HomeMy WebLinkAboutBuilding Permit 98-1333 rE nMe
CITY OF PRIOR LAKE Q
INSPECTION NOTICE SCHEDULED { �%�
ADDRESS �<jp � ; t��$ �(��`
OWNER CONTR.
PHONE NO. PERMIT NO. �— � �.�7�
❑ FOOTING ❑ PLUMBING Ri ❑ EXlGRAD/FILLING
❑ FOUNDATION /� ❑ MECH R! O COMPLAINT
❑ FRAMING {, ❑ WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION �`� ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL �� LUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS:
r
vh..r,,. G
❑ OR SATIS CTORY, PROCEED
COR ECT AC PROCEED
� COR CT OR , CA FOR REINSPECTION BEFORE COVERING
Inspector: OwnerlContr:
CALL 7-9850 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE QUI ENTSARE FOR YOUR PERSONAL HEALTH & SAFE7'Yl
lNSNOT!
DATE TIME
CITY OF PRIOR LAKE IZ-17- fid' /' 2..
INSPECTION NOTICE SCHEDULED i�/
ADDRESS � '+' �� I� : IGtS F-t. �
OWNER CONTR.
PHONE NO. PERMIT NO. ��' I 333
❑ FOOTING ❑ PLUMBING RI ❑ EXC/GRADlFILLING
❑ FRAMING e ❑ ECHANICAI ❑ LKSHORFJWETLAND
❑ INSULATION �� �ATER HOOKUP ❑ COMPLAINT
� FINAL � O�WER HOOKUP ❑ SEPTIC FINAL
❑ FOUNDATION �� SEPTIC INSTALL ❑ FIREPLACE
❑ DEMOLtT10N ❑ PLUMBING FINAL ❑
❑ FIRE PREV. ❑ SITE INSPECTION
MEN
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❑ WORK SATIS ORY, PROCEED
ORRECT CTIO ND PROCEED
❑ CORRECT ORK, REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CAL 447-423 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE EQIII EMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
ATE TIME
ClTY OF PRlOR LAKE
INSPECTION NOTICE SCHEDULED l D�
ADDRESS ���� �I�S � � li
OWNER CONTR.
PHONE NO. PERMIT NO. _�� -� t 3 33
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING O WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
J�FINAL ❑ PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS:
�� ���
��S�� �,D
� ,
� u.r � <<
pl WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: .. OwnedContr:
CALL 447-9850 R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETYI
i�von
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• �J I � i , 4 �J / h �1 � M� �Y' � ` Ir y � J / �� 4 1 ' �+ 4 / + �� ±✓+� R •F _ 'ry�y �y� �fl' 1 ��h IV 1 R �r �S. ���Y �1 i j� 1 � ��° � � _ � � � �
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� �-• i ��C�t�It� '`II-� �CClt�lt� � "�
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� : CITY OF PRIOR LAKE ���`�
�. � �e�art»tertt ot �uiibit�g �r���ection � �
� Final Permitted ❑ Conditional C.O. Expires
( `� w ��
� 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 regutating buitding construction or use. For the foltowing: �
� �.
- UseClassificacion ingle Familv B1dg.PermicNo. 98-1333
�
�- �
� Occupancy Type R3 Type Construction �1 Fire Zone N/.A Zoning Disuict R. �.,
�-
LegaiDescripcion L10, Bl, Sterling North �
�•,
� - OwnerofHuilding SiceAddress 3050 Wilds Ridge Court ��
�S' 1 ' �.
— Concraccor'sNameBcAddress Shamrock Bldrs. 3200 Main St. 4�300 Co on Ra ids MN +.
�, Robert D. Hutchins Don Rye 55448 �''
- City Planner '�'
� �. � Buil ' g Officiai �"
�' Date:
� . _ Date: }
� v �' POST IN A CONSPICUOUS PLACE �
�' - _ _ �
��y_1�M + ��`✓ t�d"�,x/�N+i%t,♦ 1,4'�,. if1/.�`.M•.1,!-�,l `
•� •, �'. t ' . Y'•
� �./\_� \r��`/`/�� �l'����./�i �./�� �/
�OF pR ��'S'� DATE RECEIVED
CITY OF PRIOR LAKE �. w►,«e File
v ,��x, BUILDING PERMIT z. P"''` c"
� 3. Yellow Applicant
TEMPORARY CERTIFICATE OF
t` �`�` 2 � '��� ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No. '�
DIRECTIONS f. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) � — .-g BUILDING INFORMATION
2. SITE ADDRESS 11. SIZE OF STRUCTURE
� / � (Height) (Widfh) (DepMi)
�/
3. LEGAL DESCRIPTION 12. NO.OF STORIES
LOT � BLOCK I PID �,�. ' ,�� ' �!� ` V
_ 13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER (Name) — (Address) ,3�(� M�ta.v� •�l' .) �` 14. FLOOA AREA APPORTIONMENT USE
U
5. ARCHITECT (Name) (Address) �� (TeL No.)
,_,,,/� o � 6
6. BUILDER (Name) (Address) � (Tel. No.j 15. NUMBER OF OCCUPAMTS OR SEATS
� ��� r1/�-OI.�-Y��� `
� � OCCUPANTS Q
ol/
7. TYPE OF WORK Flreplace O Septic O Deck O Re-roofing O Porch O SEATS
New Constructio� Alterations O Addition O Finish Attic O Re-siding D Finish Basement O i6. PROJECT COSTNALUE
Chimc�ey O Mis .
S. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. Width Depth Yes No
I hereby certify that I have tumished infortnation on this application which is to the best of my knowledge true and correct. I also certiTy that I am the owner or autl�orized agent for
U�e above mentloned properry and that ali construction will conform to all existing state and local laws and will proceed in accorciance with submitted plans. I am aware that tlie
buildi ffici I n revoke i rmit for just se. Furt e, I hereby agree that the city official or a d�� e r�y enter upon the property to perfortn needed ins ecdo .
x / ..j "' _-
Signature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required MATERIAL FILED WITH APPLICATION
A��� SOIL TESTS O ENERGY DATA O
Front Back Side Side
BUILDING DEPARTMENT VALUATION OFF STHEET PARKING PILING LOGS O PERCOLATION TESTS O
SPACES REQ. PLANS & SPECS O SETS
USE OF BUILDING
S�� SPACES ON PWN SURVEY O COPIES
PERMIT VALUATION PLOT PLAN O
TYPE OF CONSTRUC110N: I II III IV Amount Brou ht Forvuard $
OccupancyGroup A B E F H I M S U Ciry: g '•"•""""""' T �
Division 1 2 3 4 � Pa�lc SuppOrt FCe ........................... $ �'J • � V
��
Pertnit Fee ................................... $_ . � SAC ......................................... $ �C� •O�
• � . / ollective Street Fee ....................... $
Plan Check Fee ...... .. . .. .: . $ - �j � ��
�� . � �ewer Tap ................................... $
State SurGharge .............. . .... $ � r? ��/,�
rr
Pe nalty ....................................... $ � �/�� Pressure Reducer . S � .................. $ 5 . Oa �
Plumbing Pertnit Fee . �().: • f ,��J,� • • $ / (�_ Meter Hom ......... . � �.........
............
Mechanical Permit Fee �.� .�a.� $ � C�C� — Water Meter .....� ........................ $ l S• Of� .
r+ p,�� �$ �`' y �� Sewer & Water Connection Fee ........... $��. ZOD ��6
�
Sewer 8� WateP Permtt ..��1... � � p
/ y � WaterTower Fe� ......................... $ 7�0 • �
GaSFireplacePermit ..��:l�u�.. $ �� WaterTap ......� ........................... $
This o ecom Your Building Permit When Approved. Builder's Deposit ............................ $ � ����
6y Date /b - ? Other ......................................... $
CeRificate of Occu ancy a Total Due .............................. . •
Paid � �p ? � „� �eceipt No. � � � S (�
Issued
Date �� � - 9 8' By ��1+
This is to cerdfy that the request in the above applicadon and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as ested. This document when
signed by the Ciry Planner consMutes a temporary Certifiqte of Zoning compliance and allows construction to commence. Before occupancy, a Certificate o( Occupancy must be issued.
Cky Planner Oate Specfal Condibons d any
. 24 hour ratice for atl inspections 447-9850 �
�
� f;rp 1. risk • Fk �
�� �� CITY OF PRIOR LAKE - ��= ;: �,. : ���, '�
U ���, 182f� Eagle Creek Av S .E . p M� No �$ _� , 3,'� �!, TYPE OF STFiUCTUAE �c
Prior Lake, MN 55�72 `�;_ . ',
< �-_' %= � � �
HEATING A3'PLfCAT[ON / PERM ' C�'� " '� 5�'� F�rnTy 7�a+n�ty Mu�-Far�y m�
� ' 1�o nrnercial kKiusY�l Pubiic O�her �'
Dals 3lR/oQ PIQ � — � � � �
�. �
,, �
Slts Address �O$b ��,Q�fo ` �c�t.. \ \ ' \� �� � � Fee Sct�edule °
�
Lot �� Block �_ Add�ion -ST� �./N C,� A/O�,"T�f � H�ustrlai, Commerciaf 8 Mufti-Fam�y 19G ot jab oost (539.50 ma�ext�� �
Residential� Heaii�g �, AC f99.50
Owner's Name � �.A,�„o►� , d�rd Hesidet�teal. HeaEmg Or►ly �64.+5�
Address Hesidential, Gas Fke�ace 539.50
Resiclenttal, Addtiorts & IUleratioiu S39.5Q
HeatingContractotALLIED FIRF.SIDE dba FIRESIDE CO&NER p �� F ��� �
�
kddress Z70U N. FAIRVIE6J, ROSEVYLLE, ?IR 55113
T�epho�e �
6 51— b 3 3— 2 5 61 Remembet io add �re State Su��arge on the bottom oi th� app�cation.
FIREPLACE . �
p�.qQQ@�,a Make d Model IYPF OF SYSTEM The price ci your heatirsg permii includes vne rough-in �d one finat in�eci�. �
1M�m f►ir Piants °D
�
Modei Si:Q � 7�7� /,�, Gravity Asl�iicu�al i�spectia�,s w� be biNed ai �35.00 e�h. �`'
m
Gann. Load � Hctt�se Heainig Test Record musi be subrralted with ���( belws M.x1c!- A
���a�"9 ing certi�cale o( ooaipancy w� be iss�ed.
FusE � r Five Size VeM. Syslem �.
HEATM)ti OA POWER PLANT ���"��T�� RE�]U�AED wt�s number d suppty and rehxn openings I�kd �
Suppl� Openings �� room wid� CFM's psr ope�ring. Nerov structures a ed�tions send Aoor �n wMh supply
and retum locations shhewwn. NEAT IOSS CA�.CULATIONS, PAYMENT A�ID
Returr, Ope�tngs I-�t Waler APPLtCAT10N5 MAY BE MAI�EO'i'OTHE CITY OF PRIOR WCE, 16200 EA4L� �
Radiati� CREEK AVE. S.E PRIOR U1�CE, MN 55372. ID
kiput Output� d� Special Devices m
City t�-aR busir�ss hours �e 8 a.m. - 4:� p.m �
0
Edr. �� ��eS ALL WORK MUST 8E INSPECTED (ROUGH-IN Af� FINAL) - CALL CI�Y HALL °
Cfm_ ^?
447-4Z�1 �
0
7YPE aF WOAK i hereby apply for a mechanical systerns permil and 1 acfrnavr�edge tMat tl�e �
Akerations Replacert►ent Tfew Co�lr�tion � �1O�mation above is carnplele and accurale; fha! the work wilt h. in cwtlotmance °'
wilh the ordinances and codes of the ctly and with the slaie buitdinglmecha�iea
Repair Esi. Corn�. Uale ���/,3�oa codes; Ihat this (orrn does not becflme a permit until signed by tfi�e BU1l.D�idG
OFFICIAL; lhat the Mrork will be i� accordance wilh the spproved plan 1r► th•
Esl. Cosl S G�. � 8�di�g Perm� #I / 8'� 3� �ase of a�l work which requ�res review and approval 01 Rlat�a.
•� m
HEA7fNG PERM�T FEE $ pA`p�11TN Ml'� � �.� M � ����`�, w
STATE SURCNARGE $ •5O j�UIL�ING P�R s Appl e �ate �
3 �9�00 1
TO7A� PERM(�' �EES S R�e1p� � Builc� pfiical's Sigreslure Dats
O F P R/p
� �
�
U M
White - Building
Canary - Engineering
Pink - Planning
The Cenler ot the L�ke Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLtCANT ,�;;,_�! ,. y-� rr.� -y �c�- „�c.�� z-�'
��
APPLICATION RECEIVED ��-�� �� � / ��
�7 _�
The Buildang, Engineering, and Planning Departments have reviewed the building permit
appiication for construction activity which is proposed at:
�,,..d i� � �,�!, t . `-'� �n" �' r � �''�� -� t....,�
Accepted `� Accepted With Corrections
Denied
. '.
Reviewed By: � .�n Date: � t - 3 � � �
Comments:
"The issuance or granting of a permit or approval of plans, specificatians and
computations shal! 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."
O F PRIp
� �
U , M
White - Building
Canary - Engineering
Pink - Planning
The Cenler of Ihe Ldce Counfry
BUILDING PERMtT APPLICATION DEPQRTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED � �- �
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
�
�� ��n ���`�' � � .
Accepted Accepted With Corrections �
Denied
Reviewed By. Date: >D- � -�'�
Comments:
/� �� a,..,.�R- -�- � ��.s � �1rQ���r��.�.�` J.
2. l�a.��,�.. �.,.'-�. �r�s,?-� l���n/4ro �
3. P�.� ��t ��l �a-�. �
"The issuance or granting of a permit or approval of plans, specifications and
camputations 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 autharity to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
.
� _���F PRlp�, �
9�-/333
U rn
White - Building
Canary - Engineering
The fenler of Ibe L�kt Conelry Pink - Planning
�UILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT r '
APPLlCATION RECEfVED I� �- 3
The Building, Engineering, and P(anning Departments have reviewed the building permit
application for construction activity which is proposed at:
— �3U .� c �� �u� /�/ �s...t� �C
Accepted ✓ Accepted With Corrections
Denied
Reviewed By: �1�, , �r,v Date: ��/ ��_
Comments: �sE ['AVT�oN W►-IE�1 c��-2�no� AGTIUI'("1�' �r�
,�
SriE c ATGN 1�RSra n��'A-2 -rL1E REA2 Lo
Co2NE2 S Tp �,.,�-
'DAM.AGE 02 �1S'R�2L3 �7�
EE FoK ATloa ERS�. � E
�
�E /�TTf4� F�jT$ • 1 F.�fF �n 9Dis1G �NSPE�TioN �N RM�ITlan1
2. Elto � 2AL ,.� aa0„� P —
"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."
� _ — _ , r ^ a t.-- F - �.n-.� ., _ R �� , - 4.-,..., n • -„�-�-_ -- -���- e__ _�------- . - -'- ���,�n -�- _ ° ._ - . � �- - ;� . — _ Pink_�File - .
".,°� p ��• '' CITY OF PRIOR .!L'AKE ` nrPE oF srRUOrut� 3: Y��',' : c� a�
� m 16200 Eagle Creek Av.�S.E. Permit Nc. �� Z� � Single Farr'til� j'' Two-�amily Muiti-Family
Prior Lake, MN 553�2
� �ommercial In strial Public Other
HEATING APPLICATION �PERMIT
�11� PID # ` JOB VALUATION FEE
Date • _
$0 -$1,000 2% of job value, min. $20.00
Site Address • +�
Lot Block Addition � $1,001 -$10,000 �$20.00•for the first $1,000 pius $1.25 for each additional
�$100.00 or fraction thereof to and including $10,000.
Owner's Name `
. � �' � � $10,001 - $50,000 � $132.50 for the first $10,000 plus $1.00 for each addi-
Address � �� d"� � ( %�C( / ! tional $100.00 or fraction thereof, to and including
Heating Contractor � 1' � ' `} � ' �� . � $50,000.
' $50,001 and over x$532.50 for the first $50,000 plus $7.50 for each addi-
Address �� 1 �' '' �� _ � tional $1,000 or fraction thereof.
Telephone # � G � � - L- � 3 � ' � �; 7 � 7 ;�
The price of your heating permit includes one rough-in and one final inspection.
Furnace Make & Model ��� � TYPE OF SYSTEM � Additional inspections will be billed at $25.00 each.
Warm Air Plants •-
Model Size �Q�,..� ��� IJ ��, Gra�ity House Heating Test Record must be submitted with building �ermit number before build-
Conn. Load Mechanical ing certificate of occupancy will be issued.
/� 't Air Gbnditioning ar
Fuel �"' Flue Size cC,j Vent: System bEAT CALCULATIONS REQUIRED with number of supply and return openings listed
HEATING OR POWER PLANT Per room with CFM's per opening. New structures or additions send floor ptan with sup-
Supply Openings ��J ply and return locations sFiown. HEAT LOSS CALCULATIONS, PAYMEIdT AND
Steam -
Return Openings � Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 4629 Dakota St.
���� .,���� Radiation S.E. Prior Lake, MN. 55372{'
Input �Ut.�I,J Output � � Special Devices "
� City Hall business hours are 8 a.m. - 4:30 p.m.
Edr.
Other Devices ALL WORK MUST BE INSP.ECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Cfm.
447-4230.
TYPE OF WORK ' I hereby apply for mechanical systems permit and I acknawledgs that the information
Afterations Replacement [�ew Construction �,_ above is complete and accurate; that the work will be in conformance with the ordi-
, nances and codes of the cit� and with the state bui�ding/mechanical codes; that this form
Repair Est. Comp. Date - does not become a perm' � til signed by ihe BUILDING OFFlCIAL; that the work will be
� in accordance wi the pr aced- se of all work which requires review and
Est. Cost $ ,�')�(� Building Permit # approval of plans
, HEATING PERMIT FEE $ � � ' �.� �p?() ' O(.� -- _ � #(� 9�
STATE SURCHARGE $ .SO � �� A pF ' n t e � Date
� - e i�vG P�,����r ' � �/� - �T�
TOTAL PERMIT FEES $ I•� � Receipt #
� ' in 6ff' ' ' �r Date
.�. �.a.�-.,�.:.�r, k .. . _ ..,. .. . _, . . _
Sent By: PLYMOUTH PLUMBING AND HEATING; 612 5331121; Mar-17-99 2:29PM; Page 1/2
� PRIp�, CITY Q� P�IOR LAKE 3� ��, ��
� ��i3
� �^ PL UI {�B/N�, ERM/T _ P� No.
A Jicant: � I l� i''� : f�Y1 �/ f'lc p `_J.3?> — � C
PP hone:_ 7� ✓ 7
7M Ct�l�r of 16e I.�ks Countn Address: � �' ✓ � C�
SI�nBtUfe: �
Legal Desc ption: lot �o Block Sub� �j1/'lCl /(!b. �'c.� �
s�te address: � 5 � �< .1CCy.P,..� LcJ:�dS •
Building Permit # ��1333 P!D �i aS � 'f��0�
N07E: This permit will not be processed withaut comp(ete information.
FlXTURE UNITS
Quantity Type of Fixture quantity Type of Fixture �
Bath Tub with or withouc shqwer Rough-ins
Dishwe�sher ' Watar Heater
Floor Drain Water Sottner
Lavatory (bathroom sinkj � Stand Pipe (washl�g maehine)
�.aundry Tray (1 or 2 camp�rtment sink) Sewage Ejector
Shower Stall 8aockffaw qssembly (RPZ, Double Cl�ed� P1/B)
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
3 Water Closet (toiletj . Other
F�E SCHEDULE
tndustrial. Commercial 8 Mu�ti-Family
(1 % of job cost, 539.50 minimum) $
Resldentlal. New One & Two Family $99.50 $
Resldenti�l, Additions & Alterations $39.50 $
State Suroharge $ .50
� PAtD WITH
GRAND TOTAL � $ BUlLD1NG PERMIT
, 1'his permit is �antul upon the express condition �hat aaid
contrac�oc, shall coet+ply in all respects with the orrlinaaces
. of �a SLate Plumbing Code and �he amendme��hcrcof,
'� REC�;PT NO. DATE �
� A'i'IEST
. Call for all inspcctions 24 hours i� rduivs�nce.
162UU Eagle Creek t�v. 5.�., Prior t,ake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (6� 2) 447-424S
. An Equal Oppottunity Employer
;'
Sent By: PLYMOUTH PLUMBING AND HEATING; 612 5331121; Dec-15-98 7:40AM; Page 2/4
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CITY OF PRIOR LAKE NO . Y�""
��� SEWER AND WATEFt"PERMIT dp�
/ �l
NOTE: S�wez a�d Water
cantractors must
� be regis�.ered
, s�ith the City.
,� r FHONE - ��� ",�'��
APPLYCANT
ADDRESS : � ( DATE: �� °t � �`-7�5
^ • " BL�G . PERMrT ;J�
S I GNA�URr. . '���� �
SZTE ADDRESS . I pl�n,2���� ��� -v
F�LY. IN T1�iE SLANKS
1. Estimated length of water se=vice �'eet.•
2. Size of water service � in�h(es).
3_ Locatzon of ar,y cauplings from stYUCture _ �eet.
w
4. Type of sewer pipe. AHS�� PvC� Cast Iron
�, Estim�ted length o£ sewer l�.ne '�,.�feet.
6. Cl�an out (if required�, located at __�� feet from
• structure.
s:a.:s�s��:azacs���a��ma�aa�:=�ars=a� ��=�a�s=a. :s�����.�a r�—x==aa=�=a=sas
This appl'cati b�c me our p�rnit when approved,
F3Y ' DATE . ���/.5
z=����: ��v�c.—��zac=�ere=�===ms�s¢:�===a�s�x�=a=.�-ssane=��=sas���z�a==�oet�t-
F�ES: $ 35.0o Sewer and water line connection permit.
$ .50 Surcharge
$ 35.50 TOTAL
+ Fee for �ither sewer or water individually is $20.0o plu�
$ .SO surcharge.
� Sew�r and water permits issued for new c4ngtruction must be
recorded ori th� building permit card at the time of is�uance
to insure that no duplicate sewer and water permits ,ar�
issued. .
DATE PAZD � PAID WITH AMOUNT PAID
REC�.'1PT .,u� � �' N PERMIT REC' D BY � �
16Z00 Eagle Creek Av. S.E., Prior Lakc, Minnesota 55372 ! Ph. (612) 4A�7-4230 / FAJ{ (61�) 447-4245
Rn Equai Opponuni�y �mployer
• _ • ., ,. :... ... .. . , . . . •. . •. � . ... . . ..'-: .
11/14/2020 09:22 6124341699 AIR MECHAN PAGE 02
� i� 11JIc�u� �►ii�a r ►A��+
"7�'"7// 1/�I6. VI lA/ �/ V/7i. 1/ ��
HEariNC & Coo�ING
�Creating Cusrom Comfort'
�jQpse Heaq,p� T Rtterd
(Or9atc'fesq �„
� �i
�
�:_ : .
�derass 3 0$"d U� � 1d s R��y�►� Floor Ciry �' Subur6�
OCcupant �, � t+r.�+ r c� c. << Qwber S� t� �.. r u_ �r. ,
Heat Losa Date Heating Iastalkd 3/�. ti l D o
Sold By Gli• P'Ic.��,�,.� � c..-� Ti�c. IasTalkd By Cl i � P') t..�, a...: c.- I� c.
Elecirical Work By Gas Liac By_ _� � � 1�'�_t �.�+ Iw� 1 c•� ( rit ��
7`ype of Hqt�GA FA,�HW Steam Space T�or �loit R� Othec
GAS D�SZC3N 1 CONVERSION �
MS�e GL r.� � T n w, � �ke of BuIIIeI
vtoa�i G u �! �0 0 I�. Moa��
Sertal S p y 9 9 M I� S� 1 r�ax a'n.t ltaoag
�.., ..
Iaput,_ t� V r o v O Mal�e of Furnace
l�odel
CONTROLS
TbermosrscL� �Heac Pl�g�,,,,__ Vcat S'ru
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`/al�e S U 9 S V'V r"1 , Kiad of Liaet __ __ _Size Noae
L.{mlL 1 t�t� �it�TrM iti G��S �ft HOO� ♦/► �4�+ Ra�ul�r M r�e . T �t) � �wlJr
Limic Sekti�a .1 U O , Filxts Sixe IL X � s�( 1 Number 1
'�an Sttti�e � i w. e..,�, . Chi��ey Locsdoa: I�side,�_,Onffiide
PiIo� Type 1-�. � S�►•,,��Cbim�ey Constrvction �. � a� ��___,�
�.:.
Pilot Malce �....t��,,�, Smoloe 8omb � , ✓ „�, _
Pilot T' ' e Draft r Teac 1' �
LW Cwt Off Door Ptesrnz�Li�tiag Inst�„�
Prea�te�,�Pes�tat t�OZ,.,��, Daoe Taeed .; ���l .� 1,,__u y
Iaput CFfI� W� O PerceiC Oa,� Coaaq�a�y T�sciag CZ�� ! M c� �w�— :��•. ��r• G�
St�cic 7emp. .�0 ! Pare¢� CG O� � Name of'Teuer�w
l6sta Ab�rd+�i► 9�'�et N.E • Ham La1Itr.11�nn1�or�1 S330t •(81?) �3t--Tl47
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;, ;�:t;�,r; �; �� �� ` � $�.�;; .�,��:s. . �.:rDEPARTMENT�OF�=;� ��. .�;� `, .,. . w��t :>. �
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, �r O: `���'-.`9f3��` 13 33 DATE ISSUED ���o -�2e���
, � �, `, ��,: `��'t,,.,
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- , �. "CONTRACTOR'�. .:�1��-0��.13u�1�1ers � `� _ _ . ,-,.�. �w�:.; Y ,
:�,r.,y; 'tG �«. v r`sl;.,`.> . � 4- Y .. �
';✓ ��
�NOTE: THIS IS NOT A PERMIT FOR ANY t�F THE INSPECTIONS BELOW�"
:�._� . PERMIT IS BY SEPARATE DOCUMENT �� _�� �: :'�• , �
, ' ' ° � INSPECTOq " • DATE �
- »> � , ;; ' .{ `. , . � , a, /'/�''` .;t::.� A�,� �;� ,�
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. �`� :����.-:: �FO'�JNDATION (Pri�r t� iac�Cfill) � : � � . ��:l� :��� �'" :�--:� :
� ,. ���w;� ��`%'"
' ��� "`;`""+�"�� NO,�'CONCRETE UNTIL ABOV HA BE N
' P L�A�C E�. . E S E� S I G N E D�: - `
� : �:��;���;� , >��: � �. � R O U G �1 - I N _ . ,.� , f , 3 , : ..
.�� p...:: ��SEWER /�WATER / SEPTIC � ,. . -�:�:; .�*, �, � ;;. �,� y �. .;
;r,,�.. . .� . �`' �'�.� � ;
: � �� � F�2AM�N��r:-_ �y A ; ,� y , {. . ,.. y4 . .
� V � ��V � � �VI' ���`'�'� I�n,�t'�ie�- �� ���
` { 1. r•
�� INSULATION � � p� • - "'�-' .
. °ELE�TRICAL' � � � :.,.� ��,� ,
=a
- � �a. , . � ;x�. . :..
`� � '��;�* �°pLUMBING��° ' 3,-2�`._...�f 7/��f ' � , �. ,>. ..� =��.:�;�,$�,.:Y-, ,
� � r .v�' e
� � HEAtING ( required) U 7 ,9 9 g �� F� .-.�� �'��
� 84:., � . . :� a: � : :
�:�.�;��#� A-FIREPLACE � � ,� r� . , . � ,-�:�:rt,.,�'��� � � .
. � �'' ..:� .�-�h.. ,.., �--� � �;. `-
;��� '�:.':��,� t ;�:t,�- � �; y � �,: . � ' �,, �, ,.. ;�;a_
. :��:k������ .�CAS�LII�E�AIR"�TEST���,,,,... °� , y }�� : , j 7 y J/� , '� ��: :�`� � �� .:��; .
�<�y7 ��� �� V �� '� �w�' M S qY'H "M.�T� ���-
� . �� ,;S pfit�. ' x , ; � T � � ~ :s�:'�,a k
.:�*°�`��� . COVER �NO WORK UNTIL ABOVE HAS BEEN SIGNED��'��;=:`' �-���
" . ��/`�..r.�'�.��y . . ' " 't, �4 ii�t1' �.'�r' ����� -°.4 ..
� ,.��-.�� , ��WALLBOARD' �<�� . �,k.=;,. :rs�,,�:�'�;,:�;��� -
,.=+�:`,•:"' r9.. . . . �.
_ . 4 , .�+�,. .����^`�y:� ', <� '.e�m:." �4� � - � . � . . . , � ' � � , ' � .. • " +o''.::
� �, .,��� �. f�� ;:;�: f &;����,�:� ��a . , � F I N A L S . , . . . � ����',� . : .
:.�.
. �� `GRADfNG Prior to Soddin ) � � � �:�:;�`��'t ���� �
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. �. * y , ���;��.
;h.�:�,N-�t�;�; �H�AtING �`�.a� * .���x,:..;�:.: °� � .. �:; �.,. , � .: �;�f�. ��.�..k.: KF;�,;�.�.r_:�: �...:
� �.� 4 �:°'<���```�DO�`�`.NOT �_a►� ��UNTIL ABOVE� HAS BEEN - SIGNE.D����� �
_,����:;��,�-:,. . � ..�� � , �.
=�Y.�'*ly�y,4� �r..µ'.�,�_.� .. ,n. . .. _ .
�.xM .,���.�., - �:,�''-� �����,,..., N OT 1 C E � � _ -
` �.�r� �;�;«��� ����;�� } ;�.:<,_ �� , � � �� . . .. �
'� �," .;„` ,� �sr";'.s.�_. _�'�'a�, "_ ' �' ° � , _' , , .:; } ..__ � �_
'�'������.��"` ��• �'This.ca�d,must;be posted.near an electrical service cabinet prior'to rough-irrinspections=� t�" �`
= �}.`y;�,�"''� ����F=k �:and,`maintained.until have been approved.� On bt�ildings`and additior5s�";=.. �
�.�'�, "�,�'�:��'��. .,�,.... �.:.:c-��+,.,;'' - �,,
• "�°{' �'`� :_ 'vVhere�no°Serv�ce�cabinet is available, card shall be placed near ma9n entrance. r -,�;,�,�-`w:,�° � -
•'- > =�• ' : a._.. .�p., x ., : .
a�' ;r•.- �.�;,. ���;;,�. . _
� . .�;�'i ��� : `k��t`': ��n � ���Call between 8:00 and �9:00 A.Nf. for aN �nspections - . ,; ��.�+, �
� � FOR ALL tNSPECTIONS 447-4230
CITY OF PRIOR LAKE MC _ _,
162.00 Eagle Creek Av, S.E. Pormil No, 98 - /333, .
Prior Lake, MN 55372 7f - \c: - "
HEATING APPLICATION I PERM ,~?'C:;/, ~ ~ Si~le FamLly
'\ ~ \(' ...... _ Commercial
3/ K/Oo PID" 'ZO-30:'5I,).(jib........
, , \
..3D5?J DJd~ r'iJdu_. \ Pur;:; Fu Schedule
. () ~;(). /1'-;/::;;'
lot 10 Block 1 AddDion~L-IN6 ,A/OIe-7}-f' IV t:tu fty.,t. Inilustrla/,CommerciaIIlMult~FamDy
- A" _ . & - Residenlial, H..aling II AC
--u~. ',L,,,,, Residenlial, H..i1ting Only
A&Sidential, Gas Fir..place
Residenllal, Additions /I Alleralions
Residen~a/, AC Only
Dale
SDe Addross
Owna", Name
Mdress
TYPE OF STRUCTURE
I,t"ill\.
1. rinn
J. '(ellow
l1)
:l
rl-
File
ao,
CohIJktvr to'
'<
Two-Family
Mull~amDy .
"
...'
,
l1)
en
....
a.
l1)
, Induslrlal
OIher
. Public.
1 % of joo 0051 ($39.50 minilTlllm)
$99,50
$&4.50
$39,50
$39.50
$39,50
n
o
,
:l
l1)
,
HealingConlraclor ALLIED FIRESIDE dba FIRESIDE CORNER
Address 2700 N. FAIRVIE~T. ROSEVILLE. MN 55113
Telephone' 651-6.33-2561
FIREPLACE ,I
1Mm~ Make /I Model ...hILd AJ rnr.-,
Model Sizo
Conn. load
Fuel-&~'
Suppl)' Openings
~. 7_\u"/1'..
Flue Size
Return Openings
hput OUlput~..IJ).'D
Edr.
Clm.
MeraflOns
Repair
Es!. Cost $ II tJ(1 ()~
Remember 10 add Ihe Slale SUlCharge on Ihe boUom ollllis applicaUon.
TYPE OF SYSTEM
Warm Air Plants
Gravity
"'..chanical
Air eOOdilklnlng
VenL Syslam
m
U1
~
The price Df your heating permi1 ;ncJudes one rough-in and one. tinal inspection.
m
r.>
Additionallnspedions will be bmlld aI $35,00 each, r.>
. m
House Healing T..sI Record mllsl be submilled wilh lruikIi!llIllllUIliI ~ belore build- g:
ing certiflcale 01 occupancy w~1 be issued. ".
I:!fAIPALClllATIQt:1S REQUtRF.O. wfth numbvr 01 supply .00 ",Iurn """"ings listed p.
room willi CFM's per openi"9, NllW structures or addiUons send ODor plan wilh supply
and relum locallons shown. HEAT lOSS CALCULATIONS, PAYMENT ANIl
APPLICATIONS MAY BE MAILED lOTHE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
HEATING OR POWER PLANT
Sleam
HOI Waler
Radiation
SpacialOavices
;::
ll>
,
m
,
o
o
City HaD business hours are B a,m.' 4:30 p.m.
Othar Devices
,
ALL VlOAK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4Z30
Replacement
TYPE OF WORK
New' Conslruction
Xi-It
N
U1
o
I hereby apply for a mechanical systems permi! and I acknowledge Ihal tile ~
inlormation abov.. Is complele and accurale; that the work will bo in conformance --
wllh Ihe ordinances and codes 01 the clly and wltlllhe slale buildingfmechanica
codes; Ihatlhis lorm does nol become a p..rmil until signed by the BUtLDING
OFFICIAL; thai the work will be in accordance with the approved plan In th.
case 01 all work which requIres review and approvat 01 plans.
,dl~ 'J>li~Jre
- AP0/~
BUii~ OHicars Signalure
Est. Comp. Oale
. ?J/3/o~
q~rI333
~ P^\OWm.\
\ BU\lDING PERMIT.
Building Permij /I
."
ll>
'"
l1)
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTALPEF "r-EES $
I
.50
Receiplll
3;//""
, O.le
3/Q/OO
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