"7..c-::-O /_? r' (? I ^ / /,:../ ,,') / '--,..- ~ --./ '- L/!.--/ r v J ,I ;.. ( (-- I \/ \,../' Accepted ./ Accepted With Corrections Denied D~..:~..._....t D... , I.. ___ C . .-- ,- . nc;;v n:::vvc;;u DY. ..bll1..Y...r:J<' b1:UU'..:),.,RA'N ...... . , I _ . Uate: 1l.12.<J I "'f . . Comments: -.SEE I AlFtlftj\.t04"1'ON ON "'-;'E: 1?~vtft.sE S,DF: 1iu=' t1o'1"!IC,Mllt"t ~lvE~'" w\On-l Ar" -nI( Fn."J<,JT" P~oPER.T'I' L'Ne. IS 2'1 FeE.. 5, LT FENcE: OAl T"'HF' r<tA1l. PortT' IO^" o~ /He. L.01 Mv.<iT'" liE EA.E:clC,D Ar rH~ ~ of DISlvRoEb SOIl. . .sEE A-rnl~: I. F",A.J(.Il.- r:IlA~ Ws.eu.T'o,,", I tJf'()~4y",o^, l.. c:'RA()INI. nAN ~. tN}SIO^ \ ~O""'"ItOL. t'1Q1Svit.E.<; <I &t:'SI()tU LONTAOL J{,tfAl "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." &\1 ~NE5~ GREEN . flU YELLOW . ~'PLlC"" GOLD. CIU CITY OF PRIOR LAKE SEWER AND WATER PERMIT APPLICANT: ~~ Et?J ADDRESS: ItJl/i~~~fh. SIGNATURE: ~f~ ... SITE ADDRESS: /1{:] S-O Ro~...) ~ FILL IN THE BLANKS 1. Estimated length of water service 2. Size of water service / ~t inch(es) . 3. Location of any couplings from structure feet. S.w. No. 49-!t.fZ& NOTE: Sewer and Water contractors must be registered with the city. PHONE: PoC;- '7/)/7' DATE: / - :?, 7- 0" BLDG. PERMIT # q 1-/'-1 Z&; PID# 2.5 -331'-62-+-"-0 t2() feet. 5. Estimated length of sewer line ~tJ PVC K. Cast Iron 4. Type of sewer pipe. ABS feet. 6. Clean out (if required), located at structure. This feet from - ------------------------------------------ ------------------------------------------ BY s your permit when approved/ / DATE: / /?- 7 /0 6 _====================================~===l============ ----------- ----------- FEES: $ $ $ 35.00 .50 35.50 Sewer 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 insure that no duplicate sewer and water permits are issued. DATE PAID RECEIPT # AMOUNT PAID p~lO\N\"H ;.,..._' REC'D BY \ 9U\LO\NG PEHlvl\' 16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245 An Equal Opportunity Employer 02/09/2000 15:02 T.. C.nl.. 01... Look, Coua',." 'CITY ':OF: .P:RIOR LAKE '.' ' PLUMBING PERMIT Applic~nt: ot'JR"~ ;J:,i,"PI'-L~ j,~ '+- II ~ AddrElES8: ~'~' iJ;'u-<; Signat~re: "~'. ~ ~ ' Legal Oescriptlon:' Lot' . Z, Block 5 Site Addres8:~''''~P flobt;;. ~ BUilding PermlH,."" .': ' ..' 1 t{-:- / q:-~ PIO' .z.:5 - 35 c:r - 0 z.4 -() NOTE: ThI8.p~rmlt wlli . not be prOQessedwlthout complete Information. .' . .FIXTURE UNITS 612-8947972 LAKESIDE PLBG 12>~, Cb7'lAq)...IA'I:I:unt. .. Quantity Type. of Fixture' ~ I J 1 Ii I .2 1 3 Quantity Bath Tub with or without 8hQw~r '. . Dishwasher 3 I PAGE 01 1. Blue ~. Cold 3. YlIlluw filII Oty A.pp!,ieul # qq-/t.j.z~ Floor Drain Lavatory (bathroom sink) laundry Tray (1 or 2 cor1lp.rtrii~rit.h'k) Shower Stall Sinks aar Sink Water Closet (toilet) FEe SCHEDULE IndustrIal, Commercial&. MLiltl.Fa,mlly' . : (1 % of job cost, $39.50 min.im'um) '.. . Residential, New One & Two Family' '. " . Residential, Additions &AItAratloliS .' State Surcharge $99.50 $39,50 .Phone: t;. /2,. .,N-Y-?~ 0 l> Sub KNO.6 HltA.... 21\/0 Type of Fixture Rough-Ins Water Heater Water Softner -p" J'i 'Il p J ,,... .. - (.0(111'l rl n IIJI Stand Pipe (washing machine) ~ Sewage Ejector Backflow Assembly (RPZ, Double Check, PVB) Backflow' Assembly Test Lawn Sprinkler Other f- w,'.,.Pt1>!;oU .2. Ct."fS.d" l.fl,("f, /'),'bA... . . . This pennifls :gran~ upon the Cllpress condition that said ~ntl'actt:!r~ .~i1i c;Cmply'j' .all reapects with tbe ordinance. of me State'Plumbll,!.;C . .d the amo9dmepts thereof. . . z.//Q/tJO DATE . I ' ATTEST $ $ $ $ Qt;5r.) ;1$6' PA\OWrrH r BU\LO\NGPERM\T IDUD;") .GRAND TOTAL $ fr- [ - ,- f 10: rr rr:":'""~ 1;11\~. r:. '..", [ I' r I r-.." . l; .. , v' ; II I . ~ 9 2000 , I \~1~~a~\e Ctet~~~. SE., ?t\Ot ~~et'M111t\~\O~ 55'311/ Ph. (6\1) 447-4230 I FAX (6\2) 447-4245 . .;:' "An ~\\l\:O~t\ortu"\wem~\Q.,,c.t . , ,.. ,', . .- . :. , ',' "; '. ;.," .' .. ',. ',< ~ '.' . :.' ".:~ < . ' CITY OF PRIOR LAKE Me 16200 Eagle Creek Av. S.E. Permit No. qq -I if ZIo Prior I ..',. MN 5.5372 HEAnNG APPUCATION ! PERMtT Date ~/{1 / 0 U PlOt 2.5-3~- 0.2.4--0 1435"0 K.DhL1'1 KOM ; ~ I Lot Z- Block S Addition fc::'f\\O.B H' u..... 2. ND Owner's Name, J3r' ljvLL-I' {~nstvu cA([Y\ Address P,O. f3u ^- J?> I tf -/ UkLu LtG- . r' I . I Heating Contractor .l-'tuLYfa~6h H,(_IL~ Address 3{;5.o ~kx..0 [)y -it-'( oJ ~ Telephone'. uS I - 'Ir- J- - d-II ~ u t!A~RI-eL. Furnace Make & Mod.I<,~ ?.4u'" Cj n TYPE OF SYSTEM ,/ gr/ ., _' Warm Air Flanls j; ,&-00 I,/?LI# Gravity Mechanical ,/' Air CanditiClning ~/40EIL J~ /!..k-e3 (0 Vent. Systlilm HEATING OR POWEA PLANT Steam Hot Water Radiation Special Devices S ita Address Model Size Conn. I "..~ Fuel p,I1T ~ FlueSize (S ,~'I Supply ~penings Return Openings Input 1~ (roD ? Output. 70 ~ Lf&f) Edr. Other Devices atm. TYPE OFWORK Alteralions J< Replacement . New Construdion Repair Est. Cost $ _ Est Comp. Date , ~OOi) -- Building Permit fI c qq .,e;D qq -/4-2.6 " PAlO W\1'H aU\\.D\NG PERM\' HEATING PERMITFEE$ STATE SURCHARGE $ TOTAL PERMIT FEES $ .50 l6lJ ~ Receipl # TYPE OF STRUCTURE J. Jlillk 2. Gren 3. Ydluw ~ " , File City ConlDlC1Dr Single Family Commercial ^ ~ ~ , CI CI Two-Family Multi-Family Other .. c: tl Industrial Pubic F" Schedule ~ ~ Industrial, Commercial & Multi-Family Residential, Heating & AC Residential, Heating Only p.....;"'a''ltial, Gas F'lI'8place Residential, Additions & Alterations Residential, AC Only ... c: rfB 2 < Remember to add the State Surcharge on lhe bottom of this application. 2000 The price of your heating permit includes one rough-in and one final inspection. Addition. inspections will be billed al $35.00 each. House Healing Test Record must be submitted with "r~ilrf'~n cermil number before build- ing certifieale of occupancy will be issued. HEAT CAlCULATIONS ~Fnl "1=l~1') with number of supply and retlBn openings fisted per room with CFM's per opening. New structures or addilions send floor plan with supply and rebun 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. ' Clay Hall busin~s 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 COdE!S of the city and with the state buildingfrnechanical 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 an worle which requires review and approval of plans, (' l- I- Ie e: .. ~ ::Il l- e: ::Il t" j)J ~ t.r f}u~ f~ APP7t! t1:rl2-- BUildl~i~al's Signature d!f7!O() Date z./z3700 Date ~ c:: c:: I- P.L. FA>l 447- 4248" RECORD J08# sirS CITY fY'JII Ii', SUBURB . . . ~ . HOUSE ~EATING TEST I ~ ?SQ ;: OK/AI R () Itl CAPT. If ~ f N,JfL rd,vfr/Cvc7"J/v OWNER DATE HTG. INST. ~ -;J 9 -()() ADDRESS OCCUPANT HEAT LOSS SOLD BY Electrical Work By TYPE OF HEAT Or II [;U GA FA .x..HW GAS DESIGN MAKE Model Serial INPUT t;,9 PA IId,iJ 1~..lLI ()~ 6() A I) q q q:J.. 8R} OVa CONTROLS THERMOS]AT I-llf..LJ. . Heat Plug - Valve -'J..J", ~$6 ~(IlJ Li mi t E..l...x..e/, r,.J f I' ,-r Limit Setting - lQo () Fan Setting ~ c- {f tf1-fl-tJ Pilot Type -- Pilot Make } Pilot Model ~ tJ s::::. Pilot Timing/ -rr -t--- L.W. Cut Off \ ~9)/ Pressure Input CFH ~ 'Stock Temp. :5 0l.1 D Form 235 I Percent CO2-.{ Percent 0 I ~ ~ -- Percent CO FLOOR STEAM INSTALLED BY fi ri",r- k S 4rJ Gas Line By SPACE HTR. If (,.? UNIT HTR. OTHER CONVERSION MAKE OF BURNER Model Mox. BTU Rating MAKE OF FURNACE Model /. ' {LfJ 12 { t-i (~ /1\ 1'- I' / /r Vent Size -r KIND OF LINER C/~Jf A' SIZF NONF Draft Hood. - RegulaTor oM"'}t:. / Filters I Size /,( <.JilL_Number Chimney Locotion Inside Out~ Chimney Construction rf k /(' C b1}:. Smoke Bomb Draft "- Door Pressu... Wiring Test Tag r~[ Lighting Inst. - Date Tested 4- 1- a.o I Company Testing F~il:son Heating & A/C,3650 Kennebec Dr., Eagan, MN 55122 Name of Tester r - Job Address /Cf3S() eop/# N( Heating Contractor frctlyic..kJd/V ~~ Cr-?-a; f?,~ ~:- A' -=:vO 0 Name of Tester Date Percent O2 Percent CO Percent CO2 Stack Temp. Combustion air is adequately supplied per UMC See. 606 Input ~bO '~ It~~~~ Pll~lO/j> <y f\.Il.)~ ~ CITY OF PRIOR LAKE MC 16200 Eagle Creek Av. S.E. Permit No. Prior laket MN 55372. qq -1t..J.20 HEATING APPLICATION I PERMIT PIO' 25-339- Oz..4-0 ~~!"/?LJ Vc R I j<::NOB HIl-L 2ND &'iVd . Oatil d-J 1'-1 J.:>O Site Address /Y35D Lol Z Block 5 Add~ion Owner's t~ am e r-tjj.17 L1lAlkt. Address Healing Contraclor ALL lED F IRES IDE db a FIRES IDE CORNER Addfess, 2700 ll, FAIRVIE~l. ROSEVILLE. MN 55113 Tel~phol1e' _ 651 - 6 3 3 - 2 5 61 FIREPlACE . ~ Make & Model Lt.r..t,J c (;> , - Model SiZ-l~ ___\L 7.~u 1r,- Co;m. load Fuel ~ Fluf SiLO Supply Openiags Aetum Openlngs Input Edr. Oulpul ~ OX; elm, TYPE OF SYSTEM Warm Air Plants Gravity Mechanical Air Co ndilloning VenlSyslem _ HEATING OR POWER PLANT Steam Hot Water Radialion Special Devices Ot her Devices Alteratiols , Replacement. TYPE OF WORK New Construction A;:t; Repair Est. Comp. Dale Building Permit J qq -14-20 Esl. Cost $ I J ()tJ. 6.) . . HEATING PERMIT FEE~ STAlE SURCHARGE $ TOTAL PERMfTFEES $ .50 PAID WiTH .BUILDING PERMIT Receipl fI TYPE OF STRUCTURE rn m t rih" . n.. :::J 2. U....... - Orr rt J. Yell_ - C,,_ OJ '< Single Fami~' " ..... '"} m III ..... a. m Two-Family rnduslriaJ MultJ-FanUly Public Other Commercial, Fee Schedule o o '"} :::J m '"} rndustrial. Commercial & Mulli-Family Residential, Hoatlng 3. AC Residential, Healing Only Residential, Gas Rreplace Residenlial, Addilions & Altelalions Residenlial, AC Only 1 % of job eost ($39.50 minimum) $99.50 $64.50 $J9.60 FEB I A $J9.5Q $39.50- - - ..... ..;---...--'.."----- Remember to add lhe Slale Surcharge on Ihe boltom or this epplicalion. m U1 ..... The price 01 your tJeating permit includes on~ rough-In and one rlnal inspection. m Co) Co) Additional inspeclions will be bmed al $35.00 each. CIl CIl House Healing Test Aet:ord musl be submilted with ",~lrii~ ~fI!/1IVt nI,,.y,Pf belore build ~ ing certificale or occupancy will be issued. l:{EAT CALCUlATlON~ REOUIRED wilh number of $UPPIy and return openings listed Pi room wilh CFM's per opening. New structures or additions send Door plan with supply and relurn locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND APPLICATIONS MAY BE MAILEO TO THE CITY OF PRtOR LAKE, 16200 EAGLE CREEK AVE. S.E.. PAIOR LAKE, MN 55372. " m tT , ..... City Hall business hours are 8 8.m. - 4:30 p.m. ALL WORK MUST BE INSPECTED (ROUGH-IN ANO FINAL). CALL CfTY HALL 447-4230 ~ o o CIl N I hereby apply for a mechanical systems permi! and r acknowledge 1hal the ~ inlormation above is complete and accurate; that the work will be in conformance yO:; wilh Ihe ordinances and codes Df lhe city and with the stale building/mechanlca codes; lhallhis form does nol b9<:ome a permit until signed by the BUILDING OFFICIAL: thai the work will be in accordance with 'he approved plan in the case of all work which requires review and approval of plans. /) _&i~a ,_1:Mk,~1 , A~"~ Bui79 Offical's Signature ,jf M'Oj dt4Too Data '1J Q) 10 m N --- N f , PRIOR LAKE .. INSPECTION RECORD SITE ADDRESS jt...{3.S() ,ZobilA..2~ NATURE OF WORK ~ (d:2AS~wd\''t:)v1.' USE OF BUILDING $r\) PERMIT NO. '1'7 -/l(Zfe CONTRACTOR ~~""-v-.JLJ-- ~. NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT DEPARTMENT OF BUILDING AND INSPECTION DATE ISSUED J2-2'?-c:r 9 INSPECTOR DATE FOOTING I ~ If/lop I I FOUNDATION (Prior to Backfill) ~~1 '/~l/OO PJJ ~ Y/c/1fV PLACE NO CONCRETE UN~~A30/VE HAS BEEN SIGNED f:.:::/ii;; J' I tfl) ROUGH INS SEWER I WATER I SEPTIC r;:v 4,>7/41; FRAMING ~?/) 311lJ tJ INSULATION iif1J j /3/uV ELECTRICAL 0' PLUMBING VIS, /hAv )/z,/OZ/ ~ 0 2/2>%/ L{) HEATING (if required) ~z/2j}'jLJ FIREPLACE ~Z/Z5kJ 0 GAS LINE AIR TEST (f/7 ) SA7/dO v COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS ~~~~II~: (Prior ~(CS;d:;~.JI '-1:>-00 Wk-'^~L\-oo~, EX/.~ '1~~~~~' ~ le/tUf~ ELECTRICAL (I L{ - /2, - () tJ PLUMBING (Q LjpO/cO HEATING ITa 4//tl/fJO D"O NOT OCCUpy UNTIL ABove6AS 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. - R. LAT /4...... )--2/' (i) / .A_~l.._ .. .1:# Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS (612) 447-9850