HomeMy WebLinkAboutBuilding Permit 00-0893
~~
Q4TO ROr.O'''~ CITY OF PRIOR LAKE
-? 1'1 00 BUILDING PERMIT,
I . . I' TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1.
2.
3.
Permit No.
(Depth)
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12SITE54/2.. ~ C'_\.,'(\Z\!-t6-- rl1tt/,Y 111 ElttJ{)W
3. LEGAL DESCRIPTION (')
L\T -l,UJ 11' - 1, f> _ BL~K ]2J ~ - n
ADDITION \'y P"'-~' 0 \.Ai. ~ i \ \ I\. <.,
140 OWNER
15. ARCHITECT
6. BUilDER
1. DATE
7//4/2urrm
11. SIZE OF STRU
(Height) (Width
ett I(t [jie. NO. OF STORIES
PID
13. TYPE OF CONSTRUCTION
(Name)
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Tal. No.)
J4-S9 uJa~~\t(\ 3>r. S-k ~r:tO)
.t\1-.~" UJ~!N) I t <c;l-'11l 6"_""'.~_~-Jn~
7. TYPEOFWO\') Fireplace 0 epticLl Deck 0 ~porchO I
New construction", Alterations 0 Addl Ion 0 Finish Attic 0 Ae-siding LI Finish Basement 0 ~. PROJECT eOSTN ALUE
Chimneyl:l Misc. 7() /q 70
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110' CULVERT SIZE 1 . COMPLETION DATE
Sq. Ft. Width Depth Yes No
I hereby certify that 1 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 const~cti will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
bUildv'ng . ial c~n revoke~' .t~fo . st caus urthermore, I hereby agree that the city off,icial or a ~Signee may enter upon the property to perform ne ed insp ions.
X '~+"" _--..--.-.J. J.~lJu::/--6~ .
, Signa - C license!t.lo. te
(Name)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS I:l ENERGY DATA I:l
PILING LOGS I:l PERCOLATION TESTS I:l
PLANS & SPECS I:l SETS
SURVEY I:l COPIES
PLOT PLAN I:l
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~. nr'"'\
USE OF BUILDING ~
~FII-
TYPE OF CONSTRUCTION: I 11 111 IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward ...................;:
ParK Support Fee ........................... $ R 5t' ot::J
SAC .........................................$~.~
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .:............ ........... $_
Meter Horn ................................... It
Permit Fee ................................... $
Plan Chec' Fee ............................. $~~ .'=to
35" .50
70'-o.oe:.
Slate Surcharge ............................. !I:
Penalty ....................................... $
This
By
Water Tap ................................... <!'
Builder's Deposit ............................ $~
Other ......................................... .;:
Total Due .............................. $ 5: 7,25. 70
Paid !"i3Z-S ~90 Receipt~o. ~ioo~
Date /cJ'/3'crD By 4It---
This is to certify that the uest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proce~ ~qUested. This document when
er constitutes a temporary CertificaZ~ compliance an lIows const tion to comme e Before cy, a Certif~ Occupancy must be Issued.
t19. ~ /~ / ~~,~
lanner .. Date "any'" " 1
I a') . ClQ
10(') .00
.'!~ . '5'l5
ti: ermlt ...~~,~~i~~.;e~it When ~~o:e:C>
Date 10 -(,. ?r.l'Yl
Water Meter ................................. $~ _
Sewer & Water Connection Fee ........... $ 'L~OtJ .O-e
'7 tV'I . "'''-
-
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
WaterTowerFee ........................... $
Certificate of Occupancy
Issued
24 hour notice for all inspections 447-9850
~~
,
The Cl!'nler of lhe L.ktCountry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CH.ECKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
j/. /
/I(/...: /D/\
7 1-;. 06
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
Denied
Accepted With Corrections
v
Reviewed By:
d~ ~-{.AA-
, .
Date:
'1')/4 /&0
Comments:
f2DILv.\IJ-lI''"t ~ ('- ') ~Wy\ ~'0C!lJLL~r~
~ A- W(2,LL~ o...p () 0 IAJ (:Pl}\U. ~tJ..6ryZ1{\.) :5'L4M..l
_r ~I~~ (l')f!. 4JYvN/NJ)J1.I\ {x0~ C.LA.<..<., ~ ~*.sJ
(_Sc.e- ~1)^
....
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a Rermit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
00 '00/13
White - Building
Canary - Engineering
Pink - Planning
Th<r C"nltr of thl! ukr Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D /c? }..I()kTDIJ
;./7.00
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,
. Accepted
Denied
Reviewed By: GrC\nt Carlson.
Comments: :5p.f'- -l-'ke r't'tJi'.r>e..
/
Accepted With Corrections
Date:
~ 1ft., /a::>
I
$;~e.. ~... "r.iJ..J..j..",.J
..,,+~... ...,.+,'4""
.
,
.5ee a.#a,.~ !!I-tP.,./;s :
3. EI'IH,,,,, ('??hjl'~1
1. ;::;;'11 &;",,/e ..z;,PJ~t!;'DI1 :Z;-t".,.,,,!J',,,, .l. 0..../"'4 ,Pia'!..
, - J
IIf"oJtArf'~ Jj Ero.s-'b-" ~A/rd/ I%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."
~~
o ~.O~3
Thr Crnln or lhr L.b Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI~T
NAME OF APPLICANT
APPLICATION RECEIVED
D. /2. JIoe7VN
-;. /7. GO
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
,<.
Accepted With Corrections
Denied / ? / };:J
Reviewed By: ~vk
Comments:
Date: -I." -I, - ~
~
rJ/A,-/r 'Xl "K~
~..- '. yfc.-c;. . ~<;.. .
~H"""'/
D
7',t... .
"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."
AUG. 8.2000 4:11PM
GENZ RYAN 6513226147
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: H 1(12- ~~"
Address; 1t...J'Iu<::::: "~Y@r-.1nP Jt?f" -ro I
Signature: \A..).a ~ 0-.
--"Legal Description: .Lot "",1"' -;;~ "llcckll!ln<_ F'::.C;ub 'l""I:.:Q~..'~ '>I; \\Pr;~
Site Address: :1tf / z.. I~ A ~ p ('~. ~ .
Building Permit # .PID #
NOTE: This permit ~II not be processed withDut complete Illformation.
FlXTURE UNITS
TlM en......r 1M r...kc COlI...,.
Quantity
\
I
r
2-
[
z.
. .
I Type of FixtUre
I Bath Tub with or without shower
I Dishwasher
I Floor Drain
I Lavatory (bathroom sink) I
I Laundry Tray <1 or 2 compartment sink) I
I Shower Stall I
I Sinks I
I Bar Sink I
I Water Closet (toilet) I
Quantity
,
fL\!
I
NO. 528
P.10/17 ___
FEE SCHEDULE .
Industrial, Commercial & Multi-Family
(1 % of job cost, 539.50 minimum)
Residential. New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
J. Diu.:
Z. Clo,.
l. Y.u...
File
Cl)'
APP_
# (J(J -0 f/!,3
Phone: u,C;-/- U 7_?> -1/44
~l";-rllf"lro;:-~
Type of FiJCture
Rough-lns
~ter Heater
I water Sollner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Checll, PVB)
8ackflow Assembly Test
La'N1'l Sprinkler
Other
5
$
S
$
.50
GRANO TOTAL
"'\1\"
"",-,0 'I' '{:.y\\".
~r~G ~
\eu'.....
This pennit is grtIn[ed. upon the e,"pre:ss l:ondittClR that said
cOnlrUCtor, shall .ornp~f= ...,'rh rhe ordillllllces
of rhe S",.. Plumbin~ e illIlcndmen.. thereof.
. RE '. .II.1'/~OAn;
. ATTEST
Call for all inspe~oDS 24 hours in advlIDce.
16200 Eagle CreekAV. S,E., Prior Lake, Minneso~ 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245
An Equo1 Opportunity Employer
Lot _ Block
Owno"s Name
Model Size
CITY OF PRIOR LAKE Me
16200 Eagle ereekAv. S.E. Perm~No. 00 -0893
Prior lIIke, MN 55372
IYPE OF STRUCTURj;
I_It..
LG....
3. Yet,-
'"
lD
OJ
"Ie .+
a.,. <D
""""''<
Addition
LAvL fh ;11'4 flr>>.L.'
Conn. Load
Fuel ~Auo SIze
HEATING APPLICATION I PERMIT
Oalo .;J.I:J.j.D..J P ID .
Sft. Addr.... 5/.fI).. ~M"" fh#~ "AI,) A,,,,/L.
Addl.SS
H.a1ingContradol ALLIED FIBHSIDE dba FIRESIDE CORNEll
Add"s, 2700 N. FAIRVIl!Il. ROSEVILLR. MN 55113
Telllphono' _ 651-633-2561
l'tREPLACE k
lJWnt.o t.4aka & Mod.1 k. I.r;J r.;c..
, .
SL. 7JO'W.
Supplr Openings
R8IUln Openings
Inpul
Edr.
Clm.
All.ralions
OUlpul
.:).~ aD
Single Family
Commercial
."
H
:D
m
'"
H
o
m
n
o
:D
z
m
:D
TYPE OF WORK
Rop1ac8I1l.nl
T-"amilr
Industrial
Mutll-family
Public Oller
F.. Schedule
indus' rial. Commerdal & Mtjll-Famly
Resldenlial, Heell"1l & AC
Residenlial, Heating Only
Residenllal. Gas Fireplace
Residen6al, Addhiona & A1lerations
Residential, A.C Only
1 % of Job colli ($38.50 minimum)
$99.50
$64.50
$39.50
$39.60
139.50
RllI11ember 10 lIdd Ih. SlaIe Su",""rqe on the boIlom '" !hill 8ppIcetion.
'"
'"
TYPE OF SYSTEM
Warm Air Planls _
Gravily .
Mechanical
AIr Conditioning
V.nL Sr".m
HEATING OR POWEll PLANT
Sleem .
Hal Walar
RadleUon
Special D.vices
Th. ",Jee of )'lXIr heating permillncludes """ rough.in ond one ""'lnspeclion. ~
w
I\ddiliooallnspecllons will be blhd at $35.00 ellCh. a>
a>
House Healing Tesl Record muS! be submitled Wllh IlIIilllilg I!ImIIIIlIIIDllIt: belore bu .~
!ng clJrtlticale 01 occupancy wi. be Issued.
tl!;AI CALCULATIONS REQUIRED w.h II.Imber oIlUpply .00 mum openings Ilsled
'oom wiIh CFM'. pe' Ilp8Iling. NIIW .II""Iu.... or addiIionc _11oo, pian ..." ...,.",
and ""um locations Ilhown. HEAT LOSS CALCULATIONS, MVMENT AND
APPUCIUlONS MAY BEMAILEDroTHECITYOFPRlORlAKE.l1l2OO EAGlE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
cny Hall busll14lss hours are 8 ..m. - .4::10 p.m.
."
lD
C'
....
.
a
~
Other Devices
,
ALL WOIIK MUST BE INSPECTED (ROUGH-IN AND FINAl). CALL CITY HAl!.
Haw Construclion
)c
..
w
a
"
I hereby epply lor a mechanical syslems permil and ., acknowledge thai the .":
infcirrnalion above is complellJ end accurale; lhallhe work will be in con/orrnanc
wilh Ihe ordinances and codes of Ih. aly and with Ihe slale bulldingfmecha"lc
codes; Ihal1his 'orm does nOI become a permit until signed by the BUILDIN,
OFFICIAL.; lhal Ihe work will be in accordance with Ihe approved plan in Ihe
case o'-aN work which requires review and approval of plane.
441-4230
Repair
Es\. Comp. Dale
I j Of) ro Buftding Permit ,
~
Esl. Cos! S
HEATlNG PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
r PA\O Wrm...
eU\\.O\NG ~~.....;1"
:JI7/iJ/
j-[:.D ~ i]me
"
OJ
<C
lD
Receipt ,
Bufkfrlf!aIS Sll/llRtwe
Dele
HEAnNG APPLICATION I PERMIT
Date. 1\ IlJi I b 0 _ PID II ..2 ("' -1!;; 1~J O/J - /)..
SileAddrllSS 54-ll.i;,14,ICS,II..ll"g,/q ~wn mmdb\IJ C,LYve. ~
lot .;Z Block?--. ~n r ee~-.ri c/J...
Owner's Name V Q. rlnr 1-011
Address ~ WQSliu'lC1f'01'lTlv1Jtb4 ,fatw1 MN 5Sni
Heatfrg Contractor Fr.aL.r'lk~1 UftliUur J
Address 3i&'SD. !:IiJ'll'l[bfL'j)V -i?/ r:!.lll'rlJ1 MN 55l12-
Tele~hone' ~ Jo51-l/.5~_~1115 J
Furnace Make & Model fUu~ TYPE OF SYSTEM
'Ii! ~ t'J . VA / Warm Air Plants
Model Size .7 0 J /YVt/o;Z)/ 0 70 Gravity
C n Load 27. f'Y? Mechanical
on . , . Air Canditioning ::z. --rrJ""~~
Fuel /11M' FlueSize ~//a4-:rJ VenLSystem ;l-$1:>4r""'~
/3 -- HEATING OR POWEll PLANT
Steam
HoIWater
Radiation
Special Devices
Supply Openings
Relurn Openings
Inpur 71:>.0.00
Edr.
Clm.
A/;2J9
~ '
A~erallons
Repair
Est Cost $
HEATING PERMIT FEE$
STATE SURCHARGE $
TOTAL PERMIT FEES $
CITY OF PRIOR LAKE Me _ S
16200 Eagle Creek Av. S.E. Permit No. 0 .8:f
Prior Lake, MN 5.5372
/?
1/
Oulput flJ dO c::>
Other De"ices
TYPE OF WORK
Re~lacemenl
Est. Comp. Dat.
~
New Construction
.3 OOeJ/--
Bui(ding Perm~ ,
.50
PAID WITH
BUILDING PERMIT
Receipl II
TYPE OF STRUCTUR~
tAIlk
2. Circe.
3. YeUew
,
,
,
,
.
.
Fie
Clly
0.._
Single Family
Commercial
v
Two-FomBy
Industrial
Multi.Family
Pubic
Other
.
,
f.
Fee Schedule
,
,
Induslriel, Commercial & Mulll.Family
Residential, Hearing & AC
::~:..;o..~..~ Heating Only
Residential, Gas F'treplace
Residential, Additions & Alterations
Residential. AC Only
,
c
l%'of job cost ($39.50 minimum)
$99.50 PLEASE NOTE: ~
$64.50 Air Conditioner Units Canm c
$39.50 Encroach Into Required Side ~
$39.5C Yard Setbacks. ~
S39.5C ~ NOV 8 2lXXl, ~
I' ,. .
Jl!:V
Remember to add the Stale Surcharge on lI1e bottom oll~appl""';M
I
The price of yo.. heating permit includes one rough-in and one final inspection.
Additional inspections wUl be b~led al $35.00 each.
House Healing Tesl Record musl be submitted wilh buildino /lIIlI!iI numbe~ before build.
ing certificate of occupancy wili be issued.
IiEAI CAI CUlATlONS REOUIRED wilh number of supply and relurn openings listed per
room with CFM's per opening. Now structures or addUions send floor.plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED 10 THE CITY OF PRIOR uwey162QO ~G.LE
CREEK AVE. S.E. PRIOR LAKE, MN 55372. - ~ aJ.AJ
. . 0
CIIy HaM business hours are 8 a.m. - 4:30 p.m.----___ ,,,j:
'_C/.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND F1NAL)-.cAi;L-ClIYJiALL
----.,
447~
~
.
.
.
c
~
~
~
.
c
~
,.
>
:>
"
I hereby apply for a mechanical systems permil and I acknowledge that lhe
information above is complete and accurale; that the work will be in conformance
with the ordinances and codes of the city and wilh the state buildingfmechanical
codas; thai this form does not become a pBrmit untii signed by lhe BUILDING
OFFICIAL; that the work will he in liccordance with the approved plan in the
case of all work which requires revIew and approval 01 plans.
/Jh,; ./t!', r~ "?~::;:.~ /c/.:z?/I>O
/. .r APJlIiC8I1rs Signature ~ . 'Date
ex--- /(-4 ~O
BUilding OlfiGtil's Signature Dale
~
c
c
....
PL. FA;t 447- 4248'
PRIOR LAKE
DEPARTMENT OF
BUILDING AND INSPECTION
INSPE~JI~NH1~~RD
SITE ADDRESS M~~ t1~ ()IA;\- '<~. R.lJ.,._~
NATURE OF WORK ...1kw U
USE OF BUILDING SFA
PERMIT NO. Of). O?;qCS DATE ISSUED 1C'l-(p-2tx:o
CONTRACTOR :OR ~ (,,5"1-:(5C.- "7lcP3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING ~/~ ff=h 1/0/1 ~ I tn:l
I FOUNDATION (Prior to Backfill) ~VI ~ It; /~/irb I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER/WATER/SEPTIC ~ U.c,.. 6:,.. 10/;; 7//)'6
FRAMING fu-,
INSULATION t/J;ri
ELECTRICAL
PLUMBING~ U.& ~) )/!.;ft ~, . P(EJ3/f) I ,
HEATING {ifrequired){h. ~ ~'/j-?If1&'l; 1{!t,I61> c;q., ;;1.J!:f../N Iff' ;/4DI
FIREPLACE . .;./ 1"/01 ~, 3{r5J, I
GAS LINE AIR TEST ~~ P.P. tk-, d;kllor ,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I W.~B~ 9~ 4, .$/~/ I
FINALS
NfJlPb
4!J- ~/OI I ? b
3/~rDI
3/Mo/
GRADING (Prior to Sodding)
BUILDINGTLO.-tJ.Q 'is'lf YIll( m..
ELECTRICAL
PLUMBING
HEATING
-
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
q~ 1;),~()3--
q~/d<;)""
6n
~,,,
1/ft/of
fY~~/d /
BEEN SIGNED
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have b~en .a~proved. 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
~.~.~~~ -.-~..
~.,.......",.."'......
'. ..;J.'b. r.t ;;;--. t", ,of; '~~":,:'.Io; '''':''11\: i"'" ';...,,,,".
~','''-=~~''~'-~--';''C ,. ".'
i~..1 QLtrtifiralt' of '(0rmpanry
~t'l ell i OF PRIOR LAKE
~t~ I jDtpartmtnt of .uilbing Jn~ptction
(1;:01 fitJ Final Permitted 0 Conditional C.O. Expires
(~' I 1\
( ,,1 This Certificate issued pursuant to the requirements of Section 307 of the Unifonn Building Code
(. Ji,. certifying that at the time of issuance tliis structure was in compliance with the various ordinances of the
~~.~...~..~.~ :~::::'~~::::::::;"",,"'" M ~ FM ':;:::.:. oo-"~
..,' , Occupancy Type . Type Construction Fire Zone Zoning District
~';....~..i
(~~,
(~
t~
k"
r:.
~,.
I
Legal Description
LOT 2, BLOCK 2, DEERFIELD THIRD ADDITION
Owner of Building ~iteAddress 5412 FAWM MEADOW CURVE
Contnctor',Name&Addre!' DR HORTON, 3459 WASHINGTON DR., SUITE 204, EAGAN 55122
Date:
ROBERT D. HUTCHINS /,',i;
Building OffiCial I '
q - 1..-1& . 0 ?-
Date:
City Planner
DON RYE
POST IN A CONSPICUOUS PLACE
,.....
---
AOOR ESS (../,.
OCCUPANT
HEAT LOSS
SOLD BY
Electrical Work By .
TYPE OF HEAT
HOUSE HEATING TEST RECORD
JOB #
/-.
,/"
APT._FLOOR CITY
'1WNER
~UBURB
DATE HTG. INST. C
_INSTALLED BY
, . I";aS Line By
GA _ FA ~HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
CONVERSION
GAS DESIGN
MAKE ;I ,f"
Model "'I~:'~'#.4'I/ "" ,">/// /"
Serial (111:-'/ '/(,. /'(j~
INPUT _ .h
THERMOSTAT
Valve
Limit
Limit Setting_
Fan Setting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing _
L.W. Cut Off
Pressure
Input CFH
Stack Temp. _
Form 235
MAKE OF BURNER
Mod.1
Max. STU Ro'inr'
MAKE OF FURNACF
Mod.1
CONTROLS
- Heat Plug _
Vent Size
KIND OF LINER
Draft Hood
Filters
SIZF _NONE.
ReguloTor i If/( J
Numbe,
Inside 'lutsid.
Size_ .
Chimney Location
Chimney Construction
i I i j
i / '.
Smoke Bomb _
Draft
_Wiring
Test Tag
L igh.ing Inst
Door Pres sur. .
Percent CO2
_ Percent 0
_ Percent CO'"
Dot. Tested
Compony Testing Frecleric~son Heating & AIC, 3650 Kennebec Dr., Eagan, MN 55122
Nome of Test.r ./
,
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
5 '-/1 2.-
SCHEDULED '-Illo/at "'f; 30
~ 1Y1~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
() - C}93
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
1?z:r ,
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Inspector:
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIllE
SCHEDULED C;-/;;J-;;Z
7darn >>tJUt~;f20
~
PERMIT NO. iJo - pq 3 cf- fi9 C)-
ADDRESS
--.5 /fI;;, 15-11.,
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~f-T
,/ Jfr' /)
l//( /L.-
V(" _/,,-/ I
I J () ,) "'--'
~
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ h Owner/Contr:
l-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
"""'"'
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
4.23.0/1:15
ADDRESS 54/2- - 54/8 H1W AI
OWNER
CONTR.
PHONE NO.
CJU - t?:>y.:s( eJ<i <1-
PERMIT NO. P3 "IS. f'3 <1 b
,
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINA~
;P(MECH FINAL '<LS/
COMMENTS:"jt.f!?-@J .Let A.c:.., ~
~qf'l- (iJ ~ A..~, ~
54/~~ ~.~ A,r, I~
541i' I At ,4., c. ~ (flu ~~
~'U.J i.~_ 0 ~ ~ tlJ"_~
p~ V -....I",.. AAr-Pn . U
~ d ~,,_'6_ "/'''~ ",.... ~ iJ - - ~ '1-0
~ .:d~'
('4)) ~ ~ w....-J ~ ~~ .
~ ) r~ ~ ,"""':cJ b; ~~
~~ J4..t--yQ ~ ('< (70 -.r-'
~~ ~ (~J.1
u. ,
~.-r"-">!_" - ~ "
(" T.~:-b. - PI I/O f-~~
~ ~ c-~'~___'~-'
~ f2e..~:"J - 5'fN 5'f1h g:;4,'?
! /
o FOOTING
o FOUNOATION
o FRAMING if
o INSULATION
FINAL
hSITE INSPEC N
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o WORK SATISFACTORY. PROCEED
Jiil' CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~,
Owner/Contr:
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl