Loading...
HomeMy WebLinkAboutBuilding Permit 13. 0162 �� � f ` •gam^, f�/ , ✓f 3\ :., :77 fi r Es . :t�' •.. -.ta' .. :/. • f Vrrrr t r ; $;;. ��* tir ' ;;;;°•: '�p� I "A'a �IV ,40 J.Yry rVln ;r..r.. : ..:c <•, s:,: �'v:•':- to : :g..r:••st4 r +:4 h L..S 1.4"6.4 •. . .: •. L.,. . :. .� .� � r r f � rA r :. f t.t4r J t / : rr11 l .IUr..A� .NN � N � rl r rV1' r n'A 1� , Nl N 0'+;.i {•'oryy •.•; , •c.rr L.:p•...i'f tA'.�.p .. OS{,, .. ... .T. ✓ : i fe4 i, \W4 PI2 W �`iN nr... r.. r1., , in ' r1�4 f Irr ➢ NV r1 1� . V y I Y ,� 111 , 1 111 II I ,p t : 1 , .), 41111 _.n . � �"� 1 1, 1 , y y 'r � nl�r� IUtnv; �Il�a I�r 1�, nl� Y. n �lr � Y' � r �� Y a � �� � 1 �Ir a !fi � � uu u,. 1- 044Yl 1 , O p∎ s i Ptt i uht t VVwl iiJVY h ., �YI iV 9 t" t � 1 tt fOtttn ■ L tt Y s ins Y ��, ( i ' ;a 11 �A ! I � i.. il' i : 11 1 ��s N 11 1 11 ; YI 1 1 1•r l i s , Errfifir ifi of ®trupaucg CITY OF PRIOR LAKE Priaarfittruf f uiI zug in prrfi.0 v. ❑ Final Permitted ❑ Conditional C.O. Expires, This Certificate issued 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: Use Classification S IN � . FNM I l Bldg. Permit No. 13-016? 1 Occupancy Type Type Construction Zoning District Legal Description B1, JFFFERS WATERFRONT L�' 1474 PARKSTDE COURT Owner of Building Site Address Contractor's Name & Address TTAM 1 HOMES ROBERT D, HUTCHINS City Planner t r � Date: `� ij ildln; Official / Date: +) 1 \1 CE •- POST IN CONSPICUOUS PL ..V1 n `. 'N pi � ",'YYlu9 NIhYS' IUY�-'AgY' Yin " 314144 .. .. i � o P ^ P P3 . P _ n 1 I lµni 0 4 .) (C _ ,„67,140,4'; Irnl Y ,llnnl, i ie,* t lnn+. des)), ' %A I 'a I�r� .... I ti .. ,;, 1 1 11 1 YYi 11 IYiIlY 111111,. �� � 1 . 111 1111111 H111Y A11 „ . 4 116. ANr InNI ; r 1111 4 . NrH � ...N +rNr Lj r.Nl Lr ., r ;� l � s � Toile' ( { 1 ,.,, lli f ( � 1 :.:111116 1111111; . 1111 n .!111 I I n Nr r ,. ,rl r16 e.Hn. IN.O: Nr.. NrN Lf 111 f ...r ♦f .:.. � � r..r �.� ••:r,�,„ y �) ,.. ,. (I 11 (I N ;,: Ni 11 ; Y Y n G , 1 l 11 . All 111 Y 11114 1 r. uVr INN:: 1Nrr6 e I ....1: � ...rl N .. �r +rn)) LE . �f r.rr V s ••rr A. rr.r L.. .... . lliill II ,. �N:. � 11111 � Alll 1 ;) 6 I .rr , NNf. oh'''. 1 a .:. 1 ..:.r� rr.N I �f ♦f rhr r..? .� rrr ... .. .« .... ... ..... v. o `t,....•o.•.• „�...cnv.., +'?c,., ..; i . r 1111 An 11- n111l �Illln.: 1 , A. N nN116 INN 1 6 : 1 ..IN •n.. N... : . r..+ yf rr.• J!! •.:. ... r..• ..�r . A•l. ... a....r rr o.. L: aeo:.. 4 ....:... :.......•:.:..:........._...... _ ,:.. 1n116. In n111Y � V !. NN .1NIIr. NN � N11� V� 111r IN ♦ r.IN � N . af :.. �♦ rr•• J � r «. rs ..A �.... <.6 ... ......:d o...... r... o..... d,...... >..,.:..•.:...::,.,...._....... _ _ _ .r..i?.1 . : IN1 . AN11Y. INq !1r I 1 r .Nrr -N1 r ��.�1 .rJ P'O..r Q�Nrr �.f : <J. .. - - = - r Ls - - - �4r •• 'rr... rr.. r..r♦s rrr. o::.•.;•'n }Ci{t�.'?, Z W Z Fes-. LL1 r�r - au. CC U o F- La -- z v W W J Z a Q � p�w - CC Z E„ o W U W 0000044C, Y u Y cz - ........i U W cc 0 0 N O U. W Y Z W z » a r ' Z c o p 04 F - re 0 o - , 0 0 w w Z tx Z � W c 0- — ' t q 0 o m s w� m = 1 a • Z N 4 J WR - _ +W "may / W W W ++ W k a �3tna� U U a 1 z D ❑ ❑ ❑ ❑ - ----�- 0 1 w a a LL (` ° J h I W -- 0 Z 0 o SF g ` z t/j ( ` � a r o► o 2 z p Z W F 1 q F- ►- , p O z p - ': a Z v) U U .1 ty z z W Y o Q A cc � � w w pz� 0 0 0 ° y pw w z � v�zi- 3 v U N iii ° 0 p p W Z LL co O Ui 0 0 x 0 ❑ ❑DD❑ 0 0 0 c 1 LU z 1 ( § � ui § �\ a \ § �wwk/ o . W % k o rt ce a z wO�LT- C C & 12 oo000lik > & \ o = 2 • o _ o m / S z p.a. § ® Z k 0 1- 2 § 0 o §/ a � I z(X Z o c 0 0 0 a 2 co x to 2 11- 2 a 8 2 2 2 §uw § § o c c - f _jw« _jw a ■ 3 m � ■ § w ® NO O =OCOO • $70 w $ N z a 0 \ ° w �� o k e p w k \ § z — 0 z§ 0 1§ a �■ & a Fig R 2 a 2 , w ,# cs � 2 Z /§ 2 J � k W � ce ct k} k � re LU Z Rgw2z� 2 �� ' k \ k 0 E B k 0 ��� 0 ! F..) « 0 000000 U . ! 0 * f O Q f- Z P- J d'tL� W H LLzW WQ z �L uJ (�r� UU Q gggZ > ("\ a a a D U' SWW V)_ _ Z Q -a to 0 W U Li ti ( F E` W O 000E3 C w \ N 0 w O a a Q m o z _ F_- ' 0 ti- 0 U W a ix X O 000:4S H 4; w t o _ Z ce Z_ S=ZZ 0 � 55 O y O 0 O W . m SWam2 a Z 0 �� 0 z H O J W Q J W 0 W W W W Ilk a�3v)a� U 0 z a a LL r Z a ce Q Q 0 c o y Y V Z O Q 0 - r4 Z O Z U N U n OI 0 O W 1- Q < 4 Z ONO- a z \ v ) U J W W La u. o 0 i z ~z 2 � aw W c4 W ° Q v �' U Ft.-3 o o oo�zLL p 3 0 w 6 ? Q 0 o 0 ❑D❑❑❑ V Xo❑ E. V , .., i- W Z — h- W W X .4 a LL ce V �` - Z UU a a � ' Z V c) CC pe Q z Q O ` W U GI' tL 0 W co C3 C3 C3 C3 DI C3 BE ot v I w O M cc z _� O LL N O a a J m w C 0 W 0 J 2 Y Y Z Z O 0 U 4 W O O O( < ` w N p '4 1 q� z 2 �1 a =vW1n0 I W w z X - c, w1 w W a2 z re Q Q O w W W O I U O a 0 ) • ' M o -_ L T -6 LL 0 Z p Z W -t ►- f-- , n IQ O_ Q il- � O U 2 � z~ ( W / Y z W a' J A � U w W o �� a w �' 1:4 0 0 0 V } 0 W W W 2 04N21- 2 3 0 U 0 .� p § x 00 W O ❑ ❑ c c.3? 4 0 a ❑❑❑❑15�❑ 0 " U J tu Z 1(1) .T J CG W ce U E Es. 6 oLLI U Q 0 44 2 _J55Z z aaaD O 0 ,a Ul 7^ 2 W W N < � W 0 u. u 0 Fc" Z Ems, W U o re O aa� \ Ca 6 O QC J Z _ Y Y Z \ z U H IQ \1 0 0 O • ,� 1- H tY 000:i ►- a0 W a c W ` z ce z_ S z z z W C U O r N .. o a m \ N 0 z ? WQj ? W V `, W W W X IX a2 \\ U cW W i ❑ ❑❑❑D V 0 0 W W H \ )' N, Z J o w Z o a ' u. tx� a Y 0 0 \ Q \ O \ 2 Z J0 \ o U O rn a p Z O O w Fes- Q f 3 \ a = z a Z a W w w w �V w CC W 0 < '� 1 ce re cc U • V a Li x o0 0 0 0 o a o o u. ? u z — � p ` , 3 0 0 a LLI U i Q O a ❑❑D ❑ ❑❑ V ❑ D 5. J o 1� W W U W �U w 22 .az (� c a WUtitiC9 LY z O Z E` w 1 0000E10 0 re 0 O w = ce 0 N O 0 w 03 Z D z ci YYZ Z U LL, O F_ 2 OoLLJ O_ U w 000a F" 6 w ' o w Z ce _IIZ ? w c v) 0 0 w m w z a. 3 ci) N 0 _ _ ,w w w W X 0 CL �3 w w w Ly ❑❑❑❑190 w t � rn Cl. LL 1 ts1 0 a a 0 wc� Y N r O • a 0 O J f- 0 m re O z ~ N D a 3 r- c:=4 0Z O z w f- p W �Z f� Q(9� N Z 0, U U -I W n. to Z z o ? g J z W Y W o - q wW a n: W O F- Z = 0 0 0 �i O V Fi n o o c) c) p 3 U U N UZ a o 1 0 000❑❑ U❑ ❑ c o' CITY OF PRIOR LAKE BUILDING PER\IIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 0...: AND UTILITY CONNECTION PERMIT 2, 25. 13 '`�w ES °�. Z See 1 VI ai n F ite File 2 Pink City PERtiIIT NO. 2 3. Yellow Applicant �� /ca (Please type or print and sign at bottom) ADDRESS (t-E -? Cf PAP YS t D C 0 ur2 --, ZOND G (office use) LEGAL. DESCRIPTION (office use only) n LOT ' BLOCK t ADDITION c_; G — V V/- s_r e-e ,...l i PID 2- 5 4 1$ O 2-5 O OWNER (Name) I A "T"' M -l•4 o Is—I >w.S (Phone) 1. - ?, g 0 - 2l b 6 (Address) 12a t t ti R S 41 t- Giza t o L. E S .STE- t ..D t t--..l H N SS L-!-3 9 BUILDER (Company Name) r'l,1/4-T A -l"ti' -4-0 t--t ES (Phone) 9S2 - 0 9j — 1.1 23 (Contact Name) S U F - (Phone) (Address) 120 t t" k S t4 lit C1701---1 f vE- S 5T 2 0 t - 1 NJ 1., H 1`1 SS4 �9 TYPE OF WORK $ New Construction goeck ❑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 H III P/ V A B Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ t 3 0 ( b C) C --) Division: 1 2 3 4 5 (excluding land) 1 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 forjust cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X�1......` --1 B .—• 2- 1 5354 21 221 13 Signature Contractor's License No. Date Permit Valuation � © � - Park Support Fee # $ Permit Fee $ ( 2 3 3.x, e) SAC # $ •Z , 3 5. — Plan Check Fee $ 8©l _ Water Meter Size 3i1:8 "; 1 "; $ 1-80r State Surcharge $ 65 _ Pressure Reducer $ (t 0 , Penalty $ Sewer /Water Connection Fee # $ t CCO , Plumbing Permit Fee $ G4. SD Water Tower Fee # $ ` 000 Mechanical Permit Fee $ `j 4.50 Builder's Deposit $ -1506.. _ Sewer &Water Permit Fee $ 5(..3.0 Other t (t F esS 1 D , \ ) $ (54. s Gas Fireplace Permit Fee $ C 4- So TOTAL DUE $'O . "') V �j This AA licatio . ec es Your Building Permit en pproved Paid 16 r Rec t NO. f!9 0s A la' 1 S (� Date l� By r - Building 0 Da e This is to d- '- that - request in the above application and accompanying do. men is in accordance with the City Zoning Ordinance and may proceed as requested. This document when si d by the ■ 'i P . er constitutes a temporary Certificate of Zoning ..mpli , ce 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 -4415 4646 Dakota Street S.E., Prior Lake, Minnesot 55372 , • " 61 I Contractor's Material & Test Certificate for Aboveground Piping PROCEDURE Upon completion of work, inspection and tests shall be made by the contractors 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 L f .. / 7_/ PROPERTY ADDRESS: 14374 PARKSIDE COURT "ASPEN" ACCEPTED BY APPROVING AUTHORITIES: CITY OF WOODBURY ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS OYES 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 OYES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS OYES ONO 3. NFPA 25 YES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2013 1/2 10 155 SPRINKLERS RELIABLE RES 44HSW 2013 1/2 13 155 RELIABLE F3QR 2013 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 ( 1 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 CI 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 ACCE:3SIBLE FACILITY IN EACH CIRCUIT IF NO, EXPLAIN PPEACTION FOR TESTING VALVES OYES ONO N/A - — DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO MAKE MOfFL J;11PFRVI.SION 1 (tSS Al ARM OPFRATF VAI VF RFI EASE OPFRATF FFl 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 4) 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 ivater 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 OPERA 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 TESTS TTEST SU SUPPLY TEST T (j(' PSI JATER RESIDUAL ECTON OPEN WIDE H S 41 f PSI TEST CONNECTION UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY CF THE U FORM NO. 858 OYES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING El YES ONO IF POWDER DRIVEN FASTENERS ARE USED IN EYES ONO IF NO, EXPLAIN CONCRETE, HAS REF'RESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? BLANK TESTING NUMBER USED — LOCATIONS I NUMBER REMOVED GASKETS 0 WELDED PIPING OYES ENO IF YFS DO YOU CERTIFY AS - - HE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE RI)CUIREMENTS 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? EYES ONO CUTOUTS DO YOU CERTIFY THAI YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS (DISCS) ARE: FETRIEVED? YES ONO HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA YES ❑ NO NAMEPLATE REMARKS DATE LEFT IN SERVICE: WITH ALL CONTROL VALVES OPEN: 9 / 7'1 NAME OF SPRINKLER CONTRACTOR: FIRE SUPPRESSION SERVICES. LLC. TE FTNESSED BY SIGNATURES TY r 1��SIGNED) TITLE DATE/ - 1 k c / r f/ (3 •: PRIN s TRACT IGNED) TITLE DATE ADDITIONAL EXPLANATION AND NOTES (9 CITY OF PRIOR LAKE BUILDING PERNIIT. Date Reed , /... ,. 7 TEMPORARY CERTIFICATE OF ZONING CONIPLIANCE AND UTILITY CONNECTION PERMIT 4111111.0 i 'VN E 5° I %yaw F;a8 1 PERMIT NO. til 1 ZONECG "" "c:se ADDRESS i . , ....., 11... • 1 ____----2 ' _______----------____ _______________._____--- LEGAL DESCRIPTION ---------__-..-------I ,-------- LEGAL DESCRIPON (office use ani-y) 1 . OWNER A I ' ' A E-D ! t• n , 1 NI 554-3cL___ --------- PFI—EGD155r--LVICI-rePte- ro 0 (Company Name).___r_ig-----3-L. '1,FPLZ.._.E....6.1k1-`4_1 5 -1g.i/C--(44-.1__-(--__. (Phone) ■ - "7 i - • , (Contact Name) (Phone) (Address) 1/0 _—_------------------. T-------------------- ----------F) - , - 7 — . , - 0 Flreplas:c '1 TYPE OF WORK 1 gtiew Construmon ,.._.e.-ccap_r1,..Perch ORc-ItocEng _,Re,51,3nt, I__,L0 Loc. l-irusti '0 Addition OAateratton q.,iniry Connect:on \ CODE:VI:LC. DI .B.C. Ds ripe of Constru 11 HI ction: I IN' V A B Occupancy Group: A B E F XI 1 M ID S U PR OTECT COST/VALUE Division: I 2_P (excludin: land) I hereby dernty that 1 have furnished 4nforrnattort on this sarian wh.ch is id te best aim) knouledie irde and comtcs I a;s0 certify Mat t arn me pialyes r e iv :heated eseht fee the 4 above-rnentioted pi-4 and Mai all co wl-vs-tax , u(411 (.4rmfortri to 44 eassung slate and local irks 4 r4 wil4 psoceed ,r accordance with submitted plans I are assare Mat the budding of54. t . mydke this permt f 1; 11 CalISC 1110411111,it ■ bereby aver that the day ofricial 07 a designee may entei woe the ruemrs to perform( needed inseibmorn al r X _ ... . ...A _____________ — 4 „_______s_ __________- - tracum's LICemt No --...-- --__—. Pc nii:i V aluaiwn Park Sqlport Fee rs $ , Perm:: Fee $ ..._—_--, SAC ra UIIIIIIIIIIIII -------.—, .., Plan Check Frc S Water Me S ic ize 5 'S" ----_—___: State Surcharge S Pressure Reducer , 5 Penalty —ti,---------i Sewer/Water Connevion Fee P. S —_-_-- Flumbmg Permtt Fee 1 S I Wale!. To ,... CI Fee 5 — ____ - __ — ,--__ — __ Mechantcal Perm; Fee $ Bulicler's Pepos;t S 122;101520111 ...._.--; ' ------1 Gibe; ---- $ Gas Fireplace Pernut Fee 1 $ ' TOTAL nut 5 ..... 1 , 1 A1 ,,c: ,n B/ Your BuildIng Permit When Approved /I F . , , Paid Lpate _ i Recel t No . • s ... TtiLs is fa alrrertia m,-ucs: n the atio appluilLon and ac com„nanyint, documents Is in sad:dance grisb Me City loreng 4.?rdinant:e and may proceed as requested Th..s ..t..iddrneni • uiseis signed by Mr -C4ro Planner annotates a trrflporar, Cc-rev:air .34 Zdss4rig rumplusnee and idisus rortsttudoon so cernatende for cccuparicy, a Crrff,cate cf Occup.r.ry must Ex asur‘i . — Special Condinont, am , 2.4 hour notice for all inspections (952) 447-985e, fir, (952) 447- 4isalo Dokots Street S.E„ Prior Lake, Nimnala)ta 55312 4 rRro CITY OF PRIOR LAKE Date Rec'd • •=` ` ~ ' HEATING /AIR CONDITIONING/FIREPLACE PERMIT 'fi z: cps i'i» PERMIT NO. /3 o /4a1 J Yclbw App4KV,l ! (Please type orprin[ and sign at bottom) ADDRESS ZONING (office use) LEGAL DESCRIPTION (ofiie• use only) PAID WITH LOT BLOCK ADDITION BUILDINA PERMIT OWNER , (Phone) (Name) C l/ (Address) -�, , APPLICANT (` (ii), ! + / �`^ (Phone) . 1. L` � ` I LD � (Name) 0 11 (Address) V fl `U �� +/ - (City) (zip Code) ( (Address) ` `./ (Contact Person) t \(t�' \.y t k?� ` (Phone) q 5ec - -- i10 -1-- - b APPLICANT SIGNATURE - 1 Ai Q n{A „ /it -/ DATE `� 1 APPLICANT PLEASE COMPLETE BELOW - [i CONSTRUCTION ❑ REPLACEMENT 0 ALTERATIONS FURNACE MAKE AND MODEL 0, CU \*”' O l IBS) ut i- DSC)- . FUEL 1C -1- FLUE SIZE RETURN OPENINGS INPUT 5 ,D ?) 6 OUTPUT? r 0 ' 0100 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. A 0 Mechanical Radiation Fireplaces with Box Additions or Air Conditioning ❑Special Devices Cantilevers to the Outside of Buildings Vent. System ❑Other Devices Require a Building Permit. FIREPLACE MAKE AND MODEL FEE SCHEDULE Industrial, Commercial & Multi - Family I% of job cost Residential, Gas Fireplace $49.50 549.50 minimum Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50 Residential, Heating Only (New Construction) $64.50 Residential, AC Only , ^ l Estimated Cost $ W °) 0 . Building Permit il The Minnesota Statutes t 32M1.I -8 "St:RCHAR(ili" has been changed I'm one HEATING PERMIT FEE s � year efleethe STATE SURCHARGE 5 . • V� JIIh 1, 2111n, until June 30, 2011. TOTAL PERMIT FEE $ 1 ` 1 ne minimum sarchnrge for a "fled fee" permit Is ‘5, beginning duh 1,1010 (Office Use Only) _ This Application Becomes Your Building Permit When Approved Paid Receipt No. PAIL WITH Date BIIILDIN PERMIT Building Official Da te 24 hour notice for all inspections (952) 447 -9850, fai (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 . RI Date Recd °- . -- . ~ , CITY OF PRIOR LAKE PLUMBING PERMIT 1~ z3k- jNNESO�t 1. Blue He PERMIT NO. /3 .. ._ --- 0 - 7, 3. Ydtmw Apptvnt (Please type or print and sign at bottom) ---- ADDRESS ZONING (otfiee use) PAID WITH . LEGAL DESCRIPTION (ofiiceuse only) BUILDING PERMIT LOT BLOCK ADDITION PID OWNER SP (Name) `�Y J (Phone) (Address) APPLICANT ,, CL , •-� -. l bi)Ll (Name), / �1 kn - k1 /1Gt�� (Phone) V' (Address) nV c\l\ \ 13 UJ , I )-(hr \ Nkh- �J53 (Addr s (City) (Zip Code) (Contact Person) \ / ` (.1fll - (, (Phone) q -- b" -1-- 1 APPLICANT SIGNATURE;. ,r r I "). A �_ DATE _ Diu' 1 . : APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture c:) Bath Tub with or without shower Rough -ins 1 Dishwasher 1 Water Heater 1 Floor Drain Water Softener 2 Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector 0 Shower Stall _ Backflow Assembly Sinks Backflow Assembly Test Bar Sink 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 S49.50 -- The !Minnesota Statutes *32613.148 .1St $ �J G - ` 0 • Building Permit # 9 - ) "SURCUUARCE" has been changed for one year effective PLUMBING PERMIT FEE $ �`► July 1, 2010, until June 30, 2011, STATE SURCHARGE $ S,. .130 • .5,0 The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ .'L is ,L, beginning July 1, 2010 { e p , This Application Becomes Your Building Perinit When Approved Paid PAILJ ye I (f1 • Date RUILDU G PERMIT 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 V/-1",P Date Rec'd CITY OF PRIOR LAKE 7 Z e)- 43 SEWER AND WATER PERMIT ,,,, jNNESe' /3— /670, / / I. G reen File PERMIT NO. / i C a . 2. Yellow City f 3. Gold Applicant / (Please type or print and sign at bottom) ZONING (office use) ADDRESS /4-376 - 76, pfd 4"l o & , LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) (Address) (City) (Zip Code) (Name) DS 1/ t �� '/ / (Phone) (Name) � ( � � `'' Phone (Address) (Address) (City) (Zip Code) 612- � � � � �� (Contact Person) 6 i � (Phone) (1 Al' ICANT SIGNATU_�. DATE Z ° ' /3 APPLICANT PLEASE COMPLETE BELOW Size of water service inches. Location of any couplings from structure feet. Type of sewer pipe. n ABC n PVC n Cast Iron Estimated length of sewer line feet. Clean out (if required) located at feet from structure. FEE SCHEDULE Residential sewer and water line connection $51.50 Industrial, Com'l & Multi - family 1% of job cost with a $51.50 minimum Sewer connection only $25.50 Water connection only $25.50 Estimated Cost $ Building Permit # SEWER AND WATER PERMIT FEE $ STATE SURCHARGE $ RAID WITH TOTAL PERMIT FEE $ BUILDING PERMIT (Office Use Only) 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 ---''''-s---- 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 et ---/ -7 _/j PROPERTY ADDRESS: 14376 PARKSIDE COURT "WILLOWBROOK" ACCEPTED BY APPROVING AUTHORITIES: CITY OF PRIOR LAKE ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS OYES ONO EQUIPMENT USED IS APPROVED ® 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: OYES 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 2013 1/2 11 155 SPRINKLERS RELIABLE RES 44HSW 2013 1/2 15 155 RELIABLE F3QR 2013 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 Cs s,;2 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 MDR .J t(PFRVISION 1 OSS Al ARM OPFRATF VAI VF RFI FASE OPFRATF FFI FASE YES NO YES NO MIN SEC HYDROSTATIC: Hyd iostatic 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 (102 bars) for two hours. Differential dry -pipe valve clappers shall be left open during test to prevent damage. Al 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 eater 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 OYES ONO N/A DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVE,TIVES OF SODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OF STOPPING LEAKS? YES ONO DRAIN READING CF GAGE LOCATED; NEAR WATER RESIDUAL PRESSURE WITH VALVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION Wiz_ PSI CONNECTION OPEN WIDE c S' 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 OYES 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 DYES NO IF YFS DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE R= QUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3? YES 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 THA T WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISC ARE RETRIEVED, THAT OPENINGS IN PIPING AF 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) ARI_RETRIEVED? ® YES ❑NO HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA OYES ONO NAMEPLATE REMARKS DATE LEFT IN SERVICI_WITH ALL CONTROL VALVES OPEN: 9 _j 7 -/ 3 NAME OF SPRINKLER _ ONTRACTOR: FIRE SUPPRESSION SERVICES, LLC. / TEST WITNESSED BY R Pitt ■ : •' •(SIGNED)TI jlE e l / 1;3 SIGNATURES ". �`�, -_ • - SP';, PI; N1RACTOR (SIGNED) TITLE DATE ADDITIONAL EXPLANATION AND NOTES 0 / Builders Deposit � City of Prior Lake — A $L50 - Boil 3ers Deposit's included in the Budding Permit fee. The Builders Deposit is issued as security to insure compliance for a Final Occupancy Permit. (It is not an escrow account.) All exterior items including but not limited to grading, sodding, landscaping, tree planting, driveways, siding and painting shall be completed 130 days after the date the building permit is issued. If the work is not complete within the 130 day time period, the City shall notify the applicant of the violation and the applicant shall have 10 days to comply or the $1,500.00 builders deposit will be forfeited and the applicant will be billed for dean up or corrective work to rectify the situation. A $500.00 Tree Deposit may also be required and will be refunded if specified trees are preserved for a period of one year. By signing I, the undersigned contractor, acknowledge that I am aware of the erosion control requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors handout. "� DATE: SITE ADDRESS: \-4-5-1. PIN-9-1=S PIN--S D E CO v PERMIT #4 / REFUND TO BE MAILED TO: M-Av ►Th --k-o S 12 - 0 1 GTo N Ac'/ - S S V l 1 t= Z O s E '4 9 AUTHORIZATION TO RELEASE PLEASE REMEMBER 42,500.400 ynda S. Al en, Building Services Amount 1. KEEP STREETS CLEAN DURING CONSTRUCTION /o , (1, i ? Acct. 801.20204 Date 2. KEEP EROSION CONTROL IN PLACE — 3. TEMPORARY OCCUPANCY PERafir - titter OR auu. WILL bb l- (11 C:1Documents and Settingslsbare\Local SettingslTemporary Internet Files \Content.Outlook1B080X19A \BUILDERS DEPOSIT FORM.DOC PRIOR LAKE DEPARTMENT UI DUNG AND INSPECTION INSPECTION RECORD SITE ADDRESS l'l 3'(4- 1 ix- C - . NATURE OF WORK ' E A (l..)c.. PEc -om- No > -c..1,* &te_, F( J _ L. L. USE OF BUILDING �(x - FAivl t - PERMIT NO. l' W (�Z DATE ISSUED \ 3/5 CONTRACTOR MA-rya rk 1 t4 o evi c---s PHONE G1.52. S . z(on NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMEN /� (T'' I o� b k l'4" /Asrolf -3 C : i O () ATE t NL � � t�-�'��..s INSPECTOR DATE I FOOTING 1 I I FOUNDATION (Prior to Backfill) I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED JDow QevAA-06-( _ . ROUGH - INS SEWER / WATER / SEPTIC FRAMING t x.56 ww /Q 7 . //°' INSULATION r''? ` ,a' AII _ ELECTRICAL IIWEIIMII- PLUMBING �c�.. HEATING (if required) j FIREPLACE A GAS LINE AIR TEST t,.„ �`' ' COVER NO O RK UNTIL ABOVE HAS EEN SIGNED ' I V- - - tc4E t_q-11. 0,.L. 1 st T — 1 ' /,, TDA FIN ALS -GRADING (Prior to Sodding) BUILDING / -f, !! 'ELECTRICAL / PLUMBING 1 R-- 1 (. - 1 3 HEATING f � –� DO NOT OCCUPY UNTIL A O�IE HAS BEEN S GNED 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