HomeMy WebLinkAboutBuilding Permit 99-0953
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS \~\~3
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
~COMMENTS:
(1) S,~~
v
(i)
Q
f~ ~
~VVl'V J'1-
\,J/.fT
A
V~~HJ
SCHEDULED
&u..c- L& - I rL.
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~SEWER HOOKUP
PLUMBING FINAL
MECH FINAL
C-6 \ I -<A c..
~
~;~
TIME
to: CO
r JMJ7f
C5UJ:J ' ~ 5 hvu
U J^..~._
~
q q - ({'53
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
,s,FIREPLACE FINAL
~ GASLINE AIR TST
o
U~
(' l' ~cJm...
U
~r::: p>
D. SATISFA TORY, PROCEED
~RRECT "1 N AND PROCEED
o CORRECT W CALL F R REINSPECTION BEFORE COVERING
~~f-
Vr- ~
GV
Inspector: Owner/Contr:
CALL 447~850 F'OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQ~'ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED 1- zta-"fj .J tJ: ~
,1f/4 e bll'LD f\J. e_
ADDRESS
/L//~3
OWNER
OLJ_ "a_~
/7 v I ..J..J
~ -"',/"
1 J _J --~-f
CONTR.
PHONE NO. PERMIT NO.
D FOOTING ~ D PLUMBING RI
o FOUNDATION 0 MECH RI
D FRAMING ~o,., . D WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
)i( FINAL iV 0 PLUMBING FINAL
D SITE INSPECTION I'" 0 MECH FINAL
D EX/GRAD/FILLING
o COMPLAINT
D FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS(/J) K.~ t:J:k; f1o., ~ ~ ~
---.f)) .Ad. c;, ~ 0-., ~ ~ .,
~~~~~~~
91 ~I-- ~ ~ ~hJj -~~,
6/~ .~~ d ~~
~... .~
~ ~~ ~~,
~)q~.~~
I~~~~~+a~
~" ... ,,+-,
(J
~ T:C.tJ ';tf,.J}~9~/~-~
-P.1.u;t, ~ - ~-cJ~-~
D WORK SATISFACTORY, PROCEED
1ff1 CORRECT ACTION AND PROCEED
( ~ CORRECT WORK, CALL FOR REINSPECTION BE~OR OVERING
Inspector: ~I Owner/Contr: If ~.
CALL 447-9850 FOR THE NEXT INSPECTION HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
~
~~.. ~,i.~ .~~<~.:~:~~;--". I
"4-'_."
-;}Io-~~-~,?,~-.;~~ ;;,JJ.. ~;;:"~1?"~.~"":'~
~
~~::fll\!"
.. ,::'S~~~p~~~~
~ - - - ' - - - - - - ~-=--- ~ - - - .. - - - - - .-
(."...~\*...:i~'~i;U).'~~.~~.. ~"i&<<!" -n.~-~.~..I~l 0 ~ ')!Jl.Y ~
" ":.J. ..~ . ,.., t,~'1llI!'. t -,~~,; t ~'..~' t,,-.... t'll.. t ,. ~t..:-'ti.).::. ';N ~t.~.~t~;~. ~~.t,,,.....t -~~t,,,, ~t X ~..""' "'. to 0.... ;....t.." _ .. &. "0 ,
~.. _ f'.' ~..... ,A~~~,'U"""I_'_""'...:....~;_.I::,~-,:,~,:,~"I~!i~:~'.J~,~_:...~:"'I:":_='~:.' ,:.. iI"'~ ..~"'" ,0 ~.;:
;.:~~ Qttrtifuate ~. (0cmpanry'; r .~
11.::r CITY OF pjUOR LAKE f,~~.
"~~Il: J.ltpartmtnt of Jiuilbing 3Jn~ptttion
l'~J. ' BfFinal Pennitted 0 Conditional C.O. Expires
I-I, 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:
~, Single Family 99-953
Use Classification Bldg. Permit No
Occupancy Type
R3
Type Construction
VN Fire Zone N/A Zoning District Rl
2nd Addition
14143 Bluebird Trail N.E.
c;ite Address
B'drs., 714 E. 1st Ave., Shakopee, MN
Legal Description
L1, Bl, Haple Hill
Owner of Building
Contractor's Name & Address Monnens Custom
Yff7
Date:
Robert D. Hutchins
Building Official
1/-/7-0~
City Planner
Date:
Jenni Tovar
POST IN A CONSPICUOUS PLACE
...\i.....
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDULED
//-/)-03
ADDRESS /Lj/"!3 13/.Pt b/rll('
OWNER CONTR. IYlOI7I!(,/IS DI/JA!;
PHONE NO. PERMIT NO. 99 - 95-J
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
c:P'FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~ILLING
o COMlia"INT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
Gvctd-c - C) t..
C./ /'-1 T!::tJ y- () L
gf" WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InSpectOr:~~ -.,Qwner/Contr:
CALL 447-~8~ FQ~ TH~ N~T IN~PECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
INSNOTI
SCHEDULED ~ !/~f7t)~
R (CI~ b(,d '1,r !
CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/LI/4s
OWNER
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
o MECH FINAL
COMMENTS: 5::r-J +-
~
/' f
( / /
" l ~ [()~e.-
--
DATE TIME
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
r.r~e 5'
----
- '" ""
1 r )
r (~ /
~
---
~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL OR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSliOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
I,
DATE RECEIVED
e/5/91
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
c;q-Q53
Permit No.
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
7- ;2- 7 r
1<.1
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(~h~ I Z~ ' (D~)3 /
12.N/OF~;W tJ~~
13. TYPE OF CONSTRUCTI9~ 1J
'5/nble ~/lM/(Y iPdt~ 'J
14. FLOOR AREA APPORTI6NMENT USE
)1) E uJ LIJf1 rlrt/?fl 7;11
C' ,A J / '" ~., :ll/.;),d'V'lh
./(;T't71 (,... , "1 1'1 "~7
2. SITE ADDRESS i.I P J /,:J. /~, /
/'1/7"3 DIve 0, rt:f lylltl
II! E.
3. LEGAL DESCRIPTION
LOT / BLOCK I FJD /,Z5-.311t3 - 001- 0
ADDITION /J7 f1fJ~ t1iJ/ ~n ~ qdRf/'f/or)
, . ., 1"
4.0 ER vi :tile !J4ne/J/(tJ (7~it w.//if%'f!L;;:;;i1;fi;q'71J~
5. ARCHITECT (Name) J J p (Address) ;: , ) t/ ~ll NO.I)O(; . /
t>~I1~ ~hb 5" nfi/\ 0 p~C IYl J1 (6/~/ / ~j - ,;;,?~
6. BUILDER (Name) I (Address) f /~i 7;1. .N~t t/9/ ~ . 15. NUMBER OF OCCUPANTS OR SEATS
;J/q,., E$ it /"YJt)/1nt'PJ$ . J 71'f E4~ i6/.;.r / I -t) ~ OCCUPANTS ~
.mf)/l/lt'n! (,.t/rroJ/l1 Clt:fr~,{{tle )1!~!(pJ?te h1n
'I' SEATS
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
New constructio'" Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft. I~. ~ Width fio Depth /~ 'I
I hereby certify that I have fumished 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 men' d 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 off . revoke)'9lt ~~r just cause. Furthermore. I hereby agree that the city officiai,PJjI.ilrsi!Jl1ee may enter upon the property to perform needed inspections.
X / / ~ r"-_ -, 776 D <:g-:;2-9 r
Signature License No. Date
16. PROJECT COSTNALUE
;'% /) I 000, 00
17. COMPLETION DATE
/VO rJ e)1,f tJe r I'll i
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
r0
Yes
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
Front
Back
Side
Side
PILING LOGS
PERCOLATION TESTS 0
SETS
o
OFF STREET 7ARtNG
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION -' 80.&.Q1). ocJ
BUILDING DEPARTMENT VALUATION
PLANS & SPECS 0
s F..f)
USE OF BUILDING
SURVEY
PLOT PLAN
COPIES
o
o
TYPE OF CONSTRUCTION: I II III IV C
Occupancy Group A B E F ...1:\ I M @ S U
DIViSIOn 1 2 0) 4
Permit Fee ................................... $ II ~~ :;< ~
Plan Check Fee ............................. $ ~3L:>. 71
State Surcharge ............................. $ Cf~oa
Amount Brought Forward .................. $
Park Support Fee ........................... $ 8 50. ~Cl
SAC ......................................... $---LDc.::;O . f!) ~
Collective Street Fee ....................... $
Sewer Tap ................................... $
f;/ t. $
Pressure Reducer 7.'tf..................... $
Meter Horn .........('Z.ct................... $
Water Meter .......1tJ...................... $
City:
~
q&.~o
Penalty ....................................... $
Plumbing Permit Fee ......71::f..~'J... $ ( 6 0 _cPO
Mechanical Permit Fee ..f1.:.f:iJ..... $ I D 0 .00
Sewer & Water Permit .1.'.:b?...... $ 35. 5D
GaS~ire ce Permit .rf;..b~...... _$ '-10.06
This ~ ~mes 10' ,d....~iig~rmit Wh_en ~~qlI,6d.
By 77'/j. ~u"u"'~~~te 8 ffe, 7Y
Certificate o~ ~c:p4 .
/25. CJa
I. ?oO . t:!X7
??rJ . &J.O
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $ J. t;'OO. (!)t!J
Other ......................................... $
Total Due .............................. $ 7'1$ 7.1'(0
Paid 795""9.~" Receipt No. 3, to 0 I 0
Date ~/Z-d /?q By ~
that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed a~u~s~ed. This document when
Pia er const~u s a temporary ceq' te ning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
iN' MtU<. d(h'l~ widfh (I( f'/)ftr.~ L.i t'A......
D e Special Conditions ~ any
24 hour notice for all inspections 447-9850
Issued
II
CJ9-953
Tho Conlo' of Iho Lib Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CijECKlIST
NAME OF APPLICANT
APPLICATION RECEIVED
/VlO/VllIeNS 8L-O~
g/5/qq
, ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/'-I/'-/-3
t5t.-U6t3I.e.O //2..
N6
Accepted
Accepted With Corrections
~
Denied /) /J.
Reviewed By: W~ ~
I. /'
Date: E? ~ tft, --rr
Comments:
~ 'ifJ tlfkc~ h~ ~
"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
~ 0.._--
Tho Conlor 01 lho Llko Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CH~CKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
_.~~-
'if,:" '_'
/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~........' l'
Accepted
Accepted With Corrections
~
Denied J
Reviewed By: (i ~ - ~
Comments: If A- c.. tJ ni+~ CCtnhlsf
.56Ibw~
.r dL/ Vhtlx cLri VtW~
U'
Date:
<g/t ~/'i
, .
on 10' 5 ilk v4n/
.
enCroQ.dJ
uJidM d- 1?r7~~ liYle.
OJ 'r~'T cJ
"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' r
/7/r1_ C/r: '7
, I J,--"
Tht C...n of nile Lakr COUll..',.
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST,
NAME OF APPLICANT
APPLICATION RECEIVED
//D/l/v6/\.s t:c.LJk:.S
6/ ~//qq
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4/43
ec uE 8/K::'.U IR...
/'/ F:
'-"'"
Accepted
v
Accepted With Corrections
Denied
Reviewed By: ~u. E.H~Ir.SI'MA"'^,
Date:
I I
'IIIX I 'Ii
I .
Comments: flwJoFF ~1" Be OONveYC:l:J rD..-J~l:J flLDA16 DItA'~L ~ (}Ti","Y
EASE McAlTS
A~ M-yt.H JI.$ PA.IlCA1U1L -
[MMAG.E:Ot!.oNGfl.E:"iC wit,,#<' A4AfE,-S
.JtJ It.L 8~ Rt: fL.AGE:.D B'i -mE: Bult.OSJt ~IO~ n Fi,uAL .s1~N d=t:"_
.Sf.~ ItJE=../tfo\Ar,o^,"~ ~E\lf.(SE 5,6<<::.
i)n I \Jt: IoTA v
(l Au o,tJL'l' BE. 14
MA""~Vt"'\ bF ZL/ rE:.E.-r ~ "-;"E f1t.()I'EIZ./'T' L,AlE..
SEe:ArMcl-l~: l..5.JAL.. r1-1ti40~ INSPEc:rttAJ l.N.folttifMtoN 2. bR.Abu,J(. P, AN
.~. rltD$lo.v fnAl'f"'tt.Dl- ~EA5"'.tf'..S
4. E~osl<U' CO~-m.f),L 1: A.u
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a penn it for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
. --. ...., .1-"..)
rr r"
..
.' _~,::"'---'_o.,_.,....~, ....__~...,~__
"---..-..-.-.,.-..--
~. ."
-...-...-....---.......
-~..- ~ ~ ---.....~..",..":...' '.
FROM HEATING CONSULTANTS INC
FAX NO.
612 758 5434
Oct. 20 1999 12:25AM P2
,;/
CITY OF PRIOR LAKE
n. CnJ... of ,... Lak. CD....''?
I. Bll,IC file:
7- Gold Cil)'
3" Y*!jgw AppliCll.llI
PLUMBING PERMIT "''''No. ~fi_-:S
Applic;ant: ,#~.~?'? e~SC//C:-~C-5 P-....~Phone: '::;O~7..57- ~~?
Address: //9#.4./ ~~;..;? .50,
Signatur~" ~..." ~ 'f' ~~
legal ~tion: lot. I ~ Block I Sub /l1I'1P/....-6 IillA....S 21)/12
Sit. Address: ./$//"';/3 g/~G6/~ /~,./'IfIVC KI
Building Permit # 99 - ..7SJPID # 25-,.,34-3- 0 C; 1-0 .
NOTE: This permit will not be pracelilsed without complete information.
FIXTURE UNITS
Quantity
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Rough~jns
Water Hp.~tpr
Water Sottner
Stand Pipe (washing machine)
Sewage Eje"ctor
Bacldlow A$S$mbly (RPZ, Double Ched<, PVB) I
Backflow Assembly Test 1
lawn Sprinkler I
Other
~uur Dri;l.ln
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
ShOwer Stall
Sinks
Ba.r Sink
Water Closet (toilet)
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential. New One & Two Family
GRAND TOTAL
$
$
$
$ .50 _.'
o ",4\ ' ..
~p..\ G \-'\-I ....' \
\,U\\.-O\~
$99.50
Residential, Additions & Alterations
$39_50
State Surcharge
This pcnni~ is grancca upon the c;r.pfCS5 l;:ondi~ioq that saio
contra~tor. shaH com~.- " 1 ccts with the ordinances
of the State P1~mbin i a;~ft~ thereof.
- - ~ . 't:;q DATE
/ ATTEST
Call for all i:t;ctions 24 hours in advance.
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
A-n Equal OpportunitY Employer
II
.-l
ll..
E
eI
If)
(\J
(\J
.-l
(J'I
(J'I
(J'I
.-l
CQ
(\J
+'
U
o
'=S
1'1
'=S
If)
CD
If)
I'-
(\J
.-l
l.D
o
z
x
eI
I.L.
u
z
(J)
I-
Z
eI
I-
--I
::J
(J)
Z
o
U
~
Z
.....
I-
eI
W
I
E
o
0::
I.L.
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. Permit No. qq -953
Prior Lake, MN 55372
Dale
IZI
Add ress
Heating (ol1aclor . #~, .'? ~ C:Ph Sb',/ z::;-~ C ~ ~ ~
Addr&Ss/?e~-~~9 "'~ _~4/ 6?eY~ (
/' "
Telephonaj [;/.,;:2 - 7.s-tY- ?/;7...,;l-?
F uroaclI ~818 .. Model
TYPE OF SYSTEM
Warm Air Plants
Glavlly
Mechanical
Air ConditiDn log
Vent. Syslem
HEATING OR POWER PLANT
Steam
Hal Water
Radiation
Special Devices
Model 51;e
Conn. lead
Fuel
Flu e Size
Supply Qle"ings
Return (belings
Inpul
Edr.
Clm.,
Output,
Other Oevlces
TYPE OF WORK
Alleralio.s
New Construclion
Replacement
Est Comp. Date ,
Building Permh # .
Repair _
Est Coil' $
99-94?
/
HEA TIN:; PERMIT FeE $
STATESUlCHARGE $
TOTAL PER~T FEES $
/-P~\D W\TH
\ BU\\-O\NG PERM\\
Receipt 11
,50
TYPE OF STRUCTURE
1, O1uN
1_ Vellov
Oily
Culllracoor
S illgle Family ,
Coml1lercial
.><.'
Two-Family
Industrial
Mulli.Famlly .
Public Oilier
Fee S~hedule
In:lustlal, CommelClallt Multi-Family
Residenlial, Heatirg & AC
R&sidinllat, Healirg Orly
Residmtial. Gas Freplace
Resld~nllal, Addlli(\ns 8 Alteralions
A~sld:mtlal, AC Orly
1% {)I job cost ($39.50 Tlinimum) I
$99.50 'K!
S64.5O {l'
139.50 V\
$39.50
$39.50
R~mEmner to add the Slate Surcharge on the bottom of this applicalion.
~
~
The pice 01 your teatlllg permit includes one rough-In and one linal insp~ion.
AJditbnal inspections will be billed at $35.00 each.
HOUSt Heating Te!l Ae::ord musl be submitted with "'"11rli'llf' ~1'I~lY\i' ",,~r before build-
ing CErtificate of o(cuptncy will be issued_
HEA.T CAlCULATONS REOUIRED. with number of supply and return opgnil1gs listed p-er
mom vvilh CFM's ~er o,enlng. New slructures or 6ddillon~ send tloor plll1 with supply
and rtlurn localiors sh>wn_ HEAT lOSS CALCULATIONS, PAYMENT MO
APPUCATIONS w\Y EE MAilED TO THE CITY OF PRIOR LAKE. U12C11 EAGLE
CREEK AVE. S.E.PRIOR lAKE. MN 56372.
ai, Hall business hOUR Ire 8 a.m. . 4:30 p.m.
AlL \VORK MUS' DE INSPECTED (FlOUGH-lN AND FINAL). CALL CITY HALL
447-4230
I hergby apply tor a mechanical systems permit end I acknowle(gethat the
in1ormalion anovf is complete and accurate; lhat the work will be ill conlormanc.e
Vllth 'he ordinances and codes of the clly and wllh the "ale bul1d~g1mechanic.1
codes; tnal this 'arm does not become a permit until signed by fie BUILDING
OFFICIAl~ that Ihe work will be In accordance wlth the approve41 plan In the
.... 01 "~k whlol1 requt,.. ..Yi.w .nd _,ooel of plana.
~~ .1 ~~~
~ ApJ.J /'Dat8/
/0 Z. G/qq
I D.re
;;
CITY OF PRIOR LAKE Me
16200 Eagte Creek Av. S.E, P.rmit No. QQ-C/63
-Prior-LakerMN's637-2- _u ____._ - ____ _______.u - - ._._
TYPE OF STRUCTU RI;
I. PJa"
1_ 0......
,. ",,.11_
. f"ofe
01, U1
CD_IIt[e I
I\)
ISl
I
(0
(0
U1
(Xl
U1
~
~
HEATING APPLICATION I PERMJT
Date /J/n/q9 PID #~=:. -343 ~ 00 1- 0
. -, . f '
Site Actdtass /f../;(/~ 1?~~-"1AA.d AJb.- ,€ /
Lot I Block I Addillon /'lAPLG HIL- t-5 2 N,O
Owne(s Name /lI1.o81t1.€..n i t1u~ ~_.1
AdcJre ss
Healing Contraclor ~LLIED FIRES IDE d ba FIRE SIDE CORNRR
Add,ess 2700 N, FAIRVIEW. ROSEVILLE. MN 55113
Telephone 1# 651- 633-2561
FIREPLACE
~!.'P Make & Model j.k,.~ N (;,f...e,
Model Size_ Iacm ?Yl
~nn. Load
Fuel (c; u.J
Flue Sizt!
Supply Openings
Relurn Openings
Input
Edr.
Oulpul ~ 1 ~
Clm.
Single FamIly
Two-Family
Industrial
Muffi-Famlry
Other
Commercial
Public
Fee Schedule
Induslrial, Commercial & Mulli-Famlly
Residential, Heating & AC
Resldenlial, Heating Only
Residenlial, Gas Fireplace
Resldenlial, Additions & Alterations
Residential, AC Only
1% of job cos1 ($39.50 minimum)
$99.50
$64_50
$39.50
$39.50
$39.50
"
:xJ
o
~
Remember to add Ihe Slale Surcharge on the boltom of this application.
TYPE OF SYSTEM
Warm Air Plants
Gr~vity .
Mechanical
Air Condilionlng
VenL System.
The price or your healing permU includes one rough-in and one final inspection.
Addilional inspections will be billed al $35.00 each.
House Healing Test Ael;ord musl be submiUed with buildinClIll'lrmil nlllJ'lhpr before bull.
Ing certificale of occupancy will be issued.
HEAT CALCULATIONS REOIJlREO with number of supply and return openings listed I
room wilh CFM's per opening. New structures or additions send floor plan with supply
and return locations ShDWfl. HEAT lOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAilED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR lAKE, MN 55312.
City Hall business hoors are 8 a.m. . 4:30 p.m.
HEA TING OR POWER PLANT
Sleam .
Hol Waler
Radialia n
Special Devices
OIher Devlc9s
I
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447--4230
I hereby apply lor a mechanical systems permll and I acknowledge 1hat the
informalion above Is complete and accurate; thaI the work will bit in conlormanc
with the ordinances and codes of the cily and with the stale buitdlng/m6chanic
codes; Ihat this form does not become a permit until signed by the BUILOIN-
OFFICIAL; that the work will be in accordance with the approved plan In the
case of all work which requires revjew and approval of plans.
Alterations
. Replacement
TYPE OF WORK
NeVI Construction
x
Repair
Esl. Cost $
. Est. Comp. Date
BuRding Permh II
=
j J nO.oJ
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
I rJn l'fi
,
99-953
( pp.'O \11I\1'\-1 - ,
\ e\J\\.O\\~G pE.RM\\
Recelpl ..
&14..4 d~.
~
8~g Offical's Signature
\J
//~/ /9~
Date
// ~s-hC)
, "al.
PRIOR LAKE
t
.
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS Iii I L/. 3 KIIJP h,'f'd /t-t::....t. f
NATURE OF WORK - ^ }.PCA ) C ~.
USE OF BUILDING _ SFD
PERMIT NO. 79 ~ 1~ DATS-JSSUED fj-{(r.-9!
CONTRACTOR Jo.-- 5 g lA.1A~' ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DO~UMENT ~
FOOTING I 9 r;;" '14'1'1 I l3. 'l.S ~OJ
FOUNDATION (Prior to Backfill~ I ~.\ I ri9-1'~
PLACE NO CONCRETE UNTIL AB'tSVE HAS BEEN SIGNED
ROUGH - INS
~EW~EBPSEPTIC~ b I
FRANWNG - 1
INSULATION
ELECTRICAL
PLUMBING ~ ),1()~r/, 5
HEATING (if required) fj')) 1/ /<::/f q
FIREPLACE . P /J) /.?/3~ \
GAS LINE AIR TEST (l' l X;l -t\1-S JK)
COVER NO WORK UNTIL ABOVE HA~\BEEN SIGNED
71)
(I
tj-9-?c;
} I"' Ib--qq
~
I
FINALS
"
GRADING (Prior to Sodding)
BUILDING T~. -+in l.o-l<j;-&D
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY
~. 'I-2M'~,
/1
Ifl/V)
Il-If-O>
%
UNTIL ABOVE ItiAs BEEN' SIGNED
NOTICE \J
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.
115\~
..
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
w'. --
III