HomeMy WebLinkAboutBuilding Permit #00-0010
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Q[trlificalt of (l3ccupanry
CITY OF PRIOR LAKE
mtpartmtnt of ~uilbing Jn~ptttion
~inal Permitted 0 Conditional C. O. Expires
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:
Use Classification.
SINGLE FAMILY
Bldg. Permit No, 00-0010
N I A Zoning District R 2 S D
Legal Description
R3 Type Construction VN Fire Zone
W 1/2 LOT 3, BLOCK I, GLYNWATER
Occupancy Type
Owner of Building
Site Address
3483 BAY KNOLLS DRIVE
Contractor'sName&AddressWENSTvf.ANN HOMES, 1895 PLAZA DR.. EAGAN MN 55122
ROB~RT D. HUTCHINS
City Planner
Date:
JENNI TOVAR
Date:
3 ... 5'" -D a.
:1-1E 3 DaLl ~V10 \ \6
\
CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o JNSULA TION
-Pc'" ;r FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~) tJ\<
i~Ue-CfI.O(
r _ ,oS e, +\' e..-
DATE TIME
C>o -OOt 0
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, ~ALL FOR REINSPECTION BEFORE COVERlNG
Inspector: b ;\)lLtAf Owner/Contr:
CALL 447-9850 FOR n E NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
3'tGJ ~
CONTR.
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
COMMENTS:
(,~--df-
Cv(~ ~~-
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
/2.-/.-(/1
Dr.
tAl tllS/11 ~1ff'I
-CX?-/()
;s(EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
XWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector~'!!" . __
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
lNSJVOTl
~ CITY OF PRIOR LAKE
/ / 7 / z. 000 BUILDING PERMIT,
I 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
.37'4>3 /JP. y h- N(J/I...r ,b r
3. LEGAL DESCRIPTION '
LOT LJ 1/..2. 1. (); J
BLOCK
/
PID ;zr- JSO .- 0 03 - J
ADDITION
4. OWNER
(Name)
(Address)
5. ARCHITECT
(Address)
(Name)
1. DATE
J- 7-o:lotJ a
I<ZSD
(Tel. No.)
(Tel. No.)
(Address) (Tel. No.)
li"S- f'/&i,2t4. Dr
'.51- 4!lJ (, - YYD ~1
t' ~rt:!'^' J11/V S51;).2. GF1JeI/ ~9- 7(,/2-
Weptic 0 Deck 0 Re-roofing 0 . Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
6. BUILDER (Name)
W~/VJmqNN
)..J tJ /n t" J'
7. TYPE OF WORK Fireplace 0
New Construction d--' Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
Depth
Yes
Width
No
1. White File
2. Pink City
3. Yellow Applicant
HA/N FI'-~
Permit No. ()C) - 00 I 0
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
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 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 offi~ can revoke this pymit forj/st cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertorm needed inspections.
X ../.J ~ .rf ~"" / YfR /-7- -lot) cl
/ / / Signature license No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Side
Back
BUILDING DEPARTMENT VALUATION
Side
USE OF BUILDING
SEa
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION A4f"lr"r) .Or\
Water Tap ................................... $
Builder's Deposit ............................ $ /1 5()O. DO
I 0-
Other .........;,;I;...........Sq.......if:l.. $ -
Total Duer:..4Z.........~.O'~.. $ ~
Paid '7~S'"1/. () 3 ReceiP~@.T3t;. 77 'Z..
Date I r- / ()O By )' JIV
This is to certify th t the request in the above application and accompanying documents is in accordance with the City zonin6 Ordin/nce and may proceed /(requested. This document when
s' the' lanner constitutes a temporary C~~ficaittzoning complian~d allows ~~s.o~mence. efore occupa~c ,a Certif~ of Occupancy must be issued.
J,A;, ~ ,- /-M _ Y.A" _ f' or- ~l:M.c:: ~
tty Planner Dale Spec,al Conditions any v
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
~B.50
'-l!lj . ~
40.50
Plan Check Fee ............................. $.
State Surcharge............................. $
Penalty ....................................... $.
Plumbing Permit Fee ()a:.{)OJ.O... $ / t>t? . dO
Mechanical Permit FeJJ.D.:JlO./.o.. $ /on. OGL
Sewer & Water Permit (X):..COI.D.... $. JS . <<iO-
Gas Fireplace ermit rx:t...OQtf).. $ q 0 . 00
t.io1f;,_e.s Y r Building Permit When Approved.
- Date ! -11- 2DC>O
, ...,
Certificate of Occupan
~
Issued
Amount Brought Forward .................. $
Pari< Support Fee ........................... $
SAC ......................................... $ I
Collective Street Fee .. .. .. .. .... .... .. ..... $
Sewer Tap ................................... $
I' $
Pressure Reducer ..../..................... $
Meter Hom ................. ..n.............. $
Water Meter .............1................... $
Sewer & Water Connection Fee ........... $-.1
Water Tower Fee ........................... $
24 hour notice for all inspections 447-9850
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA
o
PILING LOGS CJ PERCOLATION TESTS 0
PLANS & SPECS CJ
SURVEY 0
SETS
COPIES
PLOT PLAN
o
~so. ~6
/ 00 . CLD
70.00
:z .e;Q .00
? ~l:) .01
/l:?O ~~
~
'" f /" ,/ -' I ~
I I -- i J( I ( /
1.....,,,.. \".," 1...../ ....' t \"'.~
The Crnlrr or the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
"",) L"i/ '"
~",,,_-",I t "'-,..,..'
,,-,
.....-. ,"--,,'
!i ' _ (.........;
.L.- t:._ .
Accepted
V'
Accepted With Corrections
Denied ~~ J J1
Reviewed By: ~~ Date: L-IL/-t90
Comments: ~~ ~&.-V.1 \~~ 19r.J.:::f9t0l <:J ! ~ l ! L L, 1 ,5
/~~ ? 'bJ ,"(;l T:; ~ ~t'1iloYt~ 0{
~ ~~~~~11 ~
~ ~ (9-kju.lI\~ I~'\
Ar~} SWctvv~ ~k~
~uJ< ~~~V~'J
V'.... V ~
"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."
/'
n. C.ntor 0' rho Lokr Counlry
or) - O{)/ 0
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-:::?LiO-.--:::?
,~ I CA...J
NAME OF APPLICANT
APPLICATION RECEIVED
,l / r-- , !,,- ., .." I
Ii II t:; Iv.~ IV /rl IV IV
/ / / / {)O
/ I
.f3;L7 Y
KI\/OLL5
De,
Accepted
../
Accepted With Corrections
Denied
Reviewed By: W.:1t.lZtt E..;R.E.5MA.~1V
Date:
. ,
1I/~/u
. I
Comments: ~ I NFt)ItM4.,oA.l t':)N -mE.
1<~ ~,J:Jf'
...sEE .4rTAe'ir"tE:zJ'TS: I. hAJ~,- ~f: INSPE.CT/ntJ /AJFD(f.rtfllr~N Z, ~r. Ptdl6L
'S. Efl.oSIQ.A.\ ('~.v~"l.. f'11~s
* ~~~ ~~L RA~
"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."
OQ-OO/O
Th~ C~nfer of th.e L.kfe Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
WE3tJS fV//1NN
I / / / ()O
/ '
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
34M
:EA V j::?V ~ l- t-S
/
De.
Accepted
Accepted With Corrections
Denied
Reviewed By: (r.?iJ~
Comments:
Date: / - /3 ~ 2~
{<rod.. a\ l c..1+o.~& H-o-oQ~
"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."
JAN. 27. 2000 3:53PM
GENZ RYAN 6513226147
NO.313
P.5/5
1.
2.
:3 .
.- 4.
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..- 5.
6.
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YIU.DW . oVIUCAII'I'
GaLD . c:n'.
NO. 00 - ODIC)
JAN 3 I 2000
CITY OF PRIOR LAKE
S~~~~ AND VATER ~~~~IT
NOTE: Sewer and Wat.er
contractors must
be reqistered
wi th the city.
APPLICANT: (-tJJ()Z--'~ PHONE:1.rc::.I-U.7~' ll!::f4
ADDRESS: ,IUr<'1\..J.C" ~Y~TfZ..L. ~I DATE: liz, a::D
SIGNATtlllE:.1( ~.co.. ,BLDG. ~T tOO-DOlO
SITE ADDRESS: (.~U~?) ~1I~ OtLPID# 2..f5'35f) - 003 -I
FILL IN THE BLANKS
LJ,......,'
Estimated length of water service -~
I ' I
Size of water service inch(es).
feet.
Location of any couplings from s~ruc~ure
Type of Sewer pipe. ABS PVC X Cast Iron
Estimated lenqt.h of sewer lin~ 40 f feet.
Clean out (if r~quired), located at
structure.
feet.
feet
from
This
pend t wnen appro~t. J ! .
O~TE:. '13 Lf() 0
BY
=;---===~ - --=---
______-==-c____~s~===_
v
FE~S:
$
$
~
Sewer and water line connection permit.
surc::harqe
TOTAL
35.00
.50
35.50
* Fee for either sewer or water individually is ~20.00 plUS
$ .50 surcharqe.
* Sewer and water permits issued for new construction ~ust be
recorded on the buildin~ permit card at the time of issuance
to insure that no dup11cate sewer and water permits are
issued.
DATE PAID
'Jp"t'H ,""
f'p..\U G p€.\~\\jh \
( .\\ n\N
,\:)V
AMOUNT PAID
RECEIPT #
REC'O BY
. 4629 Dakota St. S.E.. Prior Lake, Minnesota 55372 I Ph. (612) 4474230 I Fax (612) 4474245
AN EQUAL OPPORTUNf"N EMPI.J:MR .
CITY OF PRIOR LAKE
PLUMBING PERM"
Applicant ~- ~
~ress:J~~ ~ ru.
Signature: _''''''_ ;0
Legal Description: La Block Sub.
Site Address: ~g ~ f:t:'r"1 ~,~ ' iJf?
Building Permit # _ (10,- ooro 'PIO # 25 -350 - 003 - L
NOTE: This permit ~1II not be prccessec:l without complete information.
FIXTURE UNITS
MAR. 14.2000 4:31PM
GENZ RYAN 6513226147
n. C...tll' .r 1_ 1I~. C.lIl''''
- .
Quantity Type of Fixture
2.- Bath Tub with or without shower
I Diahwasher
, Floor DJ'ain
--~ Lavatory (bathroom sink)
~ Laundry Tray (1 or 2 compartment sink)
, Shower Stall
, Sinks
"" - Bar Sink
, , 2.- Water Closet (toilet)
Quantity
,
l./I
J
FEE SCHEDULE
Indu$trial, Commercial & Multi-Family
(1ey.. of job cost. $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
GRANO TOTAL.
NO. 775
P. 16/21
I. Blue FIlII
2. Gold Cic7
3. YIIU;. Applil:.ul
# 1){]-on/(L
Phone: lr;5;/-L/Z3-tIQt:/
I!!nc:..~, .~., ~
Type of FIXture
Aough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
BaclCflow Assembly (RP2, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkfer
Other
$
$
S
$
.50
/'
$....
\ ' ;-1
~
t
This pernUl is .snmed upon the express condition (bat said
contractor. shill comply in all....r~....s with the ordinances
of the Stare P1um~in d the an'l9Ddme}l[S thereof.
_ , 3//5/00 D,6.TE
~ '.' A'ITEST
Call for al spections 24 hours in acl'fance,
. ,
. .....
16200 Eagle CreekAv. S.E" Prior Lake. Minnesota 553721 Ph. (612) 447-4230/ FAX (6]2) 447-4245
An Equal OpponuniLy Employer .
- -
~, , ~
~~~ ~ 'CITY OF PRIOR LAKE' I.. J
a ~ 16200E8greCreekAv.S.E. Permit No. ()(J-OOIO
, Prior Lake, UN 55372 .
-H
N
~ HEAnNG APPUCATlON , PERMIT Single Family
lLDat.~ . PIDIt~- 3SV-0Q3-/ Commardal
'" -==3LJ~ ~ t:F)4 K:..nll I '- ~ lltz- '
STte Address
If)
l'-
C'-; tDt Block Add IIlon
o
z: Own.', Nam 8_~'
Address t&9 c;- P/Jt?-JI' 1M.- Sr.t'_.un W"J1lN Ki2"L
Healing Contractor ~"Z. -
Address\L\1Ll, ~,- 1:i'J-
Telephone t# lo$"l- L.L.LO - 'I U U
Furnace Make & Modll le.J1 VI oL TYPE OF SYSTEM
(J.., I Warm Air PI.mts ~
Model Slzl 2-~2. ~ 1, Gravity ,
MechanIcal
Alr Condllontng ~ 2- W)'J
Vent S~tlem
HEATING OR POWER PLANT
Sleam
Hal Walll
Radlatfon
SpedalDevlces
Conn.Load
~ Fuel f\J kr'. ~lul Size 4' \ PJ \I' XTf
~ Supply Openings, . ,~-
(TJ
-H
l2 Return OpenIngs _ ~
~ Input -.:l ~MD OutpullJ).,,, tj '"
r -
Il::: '
NEd!.
z:
~ Cfm.
OIller Devices
TYPE OF WORK
~
E
25 Ab.erat1onl
(TJ
"" Repair
IS) Est. Cost $
IS)
IS)
l\!HEATING PERMlTFEE$
""
-.; STATE SURCHARGE .
Il::: .
cr
ETOTAl PERMIT FEES S
Replacement New Construction
Eal. Comp. Oat. _
Bulldrng Pelm. "
() 0 - 00//
, .50
( PAID V,nTH
~.UI' nl"~"" I'>': '. '.:T
~ -::1..0' ,,,,U i ....... ....1
Recelpl ,
TYPE OF STRUCTUBE
I. Plu .~ '", FIle
1 an, :. ! aa,
3. Yell.. _/ c.a1rK1Or
)(
"
Two-Family
Industrial
Mullt-Famiy
Other
Public
F6e Schedule
Industrial, Commercial & Mulli-Famlly
Residential, Heating & AC
Residential, Heating Only,
Residential, Gas Rreplace
Resldenlial. AdrtilTons & Alterations
Reslden/lal. AC Only
1 % of lob coal ($39.60 minImum)
$99.60
$64.60
$39.60
139.60
139.50
Remember to add !he Slate Surcharge on Ihe bol1om 0' thfs application.
The,price of your /\eating permltlncludas one rough-In and ona final k1spectlon.
AdcliUonal inspections will be billed al 135.00 each.
House Heating Test Record must be submitted with m!Iding IIilDlIt number before build-
Ing cer1iJicale o' ocoopancy wiD be issued.
1:IfAL CALCULATIONS REOUIRED wflh nLlmber of 8UPPly and return op8fllngs listed PI'
room wllh CFM', per opening. New .rrucfuree 01 addftfons nnd IlOor pIan with suppfy
and relurn locallol\l 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.
Clly Han business hours are 8 a.m. . 4:30 p.rn,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447--4230
I hereby applv (or a mechanical systsms permll and. acknowledge that the
In'ormatlon above Is complele and accurale; that lhe work will b& In con'ormance
with the ordrnances and codu of Ibe city and with the slate buHdlnghnechanlcal
codes; that this 'orm does not become a permn untU slgnad bV Ihe BUILDING
OFFICIAL; thai the work will be In accordance wltll the approved plan 1n the
case of _" work which requires review and approvel of pJafls.
iA "II 11~ . . 3/1lfLm
~&i()O
~
Date
. ,
Site A~9SS
l'N~~ \J101~ ~ Block
b
Ownels Name
\ 9- A:nDN
Address
He~ingContractor ALLIED FIRESIDE dba FIAESIDE CORNf!~
55113
Ilddress, 2700 Ii. FAIRVIlW. ROSEVILLE. KN
Telephone' 651-633-2561
FIXEPLACE
~ Make & Model -iJa.r JJ (; w
$c.~DI
Model Sill!
Cor-n. load
Fuel ~~
TYPE OF SYSTEM
Warm AA Planls
Gravity
Mechanical
N Conditioning
Vent System
Flue Size
Sl.Ipply Openings
Relurn Openings
Input OVlpul .;l3~
HEA TING OR POWER PLANT
Sleam
Hot Water
Radiation
Special Devices
Edr.
elm,
AMerafons
Repair
Est. Cost S
KEA Tr.IG PERMIT FEE $
.50
Other Devices
TYPE OFWORK
Repfacemenl
New Construction
~
JlOO _ t'l)
C)/,'/d~
Esl Comp. Vate . . . r~ _ 6 (i \I ...n\ l<
ould.-.g Perm" _ f/t1j>;~
~\~
-
STATE SURCHARGE $
Reeeipl .
TOTAlPEAMITFEES $
TYPE OF STRUCTURE
en
lD
:J
I. "..k - file. r+
1. {m" - Chy tD
]. Velko. - COIlIIKl<Ir '<
Commercial
Two-Family
Industrial.
"
1-'.
-,
lD
en
1-"
a.
lD
()
o
-,
:J
lD
-,
MulU-Famity
Public . Other
Fee ScMdule
Industrial, C. ercial & Multi-Family
Residential, Heating & AC
Residential, Healing Only
Resldenlial, Gas Fireplace
Residential, Additions & Alterations
Residenlial, AC Only
1 % or job cost ($39.50 minimum)
199.50
164.50
$39.50 ViA V , ft 2000
$39.50 11.1 U
$39.50 ..__'_. _
Remember 10 add Ine Slale Surcharge on the boUom or Ihis application.
0>
U1
....
The price of your heating permit inctudes one rough-In and ooe rlnal Inspection.
Addilional t."'l' ..ctions win be biJed at S35.00 each.
0>
Co)
Co)
tIl
tIl
tIl
House Healing Test Aeccrd musl be submitled wilh IBilld!ng RalDIil DI.lIl1Ilm before build- !:
ing certificate of occupancy will bill issued.
HW CALCULATIONS BalU!BfD. wilh m. ,. 01 supply and return openings listed pe
room with CFM.s per opening. New stl\lctures or additions .end floor plan with S1AppIr
and relum locations shown, HEAl lOSS CAlCULATIONS. PAYMENT AND
APPLICATIONS MAY BE MAILED 10 THE CITY OF PRIOR lAKE, 18200 EAGlE
CREEK AVE. S.E. PRIOR LAKE. MN 55372.
City Hall busIness hours are 8 a.m. - .:30 p.Rl.
3:
ID
'<
I
....
o
,
o
o
.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINALJ - CALL CITY HALL
"41-4230
1 hereby apply 'or a mechanical systems permit and I acknowledge thai the
inlormation above is complete and accurate; thaI the work will be in conformance
Y/llh Ihe ordinances and codes of &he city and with the stale buildlnglmecORnlcal
codes; Lha1 this form does not become a permit until signed by the BUilDING
OFFICIAL: that the work will be in accordance with Ihe approved plan In Ihe
case or all work which requires review and appro\lal of plans.
A:.~~ .malo,
, . p1~. ' , Cal.
C%JYl, ~ (~'#ft~")
o -90lr1"Slf>1ll\lloi --- - - I ~
......
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Job Address 3l/10 f3:- /: /JA!/ (
Heating contract~~/,~
Name of Tester JI{. "l:. ~
Date 7 - f (., ~
. Percent O2 7
Percent co 0
Percent C02 ~
".~~6
Stack Temp. -4J' ~ ~
Combustion air is adequately supplied per
UMC Sec, 606
Input
"
PRIOR LAKE
.
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 'L~ ~\.\ k~ll So D,
NATURE OF WORK Ne\U ~)(+ ·
USE OF BUILDING ~F A .
PERMIT NO. OC, DO IODATE ISSUED
CONTRACTOR LJflV.~\Mo.\AV\. "~,~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING I (1);1:7:;; I
I FOUNDATION (Prior to BaCkfill)Q~A vVj) z(4J.(U0 I
PLACE NO CONCRETiAJNTIL WBOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTI~. (~ )-llkv
FRAMING ( Lrf8' ~ jJ?;--.Jh s/;q/tJ, 5/,?z;it!
INSULATION;l ~Ypi?f' / I
ELECTRICAL' ( . 1/ ",/ -
PLUMBING (jp, ~};/J/iiJ f;!:r/-'u
HEATING (if required) (/'1 - '0, t~1. Or;"
FIREPLACE \ Iq (Jf) 6 ) Y-~1J
GAS LINE AIR TEST C? .s--j:;)1z, . f11AIN-' j; p
COVER NO WORK UNTIL A'GVE"'HA'S BEEN SIGNED
I I
FINALS
N[5
~-U~
\
,... ---S~JJ1B
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
!1-
vc}-
OCCUpy UNTIL ABOVE 44AS
NOTICE
J - 13- 2000
DATE
I~ - 7'- 0 /
"3 ~5 ---OPt,
q -I ~ -'DO
Gl ,-,I ~ ~VV
BEEN SIGNED
This card must be posted near an electrical service cabinet prior to .rough-;,in inspections
and mS'intained 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