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Building Permit 11.572
Y ii,._ I ._ _., .. _. r ._l i` r._;I i�(tV _. Iltl'.r . ii _. rY4,� �. ill, _., ii��'YY .� _. �Y���Y _.� _. u. i ., i .. .� .. ._ iY. C rrfifhhafr of ®xr p rnt CITY OF PRIOR LAKE Prparfturrlf of uiI.�zn 1t Z Final Permitted ❑ Conditional C.O. Exp - C� ; ts Th Cert i ssued pursuant to the requirements of Section 110 of the ❑ Residential / ❑ International • ' ,. 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: ` -. Nei /1: Use Classification > Bldg. Permit No. Occupancy Type Type Construction Zoning District Legal Description Owner of Building Site Address / * / `' /71-i /t/ S/� 6 Contractor's Name & Address j If T /1 /w1r /1 C ---C r a) O(T7 / iU%C;N / �I /),4 / T / S '' Cit Pl anner Building Official / ` / : � Date: t � _ Date: r POST IN CONSPICUOUS PLACE � 1 I I l l I I I I A S I N IY � y � J 1. , � � X \e 4 J 1_` Z <N US Fa Q Z U U W Z g ggg 3 c �9';c z a w • i ''' z i — 4 re ❑ ❑❑000 ` > Na' �j 'o v Ct N O W O » � m U. c 0 W O c2 C re 0 " , ` 0 0 0 4 O O W Zw- MOCm a v) LOU. N 0 I N V a M - 6 M 0 S O 0 Z I- p �. a 23N a ae \ \ c f W w W k ' ' ❑DDDOf11 \I A O O re W V C I 0 o Z o o I- �n J ` i '�11 a a 5 N zc? z a. W ` � ~ � N 0 0 v Y cc ce L a a 1 4 O a a l 12 IL Z 0 t, �' O p W LU -J 174 t V 0 P , c 0 u.aa_ N 3 0 0 1 5Z < 0 a ❑DDO O 0 ❑ c E XO ❑ 0 000000 0 > E0 2 0§ 0 . 0 CA -TI z m k � / k rn u :u V) 0 • % / 0 z 0 ? , • 7 0 r z 73 ¥ r o 3 4, m 0 0 0 D 0001:10 m m mm • $ \ -o ■ *■� . 2 k} § } N § m i m 0 cn § 2 ® / § ��==�z Z Z z ti E m m ® rn00 %§ P 0 ■ q U z zcm z r 0 z F. § �$$ P 0 I k § < rtt , 10 § -ten V � enmm30 C\-) — m ■mm■o � ���� < � z • > s00 q 21- -te 2 w z - m �r 0 0 J W Z Z F J W W re U W `�UU d Z ry 3855= i > k. 0 W w N h O Q NI w0tLLL i r Z �" p �( w en lt� 000000 N 0 O re U 0 Os W = rt N U. CZ 0 J W 03 c 0 oC a. D 111b. 1 Z Y ? Z 0 V 0. C R F r O O LL J w oG W H x 0 0 00< U c w s 2 z z —xxz— w u. C i' 0 u) ` 1 U d D W Q n W F - � � . W 0 W Z K C mitlikimi 111C‘ 0 a 2 co a. 2 IL 0 lU ce z DODO* 0 0 re CC 174 0 Ili 0 \� _ 0 Q O r W LLI y W v a U qC U Cli g 0 4 z N 0 �` is OI re — Z J ° o w ~ a F- 4 IX re0 O 2a co W ti,A N W W W a — co Z ZG - J Z Y re 0 q 0uj co — W p D � 7Q W O p p + U O 0 Z 0 LL° 3r i:co o 3 U U 5z a O a 0 000❑❑ 0 ' N • M �' ❑ pc ❑ c of P RIp CITY OF PRIOR LAKE BUILDING PERMIT, a A ,, ;' TEMPORARY CERTIFICATE OF ZONING COMPLIANC igpVIc AND UTILITY CONNECTION PERMIT JUN 13 2011 4','VNE i ' ' ;. . I. White File ■ Ex 2 Pink City PERMI I fl — E _ `- 3 Yellow Applicant , EMI/`A (Please type or print and sign at bottom) ADDRESS 1'-131 t) px Qj S 1 D E C p V P.21 ZONING (office use) LEGAL DESCRIPTION (office use only) LOT 'BLOCK 1 ADDITION J E- cF-Erzs l..e 4 C 1 t`R- t= RQt PID 25 - 1 41 ' ,- 0 06 - O OWNER (Name) ["1 A, -T`TiN, I-1 `t' 4+0 1-1 1= S (Phone) `YS 2 - 9 8 - 2,1 00 (Address) 21 00 Ir.) C- 2 h 42 1? R N1 S ✓I Lt–E. Nt N SS 331 BUILDER (Company Name) M T h-t`i - 1-1--0 C-t 1`S (Phone) 9S - - > 9 - z.l 0 b (Contact Name) S" 1`- Tb 4,1 (Phone) q S - S S $ – 61-L (Address) 21 b O 1.4%) -T `t' 1 Li -2- 13U 17-.1S V 1 t_.Lg M N SS.3 TYPE OF WORK New Construction ❑Deck DPorch DRe-Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace DAddition ❑Alteration ❑Utility Connection CODE: SII.R.C, I.B.C. ❑ Misc. Type of Constriction: 1 II III IV V AB - Occupancy Group: A B E F HI Ni R S U PROJECT COST /VALUE $ k , , Division: 1 2 3 4 5 (excluding land) { I hereby certify that 1 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 o r authorized agent for the t 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 Ct.✓.a c....--.-- - &- 203'1 538-6 I,' 10,, 11 Signature Contractor's License No. Date . Permit Valuation k51 r de,. - Park Support Fee # $ Permit Fee $ ( ,. 3C � SAC # $ 7..-Z30. Plan Check Fee $ eg 3.te0 Water Meter Size 0"; 1 "; $ eo ` Or State Surcharge $ 145,--50 Pressure Reducer $ 9 © G F a $ t- , Sewer/Water Connec Fee # $ ( 5cto, Plumbing Permit Fee $ i S4. Water Tower Fee # $ t 000. Mechanical Permit Fee $ (S 4. So Builder's Deposit $ 1 5 an. Sewer & Water Permit Fee $ C $ 50. S-0 riles 7' ii eile S tc9� l ii Z Gas Fireplace Permit Fee $ rR ,, p. TOTAL DUE $ rill /6 This Ap /riot' t e 4 es our Building Permit Whe Approved paid G (� e- , Receipt No 63/e 1 , 1 � Date '7 - ( ( By 3V(6 uildint• Otlicial Late — This n 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 Prior Lake, MN 55372 4. Pi1 • 4 14 t ick, 4k ti ee:04111:41644A ®4 p RIOT Date Recd ,�, CITY OF PRIOR LAKE PLUMBING PERMIT v - jN NESD P 1 Blue File 2 Gold City PERMIT NO. I I • 7 . 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 1431 Par ° lae . coy-{ -- K LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION , ■ PID v OWNER (Name) - , �',, (Phone) (Address) APPLICANT f l (Name) (Phone) 1 • 1 ���J v (Address) ?.W 1) 1 ) b k) al , 3333- (Addrkls (City) (Zip Code) � (Contact Person) Ctn. 6 e'1rmAl (Phone) 0%1119 APPLICANT SIGNATURE e!s1Lt �� I ^ .: � ii .1. _ '4 DATE 0+ 14 1' APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture f Bath Tub with or without shower Rough -ins Dishwasher i Water Heater 1 Floor Drain Water Softener Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector i Shower Stall _ Backflow Assembly Sinks Backflow Assembly Test Bar Sink 1 Lawn Sprinkler Water Closet (Toilet) Other FEE SCHEDULE Industrial, Commercial & Multi- family 1% of job cost with a $49.50 minimum Residential, New One & Two - Family $149.50 Residential, Additions & Alterations $49.50 The Minnesota Statutes § 326B.148 )st $ (AN Building Permit # URCHARGE" has been changed for one year effective PLUMBING PERMIT FEE $ q 1 L I GI PAID WITH July 1, 2010, until June 30, 2011. STATE SURCHARGE $ 1-:6 minimum surcharge for a "fixed fee" permit TOTAL PERMIT FEE $ 1 BUILDING PERMIT is ., beginning July 1, 2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Building Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 P CITY OF. PRIOR LAKE Date Rec'd °4' a -, e HEATING /AIR CONDITIONING/FIREPLACE PERMIT tili •,� o�¢ . , . Pink File PERMIT NO. tNIVES 2. Green City 3. Yellow Applicant .. (Please type or print and sign at bottom) ADDRESS ZO (office use) 1 LI N O pal \/0e/O. cl,t( 4— KA,PJ LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (Name) SP&. ' �G tdli\.‘AAn (Phone) (Address) APPLICANT ,, 95) �F, i �s (Name) • (Phone) (Address) mi w. V v : A A • I i A .t ddress) ( itY) /�/.6��� � (Zip ode tt /�� r c 5 7-41.b4"--• (Conta'ct Person 11� � (Phone) APPLICANT SIGNA • .° .`y1�' 11.1 y■ , -- • • E (-71 JiLj)1 APPLI 1 T PLEASE COMPLETE BELOW W CO TRUCTION ❑ REPLACEMENT E1 ALTERATIONS Vat-- FURNACE MAKE NAND MODEL r II,JQ LD 0 FUEL FLUE SIZE RETURN OPENINGS INPUT � n OUTPUT 55 a TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner ['Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach • Gravity ❑ Hot Water into Required Side Yard Setbacks. 4 Mechanical 0 Radiation Fireplaces with Box Additions or • it Conditioning ❑ Special Devices ent. System ❑Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL 6/75 G /u - �"NC FEE SCHEDULE Industrial, Commercial & Multi- Family 1% of job cost Residential, Gas Fireplace $49.50 $49.50 minimum Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50 Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50 Estimated Cost $ WI—ail Building Permit # —13A ID Minnesota Statutes § 326B.148 s 1' AID WITH 'SURCHARGE" has been changed for one EATING PERMIT FEE $ t't1ct. IL[)IN G PER MT year eve ['ATE SURC 5',,F3\--, July 1, 2010, until til June , . ne 30, 2011. le minimum surcharge for a "fixed fee" permit DTAL PERMIT FEE. $ 4, / is $5, beginning July 1, 2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Buildine Official ` Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 04 P.. . C 1 ' e 1 ! AkE BUILDING PERMIT, Date Recd r, . I .. RIP CERTIFICA • • - NING COMPLIANCE � ti AND tTILITY CONNECTIO. ROUT I•. f� V wane e t ArNE so 11.512 ; PERMIT NO. l J�• 7Z . „i.r E O..; i f f PE- ZONING (office use) ADDRESS . . 1t tC P PAKKS'tp -vuRT r`N iL i _�, wisIu . )K i LEGAL DESCRIPTION (office use only) � I LOT BLOCK ADDMON PID OWNER i i A TT1A 1U � � �ty (Phone) � 5 2 ° `t 9 ?' - (c ( e-- (Name) 120 t l �)�1^t t &Tt c....1 1nv� S , 1 (Address) J BUILDER Ca ct : ” }�}'Z -- ;� i t o N (Phone) l v� I —11 ( � Coin any Name) [ -A.CT- o 1 r- t P , +F15O�► 1 �►iEP� (Phone) 1051 - 155 - Q (Contact Flame) _ (Address) T.?(4 L.'kL Dtur'_ UNQ J t1E H1,1 L55Ot t TYPE OF WORK New Construction °Peck ©Porch °Re•Roofing ©Re- Siding °Lower Level Finish 0 Fireplace ['Addition ©Alteration °Utility Connection CODE: CZI.a.C. ©I.B.C. ❑ Mix: Type of Construction: 1 11 ID N a A PROJECT COST /VALUES } D ivision: Group: A B E F 2 (5) M S U Division: 1 2 l l 4 (excluding land) 1 eseby a n o fy dui t have and that all co sTau mut+on oa wil: cn nforn to all esns srare and local taw ~and veal t rooceed rt accordance that I am the owner or author Plana 1 am aware that t butter . property and hat C a ust Furthermore. e g yr• i pr operty :o perform needed inspections t; for j• cut I hereby the ;ire official or a deli the ©pe G J l X official this permW T"' _ _ I ee may enter s f * 1 1 74 / ' ( X : Contra:toes license do Pate Signature ._ Park Support. Fee # S Permit Valuation OCO. Od s Permit Fee 5 SAC /03.00 S Plan C h e c k Fee S G i s . `(S Water Meter Size 5 fi ": 1 ": 1 State Surcharge S 2 . Ov Pressure Reducer $ 1 S Sewer /Water Connection Fee # l S Penalty Plumbing Permit Fee S Water Tower Fee # S S Builder's Deposit S Mechanical Permit Fee { S Sewer &Water Permit Fee 5 Other Gas Fireplace Feltner Fee S TOTAL. DUE PAID WI BULL C.1��n1�1 T es Building Permit When Approved Paid HINT' r �... pate i BY eit 451frill. soft Official Date t ed ;'bs P,owmcnt '' 1 This a to eats.'y that the request tf the above a The -ition an4 accompanying documents a i acrandance we the C ty Zoning Ordaunce and may proceed as request when signed by the Cm Planner constitutes * temporary Cent >cait �r Zoning compliance and allows .o.s:ru ti•or to _omratr:cc. Before occupancy a Ce:tifaute or Ocrspani` 'mist be esved Date Spe%tal (.'undiuoos. it any planning C�ittwtar _ 24 boar antics for all inspections (952) 44'.98SO, fait (9521447 -4245 4646 Dakota Street S.£., Prior Lake, Minnow* 55372 * 4* - • , 044,4 • ‘44 • 46. 4 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 V PROPERTY ADDRESS: 14310 PARKSIDE COURT ACCEPTED BY APPROVING AUTHORITIES: CITY OF WOODBURY ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS ®YES ❑NO EQUIPMENT USED IS APPROVED IS YES ONO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS OYES 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: El YES ONO 1. SYSTEM COMPONENTS INSTRUCTIONS OYES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS OYES ONO 3. NFPA 25 OYES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2011 1/2 12 155 SPRINKLERS RELIABLE RES 44HSW 2011 1/2 12 155 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 © 42. 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 Dat- 7/2.5i21: I 4.-5 ,..; .1.4 MAX GRAY CONSTRUCTION, INC INVITATION TO BID 2501 5TH AVE WEST p0 BOX 689 Please respond immediately HIBBING MN 55746 Telephone : (216) 262-6622 7 2011-25-ITB-07200-AUTO 1 Fax (2i5 : (216) 262 1 Date 07/25/2011 E-Mail : mgcbidinvite@maxgrayconst.com .--- Web : www.maxgrayconsticom i From DEREK MISIEWICZ , TH Estimator/ Proect Manager . To: METRO FIRE PROTECTION, INC. , 1 1 8145 LAKE DRIVE 1 Prir . ted 07/25/2011 LINO LAKES MN 55014 ! I ! Ej INTERESTED 0 NOT INTERESTED - Attn. Phone :1 -(651) 784-0417 Fax , i-(651)784-8419 I 1 , I I 1 0 . - JOB I CASDA REMODELING 1 ED CHANGE OF ADDRESS 1 1 1 i, 1 NEW . i 07200-FIRE PROOFING/INSULATION i ADDRESS ; L..... : -,- invite you to bid for the above projects:' -- '.-.''''''. '' '' „,,.,.. • ;;:'-'',':%:!... '''-•", ' i :•,,',' CONOTCH-C /NC INV I 1 AT -TO-B-1-D- 1 ProWt! : ciapDA 9 Empo E:I.,HVG Ui",;.x, 3S.9 Pie ,9'.' e r esp o 1 (1 ; M riled d y 11 I:ILIkiAVOrIN- VVI , T43 ephc n€ 21 E'..) M2-6622 N'J'Urnt.:,;-e, 1 201 1 - 25 - Ile, a7200 A L110 I Rptop3polow . 1 @ 02:0C PM - 1 E qr,9id tyl,ilt../zit,liB9,9,rbriA7.,il,p/C1)1,09.C.0 AM :op Ofan s & 806z6 areI5 they can be seen Ihpre, ciut Duluth, 11113bieti:r'O'aNicaViiiiiiiidpolis Builders Exchanges, REED toVStruction Oata' San NILS i ESI'irnatO!'" P Managf.Y T "fl F, e'ff1`,1 INK.--- . r— i f ? Qt A 4 . 3 '' ' A FI Egli IVF - --- 1 .191.K 550 I 4 ; ' ill UATERES El NOT , ' ., ,ITEFIES"I . EID ---- - - -._.- , I RESPONSE REOLIEsTED • 164s& Cheek appropnate box above, sign and fax this sictqw. back to LIS as soon as possible — - - --- ,r J, B icl' 6 t ic; CIA RI:E;I:,1C ET ING PLEASE PRINT .rFinIL : (,,..1-11-1M3E_CE_ACIDTIE --- ______......_ 1 . NEW 1 P.,.4:,c-1 Iki-L PROOR NC3, ;N SULAIION ADD'RESS I :•:-.-- .. = ; d in ii Ito you to bid 'or the -iL'io tie oro . L • , :41..' - rr.4..e''''. f;;;."X4 (it li 'Ortdllidril it' Itel_LII-IE' lUI-i , vii! ,, I:Jtte,Oriit t1OZ"40 I 1 rl Li:O.r.aIld.(,/ts Ori 7.95i t.it4! t 0? ut iudi S6 r''Ire.'it, k si:;,:::8.atEl-:, r.. 1 rchi::,..:,01.,'.3 -,,-1, !:;.c,0 b .,.., c „,,, 611,. D i -'Hibbill' 'SIi, Patti ir,I9d Ni9rit Bders L.:itmandes, H::::..Lii L;dr.stctkti li.Iik3 . alio iJitirigtt .i.,:i'icithti : riMk'0..!- i i ::, .{.- , :'T :''il lVIr .';'-.7 DIA ,-., P -': tr, ., f Z trIb I LI R E UI c'-i t; U ._J fax rhiF..., she,!. cock to us as socr az roo; ,:.i.r. 1 ; ::,. i. ,. , ,,..•,' . - .:i,,'.14,24, i:. ,„:, 'Name i For tt visit.- ouLiAtabsiter:toama-tilaxgray.co,asLcarct--.....----_—_-. ...--- -------------,,. Ei.,,EASE PI'll'T El'IlAiII - i :: : ; :: -.- - ; : ; •' -- - .' 'I OPERATION: [PNEUMATIC ❑ELECTRIC ❑HYDRAULIC PIPING SUPERVISED OYES ONO DETACHING MEDIA SUPERVISED OYES [JN 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' 'r �� VALVES OYES ONO N/A DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TQ MAKF MOflFI SI IPFRVISION I fISS Al ARM OPFRATF VAI VF RFI FASF 1)PFRATF Fl FASF YES NO YES NO MIN SEC HYDROSTATIC: Hydrostatic test shall be made at not less than 200 psi (13.6 bars) for IWO 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 t0 prevent damage. All Aboveground piping leakage shall be Stepped, 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 pressure4anks at normal wi claJifl d ' _ Bnt&Meac ti iialsbie) fro#,, Wfaciii A+goYe7(ceed 1 -1/2 psi (0.1 bars) in24hrours. ALL PIPING HYDROSTATICALLY TESTED AT 200 PSI FOR 2 HRS IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED OYES ONO EQUIPMENT OPERATES PROPERLY OYES ONO IV/ f' WA 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? OYES NO DRAIN READING OF GAGE LOCATED N AR WATER RESIDUAL PRESSURE WITHX�//AIVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION PSI CONNECTION OPEN WIDE 30 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. 858 OYES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING OYES ONO IF POWDER DRIVEN FASTENERS ARE USED IN _AYES ONO IF NO, EXPLAIN CONCRETE, HAS REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS 0 WELDED PIPING OYES ® NO 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 OYES 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? ®Y ES 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: 9 NAM. 1 I F SPRINKLER CONTRACTOR: METRO FIRE PROTECTION TEST WITNESSED BY • • • 4,1 R (SIGNED) TI E /^ DA / /( SIGNATURES RINK :I' F ONTRAC OR (SIGNED) TI E DAT r doorruyiptc31 ADDITIONAL EXPLANATION AND NOTES -C/ J erit tC rrcr. Bid Notification Date: 07/26/2011 • Attn: Jerry Kramer, Matra Fire Protection'inc Jerry, • If you are interested in bidding on any of the projects below, please go to the URL Ud at the bottom of this page to access complete project details. Thank you, • PrOJect Name: Dunwoody Apartments, Minneapolis, MN, Multi-Residential Site work and renovations of a 'medical developrnent in Minneapolis. Schematic plans calf for the conversion of a historio,hospital into a 1237upit, epertipant,,O44.10jpg,, Lffr; 4 -17 • Pi•Olett Name: Cub Foods - Remodel / Chanhassen, Chanhassen, MN, Retail Remodel of a retail building In Chanhassen. Completed working plans call for remodeling of a 53,314-square-foot Project Name: Holiday Stationstore #3588 / Coon Rapids, Coon Rapids, MN, Retail, Service Station / Car W... Nan cp..dia of a retail building in Coon Rapids. Completed working plans call for the constructiori of El L.6tivomiertzit ii6112) and gas station with 20 gas pumps. Plans include a gross floor area of 7,421 square feet, icifIgtPii4400 Oftif.4407e1W4frOafOottestitterfloor and a 2 ,343 Project Name: BuyBuy Baby / Woodbury, Woodbury, MN, Retail iiiant improvements for a national chain retail store in Woodbury. Completed working plans call for the build-out Oho 28,4454quitereiftrobtplion tm:ackuitiettetsate4410obstoregiikspadac)restheotitilalistelfietetne 'bottom oiete-pe#40-d-ma-4,i- :rfc.R14tiet,Nante: South Quarter - Phase IV, Minneapolis, MN, Multi-Residential Site work and navy construction of a multi-residential complex in Minneapolis. Schematic plans call for the --construction-of 1-2-0-unit residentiati-developmeatQn-a-1,2-aore site- thatwiii-inokide-trousing-end-oontmun ity Name', 4eklit., riihnnetitpiAiti, MN, Mu:ii-Re8iaieniivil iSle Work kintl l'er.4.)VUtiOrn,..1 or is riled ibal clevelopW in I'vlitnaiclis„ the c: Df",e. y stofio hov;:raid into qpetilarnail ,„ oview coMpleteproject detais go to the we addrest listed below and 109 dn..yiting the folloyving,;usernarrie arid„password: . pi OisirCi, ' 00 hrorioA t...7tharithEissen. MN, Hetad MilithiACidIF:f4P;imw,y6,0jogiork4m444,04.4,bicts,, i• of a 5,3,izi 14- jj,, ;'4:'-',...'484-$440,UPITteZ,RP,TAt14041 9 Pryijecli Con Rapids Coon Rapids, MN, S6 nh CP Station VJ . Nti wt 'in Coon Rapids, r U ottiiititruLttictii) nnViariiIan6a106'ea ana gas statina with 20 gas pnprt PIatts 5 area cif 7,421 tar feat pT* vr,14,i1101$.1kicpareafW..90046 and a 2 :2343 ) roject Narn u,#Stiy %lay i \Pilo buiy, . isanar. , raprovernerits tar a it al hair retail store in Wood I.:')ury. Corripisi•ad rk pians sal`, for the tdou 2kai4 iisartittareifooksplasa Pr*.o South Quarter - Ptie'i8tti: IV, lidini'qtiapoiis, sdN Site vvaiit, ianri nay ..1.,tiinstritraio9 of n1r asidentiai itorriptsx r 'itilitiineapriIis iiismatic p;ans taW for ihik" cior4ruLon..of 1204.init V4',. 1.24i.01Q. i(P0 .;; : (; PRIOR LAKE DEPARTMENT OF - BUILDING AN 'I • E ° ON r main tette INSPECTION RECORD SITE ADDRESS 143 t Q F.• As cx C ,.-r• NATURE OF WORK Sins( L FM1I LY A- n-Atkrp go . 1)Ec. ; PAP.LIA c9rR. FtN.L. . USE OF BUILDING PERMIT NO. 1L 1--. DATE ISSUED (viz-t u CONTRACTOR K ri rte* PHONE qz - $ `I8 -6[2t, NOTE: THIS IS NOT A PER FOR ANY OF THE INSPECTIONS BELOW THE PfifIMIT IS Y SEPA TED U M EN NT �( 64 � e / 4{A 1 E OR - ' DATE I FOOTING I I 1 FOUNDATION (Prior to Backfill) 1 1 PLACE N CONCRETE W1 /WOVE HA BEEN SIGNED w+sz ' ekao re:1 R OUG SEWER / WATER / SEPTIC FRAMING We $ tzf ft INSULATION . *-4,, ELECTRICAL PLUMBING ®/Ij i gt/4 HEATING (if required) f O g z t/ 9 1 1 n ,, GAS LINE AIR TEST DP/ I)? A.) / O X ( 'COVER NO WORK UNTIL ABO\(E HAS BEEN SIGNED I � 1 1 I � ZMd f1e t..8g- I a� P6 012. r FINALS Spri,M4r `I124 it GRADING (Prior to So di ) BUILDING G .©, /611q l/ fd5 �D J8 /rz ELECTRICAL PLUMBING r/fr 9 � (� //l HEATING K IG I, q ]7 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 4