HomeMy WebLinkAboutBuilding Permit #00-0008
";.(. ;j'/l'.o'
....~:>)f,:'r-l
ADDRESS
OCCUPANT
HEAT LOSS
SOL 0 BY
, .1}.. . HOUSE H EATING TEST RECORD
.. tJLfl.5" f;lUg-YjtLL APT. FLOOR
, ,'-IIOf)A t<- OWNER
') ., /\.rYATE HTG. INST.~'-oD
k H (j'<;JVL INSTALLED BY
Electrical Work By.
TYPE OF HEAT
GA
FA iX. HW
f{Ll Ovz.. L~i6:=:.
CITY
.SUBURB
_STEAM
") . l\ \f)
~ _ V.:iL.U~'-
UNIT HTR. OTHER
~
MAKE OF BURNER. /'H
Model /'
Max. BTU Rating ,/
MAKE OF FURNo/'"
Model (
Gas Line By
_ SPACE HTR. .
()~ GAS DESIGN
MAK E t'-.
Model ~ lnneA~e.e
Serial Z t= -+4Cf1912JJj z ~fd,
INPUT ! q oeo
CONTROLS
THERMOS.T." T I~. ~.Ug 08
Valve H~""'" 1
....I~I PIt.
Limit ~V' AX_
Limi. So.i.. '~" 'J f) y . '
Fan Setting _ ~
Pilot Type, t:!l.! .:..~_~I(:
Pilat Make _ \ ~
Pilat Model
"'1, ,'1t-f' ~
Pilot Timing , _, .
L. W. Cut Off '
.~I\,U V
Pressure '1\; <1 Percent CO2
Input CFH 1001 r1'T? tiC-Percent O2
Stack Temp. ~ 1.. -" Percent CO
Form 235
tf"
KIND OF LINER . . 6 Tb e...--K- SIZF.. .tjpNF
Draft Hood '"f~ . . RegulaTor ,VlAu T1lbL
Fi Iters Size.l1.(p.'l ZffiN~er J
Chimney Location Insi.de, Llr . ~ l'ut~ide
Chimney Construction ~ ,~
.,
Vent Size
Smoke Bomb _ Wiring \(
Draft. Test Tag. ~X
... . Door Pressure . Lighting Insfl J:
~ ",1 Date Tested . lt~ It ~OO.1 1/
~ompany Testing (L{r.~. ~'7- tAi....Jj
~ Name of Tester, 7 ~
Form # 5
PHONE NO.
DATE
~
/If-Ici5' !/;;"jJ,d ~I
CONTR. ~~-~~
ClJ-
TIME
.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PERMIT NO.
EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o FOOTING
o FOUND ON
OF G
o ULA TION
FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
CJMMENTS:
fJv-Mt>.x is
cY~
I .,/
~~
.."
./
/'
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT,"" CA7~CTION .E~ORE COVERI':
Inspector:, ~M~- ,'OUIIII.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ?/JeIOO z,!a-D
ADDRESS I ~z5" /3'-IJ a/ ,eL) VJ:;2...
OWNER
CONTR.
,
t1 0 "'Oo() ct
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
$ATER HOOKUP
EWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~tjo
/'' / _ b
/tJrll' /1
QA-i ~ 1Z' 5
.'t~5 M- '
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~~~
~rf ~ ~.kr..L
.
~'\ .~ ."", -. ~/'~ ~~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
//fvA-
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNOTl
~ TIME
CITY OF PRIOR LAKE JI:~
INSPECTION NOTICE SCHEDULED
ADDRESS , 4425 ~L.'y~
OWNER CONTR.
PHONE NO. PERMIT NO. ()---OtY
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION ~ ~EWERHOOKUP o FIREPLACE FINAL
o FINAL PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: A
~~ O~
- ,~()/
fiJ t rlv1) r tur
Q bctir % r +r 1 NLI><
(iJ A.j-]11/ h.'Ji/ ~/ ,in. /~snr ~
Inspector:
INSNOTI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 7/z..'f;,/()(J .LJ :~O
ADDRESS /~4 25' 3Lu.c:6/~f)
COMM~NTS:(i) ~ ~~ ~ ~ .
~:::~:~~.~
~~~~~~~
@) '::f-UuL ~ ~ ~ ' Q...- ~
~ ~, r5J)-~~ '_ - ~&€ I~
A..b rt..o ~ .+( ~ -, -=., t..f " -4-f'()-(..L 6~ a; ~ ~ . r~
o..d ~ /-~ ~~ fJ~ f
~lAL~ ~ ~ ~+ ~F'
_, q=- c.M.- ~t... ~ - Uf' ~
~ ~ ~~~~~f/~
@ ~/~ I.A-U ~ ~~.
@ (Qu..... .o:f;:id-(j
~ ~.fjL~
TGO, ~ ~ 9 /5a
o WORK SATISFACTORY, PROCE
'ft CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTIO
~
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
o INSULATION ~ 0 SEWERHOOKUP
)! FINAL '"BLJ" . &\ 0 PLUMBING FINAL
o SITE INSPECTlmI ~):lc:MECH FINAL
u/F ~
Inspector:
Owner/Contr:
t:J - 000 S'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COVERING
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
SCHEOUlED
DA1
~ t\ Q)
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
S'tr
ADDRESS l4\.f l5
~ 6.rB
111_
OWNER
CONTR.
PHONE NO.
PERMIT NO.
6",Oi"
o FOOTING
o FOUNDATION
o FRAMING
P )NSULATION
V" FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
.
deb ~ltJfuL
~ nit.
(ldy. " ~ r&-~
\n~' ~ iv :>w '\,u./
/
ROCEED
CEED
R REINSPECTION BEFORE COVERING
Inspector: I Owner/Contr:
CALl 447-9,1,0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD~IREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
CITY OF PRIOR LAKE
~ - 5 200[: BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
14425 Bluebird Trail N.E.
I 1.DATE
1/4/2000
t€/
3. LEGAL DESCRIPTION
LOT
2
PID 25-3lP2--0/7-0
BLOCK
2
ADDITION. Knob Hill 4th Addition
4. OWNER
(Address)
(Name)
(Tel. No.)
5. ARCHITECT
(Address)
(Name)
(Tel. No.)
(612) 424-4955
(Address) (Tel. No.)
Zealand Ave. N. r Brooklyn Park, MN 55445
Septic 0 Heating 0 Plumbing 0 Reroofing 0 Porch 0
Addition 0 Finish Attic 0 Residing 0 Finish Basement 0
Permit No.
1. White
2. Pink
3. Yellow
File
City
Applicant
00- O{)O~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
Multi Level
13. TYPE OF CONSTRUCTION
Single Family Dwelliltg
14. FLOOR AREA APPORTIONMENT USE
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN
o
6. BUILDER (Name)
Novak-Fleck, Inc., 8857
7. TYPE OF WORK Fireplace 0
New Construction ~ Alterations 0
Chimney 0 Misc.
R PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 1 O. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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
buil' official can r ke this permit for just cause. Furth..... M oJ. I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
. ~btJ J.I nf-.. 0001631 1/4/00
()Signature U - Ucense No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ESTIMATED VALUE
$158r880
17. COMPLETION DATE
Estimated 5/5/2000
Front
Back
Side
Side
MATERIAL FILED WITH APPUCATION
SOIL TESTS 0 ENERGY DATA 0
Amount Brought Forward .. .... .. . .. . .. .... $
Park Support Fee ......... .......... ........ $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee ..q.{~................ $
Pressure Reducer ... J1J................... $
Meter Horn ................................... $
Water Meter ................................. $
o Sewer & Water Connection Fee ........... $
o
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $ I? ~-O"'''?l-
Other ......................................... $
Total Due .............................. $-4-.825. U
Paid 7~.? I Recel,Pt. ~77] I
Date ~ () By 'A
This Is to certify. ttihat request in the above application and accompanying documents is in accordance w~h the City Zoning Ordinance and may proceed requested. This document when
Si~~ nrMlr~atemporaryCertm;2-~~PI~~~~~r~r~~eT~,,~~~Of_Occ~.:~~~Sued.
~""I ~ Cl Planner ~ --oate '-' -' spec;a1Co~any' "~H~
24 Hour notice for all inspections 447-42309:00 a.m. -10:00 a.m.
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING -----=:; F ()
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION I S"1f t'Ja"J_ 00
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A BEl H R M
OMslon1234
City:
Permit Fee ................................... $
'llaZ2~
7lD 8 - (.1:(,
l~ . r:::;o
Ic:>e.oo
100.6t>
15. s-o
4..0 . t:J '0
~rJV
I ~Ieckif
Deferred
Plan Checking Fee ......................... $
State Surcharge...................... ....... $
~&........p./!..~.Q.QQ.B... $
.. ~fU!...pP...~:..Q.QQ.~.. $
~.%...6.Q..:..O'O'.Q..~.. $
~:.......Q.....Q.Q.O'...... $
This ')?iff Becom~our Building Permit When Approved.
By (f/MJ(.p,,- - ~ Date .1::..J Z ~ 2e:oO
Certificate ~f ~pancy
Issued
PERCOLATION TESTS 0
SETS
COPIES
Rc.;O'C>{3
l t:J1!J . l!) n
I./,~ . 0lS
!:2S"."'D
1,?no.O(:)
"] tl Cl . l'9-0
;/- .r
/
("
:'" /
The eenler of Ihe Lake COUlllry
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
;. (
/j l"'"
l ,/'____
~. (:.. L.'
I ft::.~
/ t/()
f
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~/ ~+. J; -:;'.~ ~~:. .~:7 (,._w (~.
" ,L:'/' ,/i.. L:-,,'
/',/.,'/ / I CO'
Accepted
Accepted With Corrections
~
Denied
~.~
(/ -
Date:
I -Lq~t90
Reviewed By:
Comments:
~~~J. ~ ~ ~# ~~
~ L -I g) -GD pv~ 1D ~1M5t: r~~l~ .,
A J-j K-: ~~\MU~
hr~ ~~v
w~ w~ (>>t
(j'NL UvVVl ~ v:t ~ t3 - tJ ,
"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."
/ /, _, ('I ()' ('''! Cj
\....... (_.., _/ ..." C.J
Tht C"ltr 01 Ihr Lakr Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/Vf>V'JJ/::,- l-c"E-CK
/ // s /2 C'O Gl
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/44-25 l5LU6/31/2.D -772/JIL.--
Accepted
../
Accepted With Corrections
Denied
~
Reviewed By: jJ ,wrEl<..
,..
c:..UIlU....."'NN
Date:
. ,
111~/oo
Comments: DR,v{uJAv ""us. /'Jor 13E: ',..,STALt.!)\
u,,", t,..
7H~ ~Au(J)
S.OEwf\LIC.
,I:
I AI STtH..LEfi ..
.:s~ IAlF<'ttt.MtJ'T".Q,/'J.v-J rr-ff: REII~E:. ~.DE_
~
,
~
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. -
3. E:t<(}~ltJf<,.) f~....r-m.OL ~1lE.S
'1-. ~S.IOM CtuLT1tOL .fl.tw
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'-
SEE A'7'i"1tlHt'C€A1T:S: J. ntJA<... btAOE INs.l!E.-C'-fDN II\IFoftMA7iMI 2. t:AM:)"Jf, t=l.IlJN
'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."
-
00-0008
The Cenler of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
;VtJV/l~ - F{,&CK-
/ /5/2000
/ ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4425 8LU6B/R.D '/Td7/v
Accepted
Accepted With Corrections ~
Denied __
Reviewed Bl <YrE~
I. W QJ l o,Jh:tal~ ~~
Date: I - l a - :2000
Comments:
'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."
~
1. Blue File
2. Gold City
3. ~110~ ~PJlican(
PP No. OVUY
Phone:~Q- q?::6-1111
CITY OF PRIOR LAKE
4</(0, PLUMB.ING PERMIT
Applicant:!nO()').QSi)'f\ -:P\b.f C.Q:\'?,
Address: \Sl\l\\ h\:tJ(~ ..~Au.c;r~.Li<..A,
Signature~u,~, ~-'--"
Legal De~criPtion: Lot ~ Block 0<
Site Address:)4L\..:lC; ~~ h'l~\~ l Nt ~
Building Permit # 0 () - OOD B PID # 25-3(0 Z - () '7-- D
NOTE: This permit will not be processed without complete information.
Th. C.nt.r or th. Lak. Country
Quantity
~
)
ct.
L\
\
~
I
~
Sub Kfl~ I.J/1L 4-t~
FIXTURE UNITS
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Eje'ctor
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other dls~
Dishwasher
,
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
/
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$
$
$
$
$99.50
$39.50
~.
~ft:i
- '-ctt. b(f
.50
GRAND TOTAL $
r
I
This pennit is granted upon the
contractor. Shall]O 1'- I r ects with the ordinances
of the State Plumbi _ e am,ndme?ts thereof.
I 0 /1.:J..7 100 DATE
. ATTEST
Call for all :;S;ctions 24 hours in advance.
'----~
JAti \ 8 ?GOD
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
~~ ~d- ~b~.P O.J\..fu
GREE. . I'JLE
YELLOW . APPLICANT
GOLD. CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO.
NOTE:
Sewer and Water
contractors must
be registered
with the city.
~~
APPLICANT:\~~"~~' ~t~ PHONE:lo\~- q~~r1!1.L1
ADDRESS :\>>\ ~)~ u..v\u.j5:t/)~ ~\\ ~DATE: ,-. \ 4-().::) .
SIGNATURE :-:J)i-1'1/~fO/,Ja:J..l^ BLDG. PERMIT # () ()-()0013
~ITE A;DRESS:.\44':).~ '~,~A.Jnl!~\A".t.~ \~ tJfpID# Z5-=-~f#~- Q/7-,_.O.
FILL IN THE BLANKS i lJ),k<~"'. J~ ~ -'~'7_,~:;.
1. Estimated length of water service )~. feet\; JAN I 8 2000
2. Size of water service
inch(es) .
c
--.._,l.__/
3. Location of any couplings from structure
,_.feet.,
4. Type of sewer pipe. ABS
PVC
Cast Iron
5. Estimated length of sewer line
J~
feet.
6. Clean out (if required), located at
structure.
feet
from
::::=::::::::~===== ==:=::::::=::::~::::::)~~~::========
=============:l::===========-=========-=========~===~==========~
FEES: $ 35.00 Sewer and water line connection permit. 6~
$ .50 Surcharge 7~Pcj
$ 35.50 TOTAL
to
* Fee for either sewer or water individually is $20.00 plus .
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued. -
DATE PAID
AMOUNT PAID
RECEIPT #
REC'O BY
16200 Eagle Creek Av. S.E.. Prior Lake. Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. O()-()C(Yb
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
I/dc.ioo PID# ZF)-3f,,2- ()/7-()
I '
Site Address, jl/t.-/,;25 Nflf/YIJciUJw I ;<.,(
Lot 2._ Block. 2- Addition KA/o.t3 HI l.A_- 4-77-1
Owner's Name A.)-y b L ~(' Ie
Address 85:5? ?.PGk/1 (') ,.4/ A) ,&rI LA.I/YI Jf:1}-
. --~ -- /
Date
Heating Con~ractor
Address
~:SC^R HEA;:~~S Cl /~~:-;
2387 COMMERCIAL BLVD. NW
l\NUUV!:':R, MN 55304
7Fi4-400n
Telephone #
Furnace Make & Model !/? hp P /V1
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning kAe'p/'n;;2 ~ hY'/
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Model Size
IOn an fi" /'1.-4.
Conn. Load
Fuel ~i (;'7<::'" Flue Size
<; /(
Supply Openings
IS
q
Return Openings
Input /CX) c1.:O
Edr.
Output gL) ce:;()
Other Devices ;J ~;;fu;,\
-k, f:rpt'1!cr:v, ~ / OY:;,/) q01./'~
, - .. /
Clm.
TYPE OF WORK
Alterations
Repair
Replacement
New Construction
v
Est. Comp. Date
Est. Cost $. ,), ,~cu cD
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
()Q-QOO8
Building Permit #
rr' PAID WITH
.50 ,BUILDING PERMIT
.
Receipt #
TYPE OF STRUCTURE
I. rink
2. G..-.
3. Yellow
'-
Con..
/9~
Single Family
Commercial
Two-Family
Industrial
Multi-Family
Other
Public
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50 JAN 2 4 2000
$39.50
$39.50
.-.-",-"^",,"
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submiUed with hllildina oermit number before build-
ing certificate 01 occupancy will be issued.
l:iEAI .CALCULATIONS REQUIREQ with number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
I hereby apply for a mechanical systems permit and I acknowledge that the
inlormation above is complete and accurate; that the work will be In conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
C~;f; _ /Yh
~ Alf~
BUi~Offjcal'S Signature
I/:;C>/CU
I Date
J /z.(p /00
I Date
ern OF PRIORLAKE Me
'EZO Elgie CAek lit. S.E. Permit No. C7' ~g
PrIor 1.8101, NN!f372
HEAlll1G APPUCATlQ I PERMIT
~i 7-j~~Ou ~D' Qs-~ba-CI7-0
Sire MI,.IS I ~lJ jS" g'Lt, g ;/t 0
Lat ~ 8~ 61 Ad'.n K~ ~ \, 4'4-1) ~
. - -, .
Owntl'l Naml AkJJ~ k. F I eul
Add,..
Hill", Contractor (j1'tJc~;lI'f gJJ I~ ~lA f)/J' \J
Addres b 9). j ~"~.5~.
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Supply Cpenlngs
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HEATING PERMIT FEE I
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TPE OF SYSTEM
"'rm Air Plants
G1vity
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AICondilloning
Vlt. System
10M TlNG OR POWER PWfI'
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Hl Water
A31iation
~cial Devices
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Blildlng Fermcl .
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PA\O W\TH
BUILDING pERM'T
STATE SURCHARGE ,
TOTAL FERMIT FEES I
AeODt ,
TYPE OF STRUCTURE
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Two. Femily
Industrial
Public
Fee Schedule
Industria~ Commercial & Multi.Family
Residential, Healing & AC
Residential, Heating Only
Residential, Gas Fireplace
Residenlial, Add~ions & Alterations
Residential, AC Only
1 % d job cost ($39.5Q minimum)
$99.50
$64.50
$39.50 .. \2 6
$39.50
$39.50
Remember to add the State Surcharge on t.e boUom If this application.
The pricE of your healing permit includes ore rough-in and one linal inspection.
Additional inspections will be billed at $35.00 each.
House Haating Test Record must be sub milled with ~"lrlll!'I(" "flI,~lJ "'''''~flI' before build-
Ing certili::ate of occupancy will be issued.
HFAT CJI,LCULATIONS RFf'1 IIRFn with nunber of sU:Jply and return openings listed per
room wit. CFM's per opening. New structul8s or additons send floor plan with supply
and relum locations shown. HEAT LOSS C.'lCULATIONS, PAYMENT AND
APPLlCJlTIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372
City Hall business hours are 8 a.m. . 4:30 pm.
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I hereby apply lor a mechanical systel'lS permit and I acknowledge that the rt
inlormation above is complete end eccurale; that tile work will be in conformance 61
with the ordinances and codes 01 Ihe clly and wittlthe state building/mechanical
codes; that this form does not become a permit until signed by the BUilDING
OFFICIAL; that the work will be in accordance \\ith the approved plan in the
case 01 all work which requires review and approval of plans.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447-9150
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PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 144;;(5 ~\\..)e.\oiid ~~d
NATURE OF WORK J.J~..,J (\Cf\A-~-h~
USE OF BUILDING SF D
PERMIT NO. ~ ... C76 ~ DATE ISSUED I - Cl. -::<oad
CONTRACTOR ~\J~ - Fl ~c1:. ~lA.,c...
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING I _ INSP~r I 2.-11 I;;
FOUNDATION (Prior 10 Backfill) I ((if ~ V}j I z/)r)"
PLACE NO CONCRETE UNTI4("' A BO"Ji' U/AS BEEN SIGNED
ROUGH - INS
:::~:~ WATER I SEPTIC lJ C . iB- \P' /.1 l,t1 !,-'.1;
INSULATION I J) :3h )Jl _ :J<9 In,,![r; ~
ELECTRICAL ...--- I r v '
PLUMBING Vis I U)) ll2~/ritJ
HEATING (if required) /.;31!P kl/afJ'rh i1'ML '5hJb.~
AREPLACE V ~
GAS LINE AIR TEST ~ ~hhn
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
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FINALS
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DEPARTMENT OF
BUILDING AND INSPECTION
GRADING (Prior to Sodding).
BUILDING T.t.o, 1iU ~ht;{", tf, 1/tf,/fiD
ELECTRICAL
PLUMBING
HEATING
DO NOT. OCCUPY UNTIL ABOVE HAS
NOTICE
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17 ! ~fl:, / I) fI
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BEEN SIGNED
This card must be posted near an electrical service cabinet prior to rO~lgh-jn .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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
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