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Building Permit 11.1099
i ,A A ,), ?c A A A 4>c A 1 A A ,"S A A, A A A ,C A <■ A A A A A A • (trrfiftrnfr of (erritpattru - ,> K = CITY OF PRIOR LAKE * -. , . . ' - = tyarfittritf of ittibitig 3ttprrtion P ' : . K i 21 Final Permitted [I Conditional C.O. Expires , , ..., This Certificate issued pursuant to the requirements of Section 110 of the D Residential 1 0 International K _ 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 \ .., • t, Bldg. Permit No. ,/ — / K : Occupancy Type Type Construction V Zoning District K = Legal Description (. 1 ( 1 t 1 -.1 --- 1 \ - ' l ) - --‘ '1 , ) ./ , . ,, '1 Owner of Building l ' ' ''' \ ( , 1 t ' Site Address i t I ' .:". -7) i ' i : ( )) 0 ( 1 K _ Coptractor's Name & Address 1 ' .' ( v --., , City Planner - --' K _ Building Official Date: r '.. ' ) .; 1 7 Date: K - , POST IN CONSPICUOUS PLACE • • = O O n 10 2 _ § n k 0 0 0 0 9' COVk k Z m � \ Q r m � § §� % / q -1 m k�� �k KZ _ n ■ n z 2 § ■ § B ‘,... 7 o 0 Z k n m m 7 0 r 0 x k 0 � ❑ 0000 2 X W rn m pi, a ■ _� i■ mX s m 0 01 § XI M/\ \ >G E k ` m N, 0 o 0 r-n m q p, 0 ® 0 to zcc z r § \ # m > "o - a P m z 0 —_ k 13 13 0 2 000000 I z o�2§§ K R• 0 ca m < ). hi 0 X 00 § m Z - a F. 2 k § 0 5 ' )!Cc 0 n o 0000 . 0 0 > g SG n n a 0 0 0 . 0 2 coV ) § x m k � c m m n k r m m a m $� \§ §2 $ § m k \ �� o � v �■ n z z z ■ � s 0 5, \ \ 0 • 0 �� m m 73 r § m § X X 0 m ■ o R 000000 41 x m m m ; "a * ; -a o zo o �1 nc�mc . 7 § ■ � x § m n R m CA IP § » 0 �� Ooo r k m \ Si) 0 X222 k z P. m r §-o O m / a o . m N § ~ < 000000 z > 0 1 It 0 N § s v 0 "mmE > r Zo r. 1:1 4 pi AI 11 71 � k U)5 z -4 r 0 E ' O 0 _ _ — n O CCOO Tv 0) ■2 n n a §0 0 ` 2§ ( @kk z 5 12 m �/ k r �� �� m Z > o CO k-u % t 2§ � ® -I m §� 2 k tc) 7 k > k M O » -4 m m % 0 / - ' 73 r Q . X m % Oo m m m m 5 .-- 9 am ■ *■l ƒ (—I - E E ? Q o 0 x rnm x§ 0 o co $ k m G § zzzz z 3 0 k 0 A B $ r§ 0 71 g p 2 ® Ns § § i § § V m z m 4 @ r o 2 0 � m n , 0 k o ¥ ■ m OOO OOO o / t k Ck � In › _ r T, t; » m o $ tmm% 22� m 4 0 4 PR/0 + I (f.:] --: .W I _' +P CITY OF PRIOR LAKE BUILDING PERMIT, u !' Del& q' sw TEMPORARY CERTIFICATE OF ZONING COMPLIANC a AND UTILI ''' 1 " ` ' e OCT 05 2011 4 `AWE acv 4 S B 1. White File _ PERM " O , 3 Yellow City /£A. � IN r I 3. Yellow A (Please type or print and sign at bottom) ADDRESS 1 L 2 P A42-14- S l DE_ C C v RZ ZONING (office use) LEGAL DESCRIPTION (office use only) LOT l 4 BLOCK t ADDITION Fr R5 lam"'-t PID 2-'1 Li 1 eb Cl 1 LI D OWNER (Name) n A T 1 A M 44 0 t i ES (Phone) (Address) - 12-431 i■ A S t-1. t tJ 6 +,1 A V E S Si C.O t - i 1 •l S S 4 3 9 BUILDER (Company Name) 1-10, -- fit"' i 4+0 I`1 ES (Phone) (Contact Name) S U E - (Phone) (Address) 12v t 1".. 1k S 4 l+,t (, is, vF S 5'h c) I l - t NJ 4, H j1 SSA 39 TYPE OF WORK JEf New Construction gDeck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ❑Addition ❑Alteration ❑Utility Connection CODE: ]I.R.C. ❑I.B.C. ❑ Misc: Type of Construction: I II III IV V A B Occupancy Group: A B E F HI MR S U _ PROJECT COST /VALUE $ t 4 0, 0 0 0 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 can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X�t-. - . Be-- 2C1 Se)b tot 3 t tk Signature Contractor's License No. Date . - Permit Valuation 1 4 f Oa/ Park Support Fee # $ Permit Fee $ ( 2- SAC # $ Z-1.-1,0_ - Plan Check Fee $ 45 Is Water Meter Size 56; 1 "; \` _ I 0 State Surcharge $ 1 ©- Pressure Reducer $ lO o Penalty $ N Sewer /Water Connection Fee # $ S^ . Plumbing Permit Fee $ (5-4'` Water Tower Fee # $ j ogid. - Mechanical Permit Fee $ r s Builder's Deposit $ Sewer & Water Permit Fee $ - 50 Other Ft e " - � t , (4 $ l S Gas Fireplace Permit Fee $ 5 TOTAL DUE $ 7OS• 78 This • ' . "catii Becomes Your Building Permit � A roved Paid 9 7 () 6 , 77 Receipt o. 61- Z 9E) t _ 6 Date By i ' B ' ding • 4 ate This is to c. ; that e request in the above application and accompanying docum is is ' accordance with the City Zoning Ordinance and may proceed as requested. This document when sip. . th • ty Planner constitutes a temporary Certificate of Zoning com ce d allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. 4 r 'A d I � ( f Special Conditions, if an P1. • , : Director Da pe y 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 pt . ' . 4 . ) qty It Aot • * PRi CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd f•-• 7 , TEMPORARY CERTIFICATE OF ZONING COMPLIANCE -- pq AND UTILITY CONNECTION PERMIT 4 rAlloose,4■" 8. 1rES`" Wiwi ' '1 PERMIT NO. i ( 6 i( 3' • c. *.m.s:aret i (Please type or print sall slim at bottom) ADDRESS I ZONING !office USC r t , I r 0 Cr Ai 40 ,,, A5 e67■4 • .. LEGAL DESCRIPTION (office LOT BLOCK ADDITION PID OWNER . A in A r NI; tiomEs (Phone) 1 -8,0 --- (Address) 1 2 - 0 1 W e ‘a AVE- .5- Er)avgi , I-11.-I _...-5431 SWEDE!. C.-001T-4ACR: (Company Name) "5712.E, ,t"" t.)P r - C-C46k e* .CE 2- NIICC..., L-14 , (Phone) - zr- sic.c) • (Cornact Name) -.)0S. (oPo...TrE 1Z.,„ (Phone) (Address) 1 1 1 1 1„) T...b..1 I , ,.: .1 L. t - _, 1 ..., ,..-; I . _ __ ■__ _r. 11-kt..1 ail. TYPE OF WORK ; New Consrruction °Peck °Porch °Re-Roofing 0Re-St.trig °Lower Les-el Finish 0 Ftreplace Addition °Ake:anon C_ t:s Connect ion CODE: FI.R.C. I.B.C. D 0 Misc Type of onstruction: I 11 111 IV C) A a Occupancy Group: A B E F H 1 M(PSU PROJECT COST/VALUE $ --- . -'‘--- • *--- r) '-' Division: I 2 (3) 4 5 (excluding land) . 1 nent-) snit; that 1 have furnished inkernanon on this ap-i wnich is Li :lie best of my knowledge true ant ct I alsr (1:11 that I am the mime : ot ahrurd arti fot tht 1 abott-mentioned TropettY and that all construsmon will conform .0 a:: esiszing stair and local laws and w41 proceed I: IC : with submitted plant : am aware char ihc '7,11:ling cf6:41:an rev0=e Stu; permit rot NV cause Furtherncrt, 1 hcrtty &Fee h t rhe ci: ofri,..t1 or a designee mar critri int v 7,-) perform needed ,nspecl„)n, x (4,4i-N.,,da14./t6c. C - 14-5" 5-2e- la Signature Contravor's Licenic No Date Permit Valuaton Park Support Fee # S Permit Fee 5 SAC # S . .. Plan Check Fee $ Water Meter Size 5:6 ,; - 5 State Surcharge t $ Pressure Reducer 5 Penalty $ Sewer/Water Connection Fee # $ Plumbing Permit Fee S Water Tower Fee P $ Mechanical Permit Fee 5 Builder's Deposit $ Sewer & Water Permit Fee i $ Other $ ,i Gas Fireplace Permit Fee ; 5 i TOTAL DUE $ This 1 ti • Aliii, .. Your Delkkling Permit A it vtd Paid ; Receipt No. Date , By i AC Ile / 1? IZ- . Ball4; _ ibciii Da „ EINEM,' This u r minty that the request IA the abort appiteanon and aczompazy tCh:laritTLIS IS III IIC:ordan with the City &lung Ordinance and may proceed as requested Thz document j *hen slimed t+! the icy Planner constitutes a icrrorats Cr:Ili:cafe „Tf L-.g o7rnphance and aoirs consminon tti s. ilefote ocra. ncv, a C. ifitc of 4r.roaricN be , issued -,- . fiM i/Olifi a ' 1* ... Planning Ltirecior Date Special 03m.11 if an) 24 hour notice for all inspections (952) 447-9850. rat ( 447-4245 464 f• Dakota Street S.E.. Prior Lake, Minnesota 553'2 Contractor's Material & Test Certificate for Aboveground Piping PROCEDURE Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall be corrected and system left in service before contractor's personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is understood the owner's representative's signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PROPERTY NAME: JEFFERS POND DATE A -2, -1Z PROPERTY ADDRESS: 14352 PARKSIDE COURT ACCEPTED BY APPROVING AUTHORITIES: CITY OF WOODBURY ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS EYES ONO EQUIPMENT USED IS APPROVED EYES ONO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS EYES ONO TO LOCATION OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? IF NO, EXPLAIN INSTRUCTIONS HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: OYES ONO 1. SYSTEM COMPONENTS INSTRUCTIONS EYES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS OYES ONO 3. NFPA25 EYES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES49 2011 1/2 10 155 SPRINKLERS RELIABLE RES 44HSW 2011 1/2 13 155 RELIABLE F3QR 2011 1/2 1 155 PIPE AND Type of Pipe BLAZEMASTER FITTINGS Type of Fitting CPVC MAXIMUM TIME TO OPERATE ALARM DEVICE THROUGH TEST CONNECTION ALARM VALVE OR FLOW INDICATOR TYPE MAKE MODEL MIN SEC FLOW INDICATOR POTTER VSR - F 0 45 DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. DRY PIPE TIME TO TRIP TIME WATER ALARM OPERATING TEST THROUGH TEST WATER AIR TRIP POINT REACHED OPERATED CONNNECTION* PRESSURE PRESSURE AIR PRESSURE TEST OUTLET* PROPERLY MIN SEC PSI PSI PSI MIN SEC YES NO W/O Q.O.D. WITH Q.O.D. IF NO, EXPLAIN LOCATION MAKE & SETTING STATIC PRESSURE RESIDUAL PRESSURE FLOW RATE & FLOOR MODEL (FLOWING) PRESSURE REDUCING INLET (PSI) OUTLET (PSI) INLET (PSI) OUTLET (PSI) FLOW (GPM) VALVE TEST N/A OPERATION: ❑PNEUMATIC ❑ELECTRIC ❑HYDRAULIC PIPING SUPERVISED OYES ONO DETACHING MEDIA SUPERVISED OYES ONO DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE OYES ONO CONTROL STATIONS DELUGE & IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT IF NO, EXPLAIN PREACTION FOR TESTING VALVES OYES ONO N/A DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO MAKF MOfFI SI IPFRVISION 1 055 AI ARM f)PFRATF VA VF RFI FASF t7PFRATF RFI FASF YES NO YES NO MIN SEC HYDROSTATIC: Hydrostatic test shall be made at not less than 200 psi (13.6 bars) for two hours of 50 psi (3.4 bars) above static pressure in excess of 150 psi (10.2 bars) for two hours. Differential dry-pipe valve clappers shall be left open during test to prevent damage. All Aboveground piping leakage shall be stopped. TEST DESCRIPTION PNEUMATIC: Establish 40 psi (2.7 bars) air pressure and measure drop, which shall not exceed 1 -1/2 psi (0.1 bars) in 24 hours. Test pressure tanks at normal water level and air pressure and measure air pressure drop, which shall not exceed 1 -1/2 psi (0.1 bars) in 24 hours. ALL PIPING HYDROSTATICALLY TESTED AT 200 PSI FOR 2 HRS IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED OYES ONO EQUIPMENT OPERATES PROPERLY EYES ONO N/A DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OF SODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? EYES (,]NO DRAIN READING OF GAGE LOCATED NEAR WATER RESIDUAL PRESSURE WITFI V LVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION PSI CONNECTION OPEN WIDE bp PSI UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THE U FORM NO. 85B EYES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING OYES ONO IF POWDER DRIVEN FASTENERS ARE USED IN OYES ONO IF NO, EXPLAIN CONCRETE, HAS REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS 0 WELDED PIPING OYES ONO IF YFS DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3? OYES ONO WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3 EYES ONO DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISC ARE RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED? OYES ONO CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS (DISCS) ARE RETRIEVED? OYES ONO HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA OYES ONO NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: `'D NAME OF SPRINKLER CONTRACTOR: FIRE SUPPRESSION SERVICES, LLC TEST WITNESSED BY tr' n TITLE SIGNATURES j TL ONTR TOR (SIGNED) TITLE DATE $ •. ■••■■■•• tjbc) vtA.Z4i ADDITIONAL EXPLANATION AND NOTES 20 t 5 D EPARTMENT O P RIOR LAKE BUILDING AN §ee INF SP ION _ bile INSPECTION RECORD SITE ADDRESS ae - NATURE OF WORK 5 /AMYL. DSC' NO P011011 NO Lao. USE OF BUILDING S I AO* I PERMIT NO. / 7 DATE ISSUED CONTRACTOR nirrni I fridliOSS PHONE .32.198.6/2$ NOTE: THIS IS NOT A PERMIT OR ANY OF THE INSPE TIONS BELOW THE � PERMIT IS BY SEPARATE DOCUMENT ,� =air -- ArS7�] Lt E .Va d / a f ML 7t s /1ft� //J INSPECT +A �^ rwit-v ! I tICS FOOTING ¢ avar ! DEG �cl. 1 FOUNDATION (Prior to Backfill) 1 1 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED g 00 s Si t v&' 7E 61478 rlCfem,t ROUGH - INS SEWER / WATER / SEPTIC FRAMING � 025112- INSULATION (I27/i ELECTRICAL PLUMBING v9 ct ( f1f( J f2 /5-A HEATING (if required) FIREPLACE GAS LINE AIR TEST N& eh s /,6 /,z p0 ,p/ / Sy��c/y .. J �R N CgVE NO WORK UNTIL ABOVE HAS BEEN SIGNED 5pR4 OR_ FINALS --- $ /zir 'Z - GRADING (Prior to Sodding) BUILDING G 117 ELECTRICAL PLUMBING /d HEATING 8 1 27 1 2 DO NOT 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