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HomeMy WebLinkAboutBuilding Permit 00-0833 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT ADDITION 14. OWNER (Nam.) (Addr.ss) (Tel. No.) 15. ARCHITECT (Name) (Address) (Tel. No.) 16. BUILDER (Name) (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS N::Jvak-F.laX, In::., f!857 Z63larl PM=. N., Bra:klyn Park, M'l 5:M5 763-424-4955 OCCUPANTS 7. TYPE OF WORK Fireplac8L1 SepticCl Heating 0 Plumbing 0 Reroofing 0 Porch 0 SEATS New Construction 0 Alterations 0 Addition 0 Finish AtticCJ Residing Cl Finish Basement 0 16. ESTIMATED VALUE Chimn.yCl Misc. $176,400. 18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE Sq. Ft. Width D.pth V.s No ESt. 11/2<XXl 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 1 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 ~~d~~d~ ~''ll/.~;celj~ ~~'9f her.by agr.. th.tth. dty OffiC;mr(";.~~j' upon the property to p.rIor n"7 inSr)ons ..-} , I -~ UcenseNo. te f OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMITVALUATION~ Water Tap ................................... $ Builder's D.posit ............................ $..1..; E'ar'l.~ Other ......................................... $ PaJd T?,D;7~.:~.~~~;.. $ ~:Jj;.4-h ~ A ! Oat. ~. 19--QV Bv _ This is to certify that the request in the above application and accompanying documents is In accordance with the City zonig Ordinance and may proceed requested, This document when ~nner constlutes. t.mporary Cenfficat. of ZOning oomphanoe"Jl'l<llklws constr 10/1 to comm.",e Before occupancy. a Certific:ete of Oooupancy must be issued. r ~d'--- -M'i/{)tO -s.... //!:,...-4./fI7'^,_~ ~ ~8rVner . Date -. SpeclalCci ltion' --.~ 24 Hour notice for all inspections 447-4230 9:00 a.m. . 10:00 a.m. 8~ ~CJ-W DIRECTIONS SPACES NUMBERED 1 THRU 17 MUST BE ALLED IN BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 12. SITE ADDRESS 14402 Raven Court N.E. 3. LEGAL DESCRIPTION LOT 22 Knob Hill BLOCK 1 5th Mdition I SETBACKS: Required Actual front PROPOSED GRADE FOUNDATION IN RELATION TO CURatoR CROWN OF STREET USE OF BUILDING 5FL:> Baok TYPE OF CONSTRUCTION: I II III IV V Occupancy Group A BEl H R M DMslon1234 P.rmitF..................................... $~,'2(' 7. 7~ Plan Checking F.. ......................... $ R 2. ~ ~./!)() I 60 ,t'Y1') 100 ,f!)f?) (In .~~ "?S"SO statesurcharge01,........................ $ ~.......f..!'"........................$ 9!1'ti!l8,~l~," .H~...................... $ -em.r e...f.'~.................. .......... $ ~__._._ ......<3~ ............ $ This .. - ., Approved, '7 'If - 'Zr:co By Oat. 1. White 2. Pink 3. Yellow File City Applicant Permit No. on.oPJ33 1. DATE 8/11/00 BUILDING INFORMATION 11. SIZE OF STRUCTURE (Height) (Width) If? I (Depth) PID 2.5 ..:~~e. 02.2.- 0 ~i~~rj+- ~~J~~hq~IO~,-* 14. FLOOR AREA APPORTioNMENT USE ~ FOR ADMINISTRATIVE USE tiiae MATERIAL FILED WITH APPUCATION SOIL TESTS Cl ENERGV DATA Cl PILING LOGS c:J PERCOLATION TESTS LI PLANS & SPECS LJ SETS ::lice SURVEV LI COPIES PLOT PLAN 0 City; I!t, Check n Cl Deferred Cl Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ LicenseCheckFee ......................... $ Pressure Reducer .......................... $ '('5;', 00 B5n.~ /..Jf')('"J,~ I l Meter Horn ................................... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $1r-? J'lf) _ t!)l!> WaterTowerFee ........................... $ 7tA::> .t!> t::!> / '2(; . 00 ~~ 00.0033 Thr {".ntn of Ih. L.k" Country White . Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED NOVA/C- FLECK- co-3D-OO The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /44-02- eA Vf3N c:T Accepted Accepted With Corrections '"'"-<-- 7L Date: ~ -/ ';:;bcJc:i> Comments: ~JQ~ - I-I-JI-'-J~ "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." '5~~ Th..('..nl<'roflh..l.ak..Country OO'O~33 White . Building Canary . Engineering Pink . Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED ,/l (I rJ K. [/ /~.. 'J/ I <.. '-- __,/<-- ~" - _-= C / The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: .////'/J,,/ ,., -'f . ____ /'...llvt.,-.J ......'. f Accepted Accepted With Corrections v Denied Reviewed By: ~A~ ~~ Comments: ~ /..0 <iP <;"il&.Q ?wU'/1 .fhI:#-O ~ {J..-uv ~J ~ t.A fV/~~ ;; ~3 F'" \fvy~ 'A. ~.t...&,- ru\~ ~ L '-<_/P9TI'~. .A1-iYr~ '. 4/L~9~~ ~~~ ~ \?.v\UlV\'(~ T~B./1~ 'S~ ~/1 5D~. Date: q Ilt{/ &:> "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." While - Building Canary - Engineering Pink - Planning Thr Crnlrr of lhr lIkr Country BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED ,A (; 1//7 t::- o_ ? 0 U .......:.- - F(...EC/C_ 00 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 144()L K/ll/E;0 CT Accepted ./ Accepted With Corrections Denied Reviewed By: Comments: -'s'PA -If" rpl/"at!:. (}''dIi ~,.;"lJh .<) ;;Ie Date: ~~k /.u/o{~"/7<</ ~n1I"hd/1_ ~ ., ~p alkt1k1Mk: I. 1'iq,,1 ~n~ MJHt'A;,,, --t(/JrPJ"h~,. .2 44/k .3 b-As//Jn (kh/ ~S'I/'#'f" /f ,L:n5kHf ~d/ d~ "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 i I.... I~ I , ! , I I i , , I 1.- 2. 0.- 3. llIlIo. Rio a.." Conlt1lelot CITY OF PRIOR LAKE 16200 Elgie Crull Av. S.E. Permit No. Prllll'L.... MN 55372 0- 133 TYPE OF STRUCT~ '{ Single Family Commercial HEAl1NO APPUCATION I PERMIT O8Ie x:b;;;. J t"",C\ PIO. 2~'" 7J/.oc;." D (J-'J-- b SReAcfdrelS JL1LfO;:1 f(.Gr -r?11 LCxH+ ~E Lo! ~ Block --1- Add_Ion \C., (\j-<h I-\-) II S-'H'\ r1 & &;vv OVlnefsName A' /-t.:o): - c~k Addle.. ~ ?t?r-/cnd.4" lWo-Family Industrial MuIII-Famlly _ Olher Pulllic Fee Scheelule I nduslrlel. Commercial & Mufti-Family Residential, Healing & AC Resldentlel, Hellllng Only Residenllal. Gas Fireplace Residential. AddilJons & AlIrallolls Resldentlel, AC Only t% 01 job cosl ($39_5Cl minimum) $99.50 ~/ @ @ 1J3!l/\ \i '. .~ '1,1" 50 \\ \\\, 1\:. ~ 1t - III)!\ 1\11 ~\/ '.!I AemBmber 10 add !he Slale Sure"."'" on the b I 'on. .. .,... ',' \.>- ..-------- ,~ ------- The price 01 your healing pennlt Includes ona IOUgn-fn end ona flnallnspeclion. Addlllonallnspeclione will be billed.. $3&.00 eacIl. Houae HealWlg Teal Record musf be Sllbmltfed with Jwillaag llmDiIlllIlIlIlI.r beloll! build- Ing cer6c818 of ocoupancy win be lasueel. I:IJ;AI CALCULATIONS REQUIRED wiIh number 01 aupply and relum operings lisled per room wilh CFM'a per opening. New slruclures Dr addilJons send floor plan wllh supply and relurn locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND APPLICATIONS MAY BE MAILEO TO THE CITY OF PRIOR lAKE, 162Cl(i EAGLE CAEEK AVE. S.E. PAIOR LAKE, MN 55372. -/). /3,rrr\I::.~{J .far): R(CCAR HEATINr. R. Alp 2387 COMMERCIAL BLVD. NW Helling Contr_r Addre.. ~ '~.r-.........._ , .. ..-'-....,vcn,--JVT1" JJJU'"t TellJlho'" , Furn_ Melee I Model tRheeYrl ModeISJa Q::':;crz.::, FiLl cn~Ji.... 754-4000 01: o .... g: ... o TYPE OF BYSTEM Warm Ai.Plarlta Gravity Mechanical Air ComIalonlng t;he:E/Y> Vent. ~...... HEA1INGl OR POWER PLANT Sleam Hot Wate, Radietlon . Special D',ylc.. Com. Lolld FII8I Ahf-!:!c" .Flue Size . 2; II Supp~ Openings I."") S? i:: .... u Return Openings ,"pill c;o (X;O Output 'FN. CJcX) '" .. .. .. ... .. .. .. .... .. CIIy Hal business houra ara e lI.m . 4:30 p.m. Other De~lc.. t}" Fv Ar~,~. ALL WORK MUST BE INSPECTED (ROUOIf-IN AND FINAL) - CALL CITY HALL 1./.l/i/YCr ('cn~,faHk). i. 51 0b1o"~ ) 447-42l1O TYPE OF WORK Edr. elm. ~ I hereby apply lor a mechanical syslems permll and I acknowledge lhat Ihe Inlol " . above ia oomplele and aocurale; thatlhe wo.k will be In oonformance wilt> the o.dlnancas and oodes ..I tho cily and with the alale building/mechanic. codes; Ihatlhia form does not become a permil until algnad by tile BUILDING OFFICIAL; lhallha work wi' b. In accordance wllh the approved plan In the caae 01 all work which requl.as review and approval of plans. (J11~ qd:hnraM:;~ ,; ~g Ollie81's Slgnll1ure Ahrallon. Repair Est. Coil' Hl:ATING PEAMIT FEE $ STATE SURCHARGE , TOTAL PEFlMlT FEES S x Aeplacement New ConnucIlon '" .. e.l. Comp. OllIe IMdinll Perrni . , .. '" .... ~ PAID WITH BUILDING PERMIT , c--\Jrpd ;;:/;)~b .. Dole t! v 8-/ - ot> Oale .. '" "- .. .. "- '" c> .50 Aeceipt. I (},W/.J ~+A.; 111 F,'ftc- plAtt" .. , .. ii. CITY OF PRIOR LAKE lIZDD Eallll er.k At. S.E Permil No. Prior Lau, a.w 5!D72 ()~713 III ~ ~ lU .. III 8 I- Auasaa SupplJep.nna. . "-IumOpMll",. , ......:l',.,.... .OIllpUl Edr. elm, "5 rJ'l.t TlPEOf........M Wwm ArPI..1s , GlIlvity MlChlllill AllCa "I,., V.nl. ~am HQWCOR,OWERPUUff .SlIlm Ho: w... Rldlaler Sp.dll Caval OIIa, DlIas Ahrallanl , Ra,,_manl "Pi OF WORK Hili ::Onllluc:llan / a: iil~'" lal Camp. D.a .. -ilj-- -- -. E& QIII' ..-----.-- -.--:-Bulldlllf-Parmll.--..- = I HEA11NG PEIMITfEE 1- /. ~ /' STATE SURCHAR3E I / .50 , TOTAL PEM FI~ A.cllp!'_ .--.~-..,- PAID Willi BUILDING PERMIT 1VPE OEJiJRUC~ Singla Family Cll~al _ lWo-Flmlly Induslrlal Fel Schaclula Industrial, Commln:ial & MulU-Famfty RealdenUal, Haeting a IIC Raldlnall, Haaling Only Aeslden"I, GIS Fireplace AntlllnO". Addillons & AllsraUons Relldandal, AC Only I. PI.\ Filo 1. GUll ai' 1. Yell_ CaIIr.'. z o c , ru I ru IS) IS) IS) . Mulli.FlIl1lly , . P"'lic. Olhw /)(1/ )j , IS) OJ IS) IS) D ." ;U o ::< () o o -U m ;U D .... .... C m (IJ c .... r o .... z G) (J) <J1 .... -J -J -J OJ Ul .... <J1 1% IBS., llil $31 ! 13! ! sat:sO IIOV -, am ~' Addrl" HI-'ConIratOI ~,I'; HPI,4-t.e:r! f,ir<fllcfJ MhU~~'J ~J4-. S~. ~o.l~. fWJ T, , ,II' ~'1..,-r;Jr'" ~ J'n- w.z:; "'I( 'Urc'+i,.. ) ~ . MDdII SIll _ 5S01~ .. CarllLLDad ~ Full - ~ ... 9 ... iiI ~ I ~ Rlmember 10 add Ihe SIIII Surchargl an IhI troIlom ollhls lfIIIIiclllon. Thl priel al your heeling perm~ Includl' onl lOugh-ln ond ani l..oIlnspedlon. Addiaanll Inlplcllona will bl billed II $35.00 each. HIMe Hlallng Teal Rlcord musl be lubmillld wilh IIYikIIDlI RlllllllIUIIIIIII1Ircla11INl~ Ing clrlllCI'1 01 occupancy will bllllUld. ~ r:&l r:ULATIONS RFOUIRED wllh number aI aupply and ilium apa_lllloled ~r 100m wlh CFM'a per ' , . I' Nlw "Nelllrel or oddllOnl IInd 11- pllIl will lupplt ond ilium I_"ona shown. HEAT LOSS CALCULATIONS, ""WENT ANO APPUCATIONS MAY BEMAlLEOlOTHECITYOFPRIORLAKE.Ie2Ol100LE CREEK AVE. S.E. PRIOR LAKE, MN 55372. CIIy HIli bulln"l IlOUII are 8 a.m. . 4:30 p.m. ALL WORK MUST BE INSPECTED IROUGH-IN AND FINAL). CALL em HALL , 447-4230 I hereby Ipply lor I mlchlnlcalsysllml permit and I acknawlldgl l'lllhl inlormalion IboVI Is Complltl Ind Iccurall; Ihallha wark will bl In co"ermallC' wllh Ihl ordinances Ind cod.. allhl clly and wllh Ihl Ilall bulldlng/"Ichllllcll cod..; Ihallhl.~ do.. nol blcome I permit unl" Ilgnld by Ih. BUILDING OFFICIAL; Iho' wark will bl in Iccordlncl wllh thl approvld pllIlln Ih. CISI 01 1\1 wor blch ,Iquire. review end approval al planl, --'---" ~liC.~". SignllUII .iJ - 3 -cJ?:J .. BUilding, Oftlcol'l Slgnllure - .... o (J) .... ru ... ... -J ... ru ... <J1 -u DII. Jl:"~~) 'D'III .... , .... l. Blue File 2. Gold Ory 3. Yellow AppIiCIUIl PPND.O- <;;l~ ~ Phone:q~-q~-'7'111 ~A.. . '\\'".0 ~s.9-.4.~ , . CITY OF PRIOR LAKE PLUMBING PERMIT APPlica~~{'"~,,", ~.\.....{)' C'O'l.'"ih Address: tc:;........., ~~... \=l~.-:::t!'."...O Signature: ~~ !A""-- <;:On..."Jl,- Legal Description: Lot t J...0l-.. Block..$- ( Site Addresd<\1.i (');l. ~r",,"...... C\..-L N E-- . Building Permit # PID # ;)5 -3lo8- ();)..J.- 6 NOTE: This permit will not be processed without complete information. FIXTURE UNITS TfHo C~ln ld Ihf I..h Coyn,,.,. Quantity ~. / I 3~ J :J.... / c:>... Type of Fixture Quantity SUb.ka..1-. \l. \ll.- S-tb. Type of Fixture Rough-ins Water Heater Water Softner Stand Pipe (washing machine) Sewage Ejedor BackilDw Assembly (RPI. Double Check, PVB) Backflow Assembly Test Lawn Sprinkler Other 0( - ';:)\ IIC-oc..\u. I-rb~&)"'" I-)~\\~ $ $ $ rd b~ $ .50 &J;t. Novo1<:- :t\~ $ This permit is granted upon the ex.press condition lhat said contractor, shall comply i'n all respects with the ordinances of the State Plumbmg Code and the,amendments thereof - ~ RECEIPT NO ~/ /f7J DATE ..~ I ATITST PAlu WI' I-j BUILDING PERMIT 16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4:30 I FA..X (612) 447-4245 An Equal Opportunity Employer Bath Tub with or ..:tp,:,yt shower Ii J Dishwasher Floor Drain Lavatory (bathroom sink) Laundry Tray <1 or 2 compartment sink) Shower Slail Sinks Bar Sink Water Cioset (toilet) 84 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 GRAND TOTAL II for all inspections 24 hours in ad..ance. _1.1:. . PILI: TI:LLOW . """\.tCAn GOLD. CtT' CITY OF PRIOR LAKE NO. (')- ~ .32 SEWER AND WATER PERMIT NOTE: Sewer and Water contractors must be registered with the City. APPLICAN~Cl~~\ +\h). 0Jl),,, , PHONEf\~-9~~'7'7/'7 ADDRESS:I6C:i:i~\,~\ ~~S- DATE: q-dll.~ SIGNATURE~:"'- _.fOr... ~ BLDG. PERMIT # SITE ADDRESS: \414~Ko..ven.~-t tJr- PID; ~S-3t..3'-au-O FILL IN THE BLANKS 1. Estimated length of water service -'-/r:::: feet. 2. Size of water service inch(es) . 3. Locati.on of any couplings from structure feet. 4. Type of sewer pipe. ABS PVC~ Cast Iron 5. Estimated length of sewer line 45 feet. 6. Clean out (if required), located at structure. feet from ================================================================== This application becomes BY~O~ E{{]~ your permit when approved. DATE: q-Ol. g-tJJ ===============================================================::== ~L~ ~~L7~ .~ Fee for either sewer or S .50 surcharge. 35.00 .50 35.50 Sewer and Surcharge TOTAL water line connection perm:t * water individually is S20.00 plus * Sewer and water permits issued for new construction must be recorded on the building permit card at the time of issuance t6 insure that no duplicate sewer and water PPAftj~THFre issued. . BUILDING PERMIT ~ / () / ;;/1 DO I I AMOUNT PAID RIC'D BY r9 (J~ DATE PAID RICEr PT if 16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 553721 Ph. (612) 447-4230 1 FAX (612) 447-4245 An Equal Opportunity Employer PRIOR LAKE INSPECTION RECORD OJ. DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS ~fJ2 ~v'-eJ..A.. NATURE OF WORK k)p", USE OF BUILDING SF..D PERMIT NO. ()(). 0 B3-S DATE ISSUED CONTRACTOR kbt/aK -Hecl '1fs,~f21*~ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT e;;~PECTOR I FOUNDATION (Prior to Backfill) I 4:A: ~ I <9 - ?/-~~ PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS 8-4- i'?:t-, ~, ;, iJ, ~, (In, ~, /oj?t/tn> I FOOTING SEWER I WATER I SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if required) FIREPLACE "r. Ort- ~..,.~ GAS LINE AIR TEST ~ I/~ P6 L-L.- PI3 DATE I 1//CJ/tft lI-;).-CJ1) /~jat,/~ ll-J.-?o Ij/~ /IJO II-:;'-db . , I j()//f/m 1~/j.(,Itr4 IJ/;o/n , COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I~ I I FINALS 1/~ / /:x; 01 If);;., I GRADING (Prior to Sodding) BUILDING -r:c..O. -Wi ?/r/() I t'R-. ELECTRICAL . , PLUMBING HEATING DO NOT OCCUPY UNTIL ABOVE HAS NOTICE z~ q-/~-ol 9/';/M( II /~tTl> I /~i://tJ I BEEN S(GNED 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 ",hall b.; placed near main entrance. Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS (612) 447-9850 t:'\i .'I~"::"!J~~j~,\~...~h. i r QLtmfuau of fllctlq1llllry :~~r CITY OF PRIOR LAKE i_I ]ljFmol~tpatl:'~~Uo~:, JllBpttlion (~. _I' ThiSifyC.ertif!.c.ate iSh sued p~,:uant to thh~ requirements ~f Sectil~n 307 ~fh thhe Un.iform dB~iltling Sod he (1"'..._"1 certl mg tnat at t e nme OJ Issuance t IS structure was m comp lance WIt t e vanous on mances OJ t e . City of Prior Lake regulating building construction or use, For the follawing: ~." !, (\;,1 (~ (,I,,:. Cr, Il~ ~ \ J'r I~ IY' . ~,. Use Classificatiol1' SINGLE FAMILY Bldg. Permit N', 00-0833 N/A R1 Occupancy Type R3 VN _Fire Zone Zoning District Type Construction Legal Description L22, B1, KNOB HILL 5TH ADDITION Owner of Building SiteAddress 14402 RAVEN COURT NORTHEAST Contractor's Name & Address NOVAK-FLEqI<, 8857 ROBERT D. HUTCHINS (rr < I ~~dJ~ official r I Ie I ZEALAND AVE., BROOKLYN PARK, MN 55445 City Planner DON RYE Date: Date: POST IN A CONSPICUOUS PLACE ,-, ~ ADDRESS OCCUPANT HEAT LOSS SOLD BV Electrical Work By TYPE OF HEA T MAKE Model Serial INPUT Form 235 I 4 '/02- alS . ,<.d)v...../--l HOUSE HEATING TEST RECORD CITV. OA TE HTG. INST. il , " ( 1.:>t:L _APT. _FLOOR OWNEP 0nVl)K rL'.1Z. L~ .SUBURB .INSTALLED BV _ I) ,-, E, . Gas Line By \-.. \ 1t--.5' N\.,-- GA_FA~HW_STEAM_SPACE HTR. _UNITHTR. _OTHER_ ~'I .~ GAS DESIGN Irnl-tt'eJllA, ,_ . . t'U. (lA.~ G'-tt.' L-N~ e:H-~ l \\ l-t'f.3..'.lnM 3l,2{r '7 n. D[j[) , / "1 DO';: _ (nS-j.",( > 7(...<15U I,).?~ (. I.) ,.;ll ) ('1;2.-"'J 6..L CON~DN MAKE OF BURNER _ ~ Model ./" Max. BTU Rating ../'" MAKE OF FURNA~ Model ./' Vent Size /' 3 U KIND OF LINER Draft Hood SIZE NONF Regul",", _illJJ.... IntI:, L \ 10)1.. 'US:'/-. \ _Numbe, I Insi~. _' Outside \VVC, ,/ , CONTROLS c THERMOSTAT J-f~lu. Heat Plug ....... 0 Valve Il1 J..~ Limit 'pr0 Li mi t Setting Fan Setting Pilot Type Pi lot Make Pilot Model Smoke Bomb Pilot Timing----L:>:)rr-.> 7.~ Draft L. W. Cut Off _ Door Pressure__ P,ossu,e. ?j. < iI'~.cent CO2 --i:f~~ Date Tested Input CFH ?rLIi.'(l'i~j Percent 0 _ . rJ~ Company Testing I'D on~ 2 r>.<'l Stack Temp. __ 'l.....-r Percent CO c..... n Name of Tester Fi It.rs Size Ch imney Location Chimney Construction Wiring _ _Test Tag _ Lighting Inst. I I vI y, --lJD v f._Ie fAXL. _ \ Ll...)\,,,z,\j) i7 Form # 5 DATE TIME CITY OF PRIOR LAKE I - ~5-01 INSPECTION NOTICE -SCHEDULED ~:oo ADDRESS IL.{~ ()') Qt') Ue '^ C+- OWNER CONTR. PHONE NO. PERMIT NO. D-(JR~\ o FOOTING 0 PLUMBING RI o FOUNDATION 0 MECH RI o FRAMING @ 0 WATER HOOKUP o INSULATION 0 SEWER HOOKUP .s FINAL 0 PLUMBING FIN~ '1' SITE INSPECTI f< MECH FINAL \.!9 COMMENTS: ~IA.~. !J) ~ ~ ,fflLli, ~~(~ ~ ~ha'~.ojj -11 ~ er -k ~- ~ ~ U~~ ~ . 'M[l~ ~./\~~~4~.~' ft}/l,,",,~A.f/Pyt o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o ._----''"'''"'-- ,..;. --- ------ . -........ -----.... T C-, (!), -ti..lJ B/ [ { 0 I "' .. -~ ~ . .~ o WORK SATISFACTORV, PROCEED '/J- 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 & SAFETY/ INSNOTI SCHEDULED /I/~;I~ KA-J67V ~fl CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS /Lf"'/OZ- OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI o MECH RI ~ WATER HOOKUP lif SEWER HOOKUP tJ PLUMBING FINAL o MECH FINAL COMMENTS: (~. f L \ \y~"' j DATE TIME /(): :$0 o - 8'3~ o EX/GRAD/FilLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o / ~$ I I I \. \ / ...... /4.- LK SATISFACTORV, PROCEED o CORRECT ACTIO~~PROCEED o CORRECT W~rJ' A FO INSPECTION BEFORE COVERING Inspector: --f_.. Owner/Contr: CAll 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNOTl CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! DATE TIME CITY OF PRIOR LAKE IIJ-ff/1J1J II: go INSPECTION NOTICE SCHEOULEO , . AOORESS It..JLlrJ 2 ;? rh/erJ cr. OWNER CONTR. PHONE NO. PERMIT NO. t) -.P33 o FOOTING 0 PLUMBING RI o FOUNDATION 0 MECH RI o FRAMING ~ J WATER HOOKUP o INSULATION J SEWER HOOKUP o FINAL ;t:: PLUMBING FINAL o SITE INSPECTIO '0 MECH FINAL ' o EXlGRAD/FILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o COMMENTS: 0 ~..O~ ;t;;.. l-;::;jy (E>> j/. I-:-:t:i, ~!' .A~ ~, I&'~~ ~ (J~, r @ fJLd-, ~ r l~fWto~ f-~ l.t.1"r ~ IJJ"[JJJI. Moli/U .!.. rvv~-~r o WORK SATISFACTORV, PROCEED ~ CORRECT ACTION AND PROCEED :S::~O:ECT WO~~ FOR REINS::::::::FORE COVERING ;;. , CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/ INSNOTl 9--/2~ ) J:? cvJC-l0C:t- IJIPU'1t--- f/<<-K ()- R33 CITY OF PRIOR LAKE INSPECTION NOTICE v~ SCHEDULED ADDRESS } LjUO;::).. OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL COMMENTS: LJrlo $ox -0 K... 17/"..,1-<. - D t DATE TIME >> EXIGRAD/FILLlNG "ct- COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o )( WORK SATISFACTORV, PROCEED , D1:0RRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ~_' "": Inspector:/d~ Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNOTl CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!