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HomeMy WebLinkAboutBuilding Permit 12-0026 DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ' 1 ,9-./ I _ ADDRESS L1 n i --- OWNER CONTR. PHONE NO. PERMIT NO. ( (- i 30+ ❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING ❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT ❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI ❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST ❑ SITE INSPECTION ,MECH FINAL ❑ >A r-- COMMENTS: ;,e D�� � �- -�P � �,�.,, t r-e app , Nose ( -w<; s t WORK SATISFACTORY, PROCEED ❑ CORRECT ACTION AND PROCEED ❑ CORRE ORK, CALL FOR REINSPECTION BEFORE COVERING Inspedo Owner /Contra CAL 447- 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTI o rxl o4, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE rr AND UTILITY CONNECTION PERMIT I E SO `S I. White File PERMIT NO . ^-� i / 3 Yellow Applicant L�� ��.{� 3 Pink City (Please type or print and sign at bottom) ADDRESS ZONING (office use) D , s r , L , - Stitt/la 0 , N T t' - ' S 4 / 0 T O w t i c S t r St LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) BUILDER nn /l / (Company Name) A.CSEf` �e f/010 1 (4 L /)I& I p e-7" (Phone) F s7- 7 77-4 0 ° 1 (Contact Name) lyfsi CHUB itvSo -+ (Phone) (a 57- 217 / /11 (Address) aZz Sovrl, 49 »6,9JNA Sr, ST /A-4. , "4 sf o7 �� -___ TYPE OF WORK ❑ New Construction ❑Deck EPorch ❑Re- Roofing ❑Re- Siding ELower Level Finish ❑ Fireplace ❑Addition Alteration 0 Connection CODE: ❑I.R.C. ❑I.B.C. [ Misc: / S /iL/ v, f/( Type of Construction: I II III IV V A B 3' Occupancy Group: A B E F HI M R S U PROJECT COST /VALUE $ O Division: 1 2 3 4 5 (excluding land) 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. I am aware that the building official c r oke this . = -. or just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X e‘ / k /'f Signature Contractor's License No. Date Permit Valuation 1.ZSel9 Park Support Fee # $ Permit Fee $ /1/7 // SAC # $ Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $ State Surcharge $ Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE $ / 4 -7 T • r , li ation Becomes Your Building Permit When Approved Paid / 7. Recel O. 67 / Date /. t". Z- By L AP/1_, lib 112112- . g O Bu . Fa �Official ate 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 issued. Planning Director Date Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 • a t� o 0110 N N U 41. -3 y._ m. ...., U O ( 1) a o HP : pP w@�O w � Q m w yu� Q ~ .. O wNOK w } EL H g 8 r 1z1Q a - � J `n y ?LL pw w . "O'224t w w E == Q0 a; re 4c 1 .( w Z wo O w p t� , O 6i w ` Q p y- ' OF PI 6 �- d F Y J t a d Q E E '6 I . w t a z 4 O SS O O O O E K ,, - Z .. O 0 0' E 2 o o r g h �i " 3m • ,„ n 0 _i� p w Z a w J EZ a , , ,, x‹, . _,F ax Ariz �. -yyam u § Z "�> OM ¢ Z Z O I � � p N a _ u _ 333 W z O 24r J Pt gNd 0 -4 O 0 v � � S O q` dm ~OZ �� ZO � 0Z ��� zD a in Q Y a 2 4 g Jg W S � z E 0 LT - Ei ,2 rriaaO v ti viaT, .d1S � LT z Q J Z O 0 v 1 LI �O o Z n Ci a N i ••:`, ifir••••# § f aSi; 6 *11 o 1 €11, L.........A < Q-11.' ILI , 2 a E C O u 1 § Z V C Z w :: Q O H I h Zo cz LLJ 0 ■.) �a o o � J oil m. 3 6 s C 7 FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 - FIRE ALARM SYSTEM RECORD OF COMPLETION To be completed by the system installation contractor at the time of system acceptance and approval. 1. PROTECTED PROPERTY INFORMATION Name of property: re , f j {{ / Ski( _�- S� YV2. O2 py t� Add„„: 4S 4 I (WQY Si . SI `fir ,yr L F��� M14 ; J - 1 c� Description of property: /-‹ ( .s Occupancy type: Name of property representative: Address: 5 < ""` Sj *ea V `- Phone: Fax: E -mail: Authority having jurisdiction over this property: Phone: Fax: E -mail: 2. FIRE ALARM SYSTEM INSTALLATION, SERVICE, AND TESTING INFORMATION Installation contractor for this equipment: `- Address: 7 c'S LI co z' V /" Phone: G 1"/ - V `ge " 4.- 2/ Fax: E -mail: Service organization for this equipment: Address: Phone: Fax: E -mail: Location of as -built drawings: Location of historical test reports: Location of system operation and maintenance manuals: A contract for test and inspection in accordance with NFPA standards is in effect as of Contracted testing company: Address: Phone: Fax: E -mail: Contract expires: Contract number: _ Frequency of routine inspections: 3. TYPE OF FIRE ALARM SYSTEM OR SERVICE NFPA 72 Chapter Reference of System Type: Name of organization receiving alarm signals with phone numbers (if applicable): Alarm: ' /' ›e" Phone: Supervisory: 1, vim- / k > Phone: Trouble: V%-\ i' k / Phone: Entity to which alarms are retransmitted: Phone: Method of retransmission of alarms to that organization or location: © 2007 National Fire Protection Association NFPA 72 (p. 1 of 5) FIGURE 4.5.2.1 Record of Completion. 2007 Edition f�l 72 -34 NATIONAL FIRE ALARM CODE 3. TYPE OF FIRE ALARM SYSTEM OR SERVICE (continued) If Chapter 8, note the means of transmission from the protected premises to the central station: ❑ Digital alarm communicator ❑ McCulloh ❑ Multiplex ❑ 2 -way radio ❑ 1 -way radio ❑ N/A If Chapter 9, note the type of connection: ❑ Local energy U Shunt U N/A 3.1 System Software Operating system (executive) software revision level: Site - specific software revision date: Revision completed by: 4. SIGNALING LINE CIRCUITS Characteristics of signaling line circuits connected to this system (see NFPA 72, Table 6.6.1): Quantity: Style: Class: 5. ALARM- INITIATING DEVICES AND CIRCUITS Characteristics of initiating device circuits connected to this system (see NFPA 72, Table 6.5): Quantity: Style: Class: 5.1 Manual Initiating Devices 5.1.1 Manual Pull Stations Number of manual pull stations: Type of devices: C Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A 5.2 Automatic Initiating Devices 5.2.1 Area Smoke Detectors Number of smoke detectors: Type of coverage:omplete area ❑ Partial area ❑ Nonrequired partial area ❑ N/A Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter ❑ N/A Type of smoke detector sensing technology: ❑ Ionization ❑ Photoelectric 5.2.2 Duct Smoke Detectors Number of duct smoke detectors: Type of coverage: Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter0 N/A Type of smoke detector sensing technology: ❑ Ionization ❑ Photoelectric 5.2.3 Heat Detectors Number of heat detectors: Type of coverage: ❑ Complete area ❑ Partial area ❑ Nonrequired partial area N /A Type of devices: ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter C N/A 5.2.4 Sprinkler Waterflow Detectors Number of waterflow detectors: Type of devices ❑ Addressable ❑ Conventional ❑ Coded ❑ Transmitter At N/A 5.2.5 Alarm Verification Number of devices subject to alarm verification: Alarm verification on this system is: ❑ Enabled )isabled ❑ Set for seconds ® 2007 National Fire Protection Association NFPA 72 (p. 2 of 5) FIGURE 4.5.2.1 Continued El 2007 Edition FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 - 6. SUPERVISORY SIGNAL - INITIATING DEVICES AND CIRCUITS 6.1 Sprinkler System Number of valve supervisory switches: Type of devices: ❑ Addressable 0 Conventional ❑ Coded ❑ Transmitter N/A 6.2 Fire Pump Type of fire pump: ❑ Electric ❑ Diesel Type of fire pump supervisory devices: ❑ Addressable ❑ Conventional ❑ Coded O Transmitter N/A Fire Pump Functions Supervised O Fire pump power ❑ Fire pump running ❑ Fire pump phase reversal 0 Selector switch not in auto O Engine or control panel trouble ❑ Low fuel Other: 6.3 Engine - Driven Generator Type of generator supervisory devices: ❑ Addressable 0 Conventional ❑ Coded ❑ Transmitter O / 14 /A O Engine or control panel trouble O Generator running ❑ Selector switch not in auto ❑ Low fuel Other: __ 7. ANNUNCIATORS 7.1 Annunciator 1 ❑ Local 0 Remote Type: ❑ Addressable ❑ Directory ❑ Graphic , N/A Location: 7.2 Annunciator 2 ❑ Local ❑ Remote Type: ❑ Addressable ❑ Directory ❑ Graphic i' N/A Location: 7.3 Annunciator 3 ❑ Local ❑ Remote Type: 0 Addressable ❑ Directory ❑ Graphic ❑T /A Location: 8. ALARM NOTIFICATION DEVICES AND CIRCUITS 1! 8.1 Emergency Voice Alarm Service Number of single voice alarm channels: Number of multiple voice alarm channels: , Number of speakers: Number of speaker zones: 8.2 Telephone Jacks Number of telephone jacks installed: Number of telephone handsets stored on site: Type of telephone system installed: 0 Electrically powered 0 Sound powered 7 70 N/A 8.3 Nonvoice Audible System Characteristics of notification device circuits connected to this system (see NFPA 72, Table 6.5): Quantity: Z-- Style: 'J Class: 1 3 m 2007 National Fire Protection Association NFPA 72 (p. 3 of 5) FIGURE 4.5.2.1 Continued 2007 Edition ( 1 72 -36 NATIONAL FIRE ALARM CODE 8. ALARM NOTIFICATION DEVICES AND CIRCUITS (continued) 8.4 Types and Quantities of Nonvoice Notification Appliances Installed Bells: With visual device: Horns: / With visual device: Chimes: With visual device: _ r Bells: With visual device: Visual devices without audible devices: I Other (describe): 9. EMERGENCY CONTROL FUNCTIONS ACTIVATED ❑ Hold -open door releasing devices ❑ Smoke management or smoke control U Door unlocking U Elevator recall U Other 10. SYSTEM POWER SUPPLY 10.1 Primary Power Nominal voltage r ` C Amps Overcurrent protection: Type r ` �`� Amps Location (of primary supply panelboard): ( — 3 c Disconnecting means location: 5 ocA k " J U e`.) 10.2 Secondary Power Location: ° / Type: ` Nominal voltage: I � Current rating: Number of standby batteries: - Amp hour rating: 7 Location of emergency generator: Location of fuel storage: Calculated capacity of secondary power to drive the system In standby mode: In alarm mode: 11. RECORD OF SYSTEM INSTALLATION Fill out after all installation is complete and wiring has been checked for opens, shorts, ground faults, and improper branching, but before conducting operational acceptance tests. The system has been installed in accordance with the following NFPA standards: (Note any or all that apply.) ❑ NFPA 72 ❑ NFPA 70, National Electrical Code, Article 760 ❑ Manufacturer's published instructions ❑ Other (please specify): System deviations from referenced NFPA standards: / /,d Signed: " - � �/ Printed name: G t L y Date: Organization: �� 1 ^' r� Title: -) S- r I Phone: 12. RECORD OF SYSTEM OPERATION All operational features and functions of this system were tested by or in the presence of the signer shown below, on the date shown below, and were found to be operating properly in accordance with the requirements of: ❑ NFPA 72 ❑ NFPA 70, National Electrical Code, Article 760 ❑ Manufacturer's published instructions ❑ Other (please specify): ❑ Documentation in accordance with Inspection and Testing Form (Figure 10.6.2.3) is attached Signed: Printed name: Date: Organization: Title: Phone: © 2007 National Fire Protection Association NFPA 72 (p. 4 of 5) FIGURE 4.5.2.1 Continued 0 2007 Edition FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 - 13. CERTIFICATIONS AND APPROVALS 13.1 System Installation Contractor This system as specified herein has been installed and tested according to all NFPA standards cited herein. Signed: _ Printed name: Date: Organization: Title: Phone: 13.2 System Service Contractor This system as specified herein has been installed and tested according to all NFPA standards cited herein. Si /s /`L C:/ c Printed name: M r cL .C> 6- • c'.. y Date: 2 - /)– Organization: 1 v.3 v t +'I. ; 1 Title: /'U 5 y`' / / Phone: 13.3 Central Station This system as specified herein will be monitored according to all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: 13.4 Property Representative I accept this system as having been installed and tested to its specifications and all NFPA standards cited herein. Signed:_ Printed name: Date: ---- Organization: Title: Phone: 13.5 Authority Having Jurisdiction I have witnessed a satisfactory acceptance test of this system and find it to be installed and operating properly in acco • . ce wit its app oved plans and specifications, its approved sequence of operations, and with all NFPA stand. g i 0• rein. Signe• —' j, . c.. Printed name / 8C L Date: al�Z Organization: ' % ri ' . _ � ' Title; DOl IGC {< s ..r Phone: ?�2 7Z ' © 2007 National Fire Protection Association NFPA 72 (p. 5 of 5) FIGURE 4.5.2.1 Continued 2007 Edition