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HomeMy WebLinkAboutBuilding Permit 11.1102 (2) ,4" AAAAAAAAAAA 1C A ?S' A A A A ?c A ,. 4> AAAAAAA\ (11erfifiraft of Mrruilartry CITY OF PRIOR LAKE Priaurfturnf of Puiibing c Ittsileriton > K - Final Permitted Conditional C.O. Expires K = , This Certificate issued pursuant to the requirements of Section 110 of the El Residential / E 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: Use Classification - C / Bldg. Permit No. K Occupancy Type Type Construction N- Zoning District K , Legal Description / 1 r 1 7. 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OWNER _ MATTA NI ti i-ICMES (Phone) r: 16 - 2. - g - 2/00 (Name) t. (Address) 120/ WfiSi-ibii&TONI /l E/iN A I Masi 33439 aniiikeet. c_01.31atAcri>r (Company Name) cliZg.._ '. 9 firc-c4S3/4 c.:4 .ce" 2.-Ar...c..,5„ t.-t-C.. , (Phone) is, - Z77-131bc. , I (Contact Narne) -.)1 61120X-E.IZ, (Phone) (Address) I1 1 I (> I.4409.c C. c.-.. 0 4.4). S■.:: LTE. l-k . C.t..e., LN.)E..12 #..ki•:1 5534::) ' TYPE OF WORK X Nev Construction Cipeck 72,For„th pRe Roofing ORe-S;d:rg DL Line: Frmstr 0 Fireplace ljAddiuon OfOtenallon CI:Z..1:7y Ccirmcction CODE: pi.R.C. DLB.C. 0 Misc. Type of oust:ruction: I Il III IV 0 A a Occupancy Group: A B E F Iii I M (j) S 0 PROJECT COST/VALUE $ 325) • 6) ' Division: I 2 (3) 4 5 (excluding land) 1 ncret/ erray than I have &flushed tnforrriation en this apeti.:-sion rhfirdl “: ro ar be of my knowredge true and r:orren i a:30 cemf Mat 1 am the "Aver or luthenied agent for the i above.mennone4 pronery and that all masfruclon w,11 COfifO !:.: a;J C i.5: vale and Inca; laws and %rail pacer.; , 4;:e•..!,;,;:e ,, rj pt., 1 an e ,,,, a ,.., .t.. anrrai can re.Ote tt,S pertnn for just caw( FU:1: ; haier agree :sat :he cm rlf!lc.al or a designer ma% Me• . ...n ,- ,r ■ne. p.one •,. perimrn needed msremms X 4o4iik_ 4 aii±k, (1 - 146 5 -. /a Signature Contractor s License No Pare Perrnil Valuator) Park Support Fee ri $ Penni: Fee S SAC # $ Plan Check Fee 3 Water Meter Size 5,' 8' State Surcharge $ Pressure Reducer $ Perialry 3 Sewer ='Water Connection Fee # S ...-...-.4 Phimbtng Permit Fee $ Water Tower Fee it 3 Niechanica! Permit Fee $ Builder's Deposit $ Sewer & Water Permn Fee 3 Other 3 Gas Fireplace Permit Fee 5 TOTAL DUE 3 This . 'co: . ,;,;',•• .. - . Building Permit ved / 1 ; 4 Paid Date Receipt No, 1 BY Boddr Dare Th u to men6, tart rne request In the above pputanon and uccropazi:):ng JoannentS Ls rn accerdanze w the Cr:, 7.....Mr4 0:Jusance and may pTOc4 as revered This 400=en when signed ty air Cr Y ?lanner ennstIrtnes e terrpC•rary CerCaZr rlf eerrMran and arrows MISM);7:31.4 1. cnrmr Before r, a ertrf=te vf 0, fre-, rerun ere rianed Fir' Pismo* er,rectot 13 pnerla! Condi rionL rim) :4 boor notice for all inspections (952) 447-91150, fax 052, 44 4646 Dakota Street S.F., Prior Lake. Minnetota 55372 ��� rxlp� CITY OF PRIOR LAKE BUILDING PERMIT, D - - t' 0 TEMPORARY CERTIFICATE OF ZONING COMPLIAN 3 1 � � ' AND UTILITY CO O OCT 4 5 2011 T �� 1�Sa j NN B S O i ;i, 2 . Pink File PE ' l �I 2. Pink City oVA 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS 12 p.4 (Z-f' -S (tE OUP-q. ZONING (office use) LEGAL DESCRIPTION (office use only) LOT 1'1 BLOCK t ADDITION c i Ec s 1 /\/ A 1 Z G -J PID 2 -5 4 - 1 60 t '1 0 OWNER (Name) ;'l R T T 0, 1•°1"1 -t4 U N-1 1 -S (Phone) (Address) 12_c.t tNA St-.1t l 6 i& Av'E S s 2a l EA) tt.J-A 1-1 t1 SS439 BUILDER (Company Name) 1-11 1-1- -two l"' ES (Phone) (Contact Name) S U l= (Phone) (Address) 12o t 1...1k S t-! t ( - t...J F vE S STS- 7 ra t t' -O t NJ .1s t--t 1.3 S SL-1- 3 9 TYPE OF WORK $ New Construction Speck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ['Addition ['Alteration ['Utility Connection CODE: I.R.C. ❑I.B.C. ❑ Misc: Type of onstruction: I II III IV V AB Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE S t t-}b , o UU 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. gC — P B— 2- `I SP) b t k. 1 1 Signature Contractor's License No. Date Permit Valuation to r Q-- _ Park Support Fee # $ Permit Fee $ r Z , o SAC # $ --. -- , l } Plan Check Fee $ 5 - Water Meter Size "; 1 "; $ FO 1 CJ State Surcharge $ . 7 D _ Pressure R e d uce r $ A- Pe $ Sewer /Water Connection Fee # $ ( Plumbing Permit Fee $ (S S-4? Water Tower Fee # $ I Ca), '- Mechanical Permit Fee $ t Sd S p Builder's Deposit $ k Soa — Sewer &Water Permit Fee $ 5 , O . � Cl��J t $ , — % Gas Fireplace Permit Fee $ 5-¢ TOTAL UE `, $ r O . e1 This 4. .1i • in Becomes Your Building Permit en Ap ved Paid Q 966 . .7). Receipt (.. ‘,..2-01) Date By , �� (O (7 (( w - •. • 7 dal Date This is to cw / . that e requestin the above application and accompanying docum is is ' accordance with the City Zoning Ordinance and may proceed as requested. This document when sign • • th ( ity Planner constitutes a temporary Certificate of Zoning com ance d allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. Illi � ; to C? I I ,,, g .1* Date ' Special Conditions, if any 24 hour notice for alt inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 4144 !(‘14 ok.,316 # 11 1.111.,40. ch„ 7 11, t 7,7,A * 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 7- 1 q- / Z, PROPERTY ADDRESS: 14356 PARKSIDE COURT ACCEPTED BY APPROVING AUTHORITIES: CITY OF WOODBURY ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS YES D NO EQUIPMENT USED IS APPROVED YES DNO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS [OYES DNO 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: EYES DNO 1. SYSTEM COMPONENTS INSTRUCTIONS OYES DNO 2. CARE AND MAINTENANCE INSTRUCTIONS YES DNO 3. NFPA25 YES DNO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2011 1/2 11 155 SPRINKLERS RELIABLE RES44HSW 2011 1/2 16 155 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 `15 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.0.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 DELECTRIC ❑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 MnnFI SIIPFRVISIf1N I OSS Al ARM OPFRATF VA VF RFI FASF OPFRATF Fl 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 NO 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 ONO DRAIN READING OF GAGE LOCATED NEAR WATER RESIDUAL PRESSURE WITH VALVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION POOPS! CONNECTION OPEN WIDE �7 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 ❑NO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING A YES ONO IF POWDER DRIVEN FASTENERS ARE USED IN EYES ONO IF NO, EXPLAIN CONCRETE, HAS REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS 0 WELDED PIPING OYES ENO IF VFS DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3? EYES 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? YES ONO CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS (DISCS) ARE RETRIEVED? CS YES ONO HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA EYES ONO NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: -15--/ Z NAME OF SPRINKLER CONTRACTOR: FIRE SUPPRESSION SERVICES, LLC T WITNESSED BY O ` / TYO ) T ITLE DATE SIGNATURES / � U1'(` I 'j' �n� S �KL" NT CTOR SIGNED) TIT E DATE \Jt}v r / 9 -/ Z- ADDITIONAL EXPLANATION (0J P R I R LAKE DEPARTMENT OF BUILDING AND INSPECTION See ,, . ,, ' I ?i1 INSPECTION RECO SITE ADDRESS 2r�ScA� NATURE OF WORK 5 / . DS= NO N1 d V NO L..`. USE OF BUILDING S "OW PERMIT NO. //. / O DATE ISSUED CONTRACTOR MATTA my Nook PHONE 952. 198. 4128 NOTE: THIS IS NOT A PERMIT OR ANY OF THE INSPEtTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT y� - � �; /NS M LI. EZOcs7dA/ dOMZ1 . i Mi / AI INSPECT 7W 6 O��C. I 7 I FOOTING ¢ atfirri Dericr-7451 1 i 1 FOUNDATION (Prior to Backfill) 1 1 I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED gA 0o s s7 1 ve `7E 6 s Mene # ww ROUGH - INS _ SEWER / WATER / SEPTIC FRAMING kC. /_1 61/,//- INSULATION 6ve %, J/ 0 -- ELECTRICAL PLUMBING f2' q /// HEATING (if required) PA FIREPLACE GAS LINE ,,ppAI�I��RvvgyTESTT `` 4 °N CVVER NO WORK UNTIL ABOVS BL SIGNED gfEW 9P 5 P" k/ itt 6 R , . , r , • f I N A L S it IJ GRADING (Prior to Sodding) BUILDING iPj, 8 ((z ELECTRICAL tr PLUMBING eo f �/ HEATING r 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 (9521 447 -9850