HomeMy WebLinkAboutBuilding Permit 00-0933
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~\,
OATI=ClE:'r-E.IYE.Q
OCT - 4 2000
I
'I
_\.\
DIRECTlONS_. _____
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
14306 Dove Court N.E.
3. LEGAL DESCRIPTION
LOT 9
BLOCK
1
ADDITION
4. OWNER
Knob Hill 5th Addition
(Name)
(Address)
5. ARCHITECT
(Name)
(Address)
6. BUILDER
(Name)
(Address)
1. DATE
10/4/00
I.
2.
3.
File
CilY
Applicant
BUILDING RMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
R- /
115- 3fcX- oOCl.('
12. NO. OF STORI~
-r<..,..,;>O _1~""4
13. TYPE OF CONSTRUCTION .
6Fb ce..faj..,d. Pw...,vi"nfrn.J
14. FL~OR AREAAPPO~
(Tel. No.)
(Tel. No.)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
DeckLJ
i'bJak-F.la:k, In:::., fH57 ZrelarllM;. N., Bro:i<lyn Park, MIl 55445 763-424-4955
SEATS
7. TYPE OF WORK
New constructiO~
Chimney [j Misc.
Finish Attic 0
Septic 0
Addition 0
Fireplace a
Alterations 0
PIO
Rs-roofing 0 Porch a
Re-siding 0 Finish Basement 0
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
1~ PROJECT COSTNALUE
-"'2.2..0, ..q 80
a. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
Sq.Ft. Width Depth Yes No E~t. aI/ZOO I
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 I am the owner or authorized agent for
the abov mentioned roperty 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
buildi ffieial can roe this pe it for jus cause. Furthermore, I hereby agree that the cily official or a desi n? may enter upon the property to Pi~rm J~i :!JOons.
License No. r. , Date
Front
Back
BUILDING DEPARTMENT VALUATION
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS (") ENERGY DATA (")
PILING LOGS LI PERCOLATION TESTS (")
USE OF BUILDING
Sr))
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION . ~O ".-:loCl. C)O
PLANS & SPECS (")
SURVEY (")
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
. Division 1 2 3 4 ~rr
PerTmtFee ................................... $_1. Y . ~
'''\lolo.71
"(}.OO
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
100.00
{ 00 .00
35'.$0
4D .00-
Mechanical Permit Fee ..... ................ $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Thi~Ai~ Becomesj!5wr Building Permit When Approved.
ey f.o-.ll: J]""'-......... Date ID -l'~'7~
(J
Certificate of Occupancy
Issued
City:
~u
PLOT PLAN
o
SETS
COPIES
8S().O~
11100.00
4.I:i.dJ
I';;l.S.OE>
I. () 06 .00
. ,., oCJ .00
L nOO .e>o
~35(J. 4b
~9 t4 /4'--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may pr requested. This document when
sig by the lanner constitutes a temporary Certificate of Zoning comPlian<~ a;ws cp~struction to commence. Before occupan~ca ~ancy must be issued.
.,....... . , . .JDfi~(;<:o _ - V~Jl5L- G--D,f~ \~. r: E"-1f L-
v City Planner Date speclalgndrtiO~s ~ any
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
SA .. $
Pressure Reducer ......f................. $
Meter Horn ... .... ............................ $
Water Meter ................................. $_
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $_
Other ......................................... $
Total Due .............................. $
Paid ~35q.4C:.
Date /0. /IJ. tI1)
24 hour notice for all inspections (952) 447.9850
Ob -oQ3 3
ThtCt'nlt-roflh" LlIkcCOQluty
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT NUM::/.)::' I='jpc 1::'. ~ -.M"~
APPLICATION RECEIVED 10 - Ll- 00
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/'/301::, D() /..JC- (11-" IV E~
/
Accepted
Accepted With Corrections
Denied
Reviewed By:
Gra.n~ .(b.rl<;OI1 Date: /())~/~O
5/rtf's: > 3:/ wd/ 1"'11///,7- .r~/c/'i1!y
oi/er5e Sidf.for dd'tIrMal illtrPltllrmr.
/.Va/!.5 .
Comments:
See. -!-Ill
See 11#t7t'hmfnA : I. Filln! aela?-znYf"t'8tn1 Y;;';;~a;;M<. ;/. r:;/l7~ 17'<4t-
.3 U05tim a/'!Ir~1 Hfl!JIYas" L{ G-~>fM-z a,,~/ PIa.rt ~
"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."
~
~~
00 ,o~ 33
White - Building
Canary - Engineering
Pink - Planning
ThO' ('..n.... of the L.k.. Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CI-IECKLlST
NAME OF APPLICANT J..J omJ::. ;:: /ec.k" r K-.,
APPLICATION RECEIVED /0 - '1'- 00
The Building, Engineering. and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/'13-0b Doue- CJ.;f- N E
Accepted
Accepted With Corrections
Denied
Date: jt; -/s-2cnCJ
Reviewed By:
Comments:
~ d!J (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."
. '~1
OD O~3)
Th~ C..nl..r of lhe L8k.. <:ounlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ;UU,>i! <- ! /-C->( J.:/ L PC
APPLICATION RECEIVED 10... 1/.. tJ-.-21
The Building. Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/Y:!)Ub l/.I- jut:"
Accepted
V'
Accepted With Corrections
Denied
Reviewed By: c;- ~ ~ A'''''''.A.-,
Date:
I~ Ii 3/ &:>
Comments:
~_&J.-Q ~tLY ~/~t.~.Q 4'"
<+7~ ~_ ~'(YL'-~ ~ W.p-~~
-6(~Cc~<f7'E.JP ~..
"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."
...
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S
elTY OF PRIOR LAKE /J? ~
1.2110 Eqfe C....k Av. 8.1. Permit No. () - '1 J J
PrIor LMe, ... 11371
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'110
10
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Ad*_
He.1ng Conlrlllllclr . '~I'rr (') If=> ,
Ad*_a..~J romfN AL-A.?1A (~I vd ^- llA)
,...... ~,-\l()()O
F_MIlk.&Madel f\hr .PA2:) TYfIEOFSYSTEM /
Madel8_ tCJE> q () t :~ AlrP...... v
MecMnlc:ll
CDnn. I.OIld Air CoI1cIIIIonIng v'
Fuel ~~S1z.~I' AXI, V.nl.~ ./
suppt;o 011 ln/lI111 F:J"S HEAlING OR POWER PLANT
n S"",
R81urn C " I Hot W...,
Input~ Ou~(') =-~~
..
...
N
...
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...
...
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...
.
EcIr.
Cfnt.
01'- DM:ee
~
TYPE OF WORK
New ConIInIcIIon
v
TYPE OF STRUCTURE
1._ RIo
Z. _ ClIy
I. _ c.......
SIngle F....,
Commerol8l
,/
_ 1\w-Famil)<
IndullrlIIl
Fee SchecIuIB
Induslrl8l, Commercial" MuIII-Famlty
-enllal. HaaUnq" AC ?
.M, Healing Only
Realdenllal, Gas Finlplace
Rasidentlal. AddUons & Alarallona
ReIId8nlIaI, AC 0nIr
M...-F....,
_ PIIIlIc 0Iher
1% of job cosl ($31.50 minimum)
C:l99~
$84.50
$39.50
$39.50
$39.50
Remllllbar 10 add ... SIal. Sun:haIga 0Il1he boItom oIlhl1 appIlcdon.
Tile prfoe 01 your healing pennllncludes one Rlllgh.1n and one IlnaIlnspscllon.
AdaMortal.... .. ... be b.lICf a"35.OO 8Kh.
House Healing Teal Recont lI)usl be submittad w.Ih lIIdllIIIa IlIDIIIIIIIIdlIJ: balore bull...
Ing -...... 01 oocupancy wi! be lMued.
I:EAI CAlCUlATIONS REQUIRED wIh numbef 01 supply and ralurn opelinga IlsIad per
rt)Dm wlIh CFM's pe' opening. New 8lJuc1ura8 or addiIIon8 ..nll 1Ioor plan wftll8upp1y
and retuII> locations shown. HEIlf LOSS CAlCULATIONS, PAYMENT AND
APPlICATIONS MAY BE MAILED TO THE CITY OF PRIOR lAKE. 18200 EAGLE
CREEK AVE. S.E. PRIOR lAKE, MN 56S7l!.
CIIy Hal buslnen hounI ata e a.m. . 4:30 p.m.
ALL WORK MUST BE INSPECTED (AOIIOH-W AND FINAL) . CALL CITY HALL
447-42JO
AbrtIIona Rap! ,
Rlpelr Eat. Colnp. 0...
EaI.00Ilt-10rfJ.OO Bu"'P.rmU
HEATlGPERtMT FEE' 99.. <:7...)
..
~ 8TATE IlURCHARGE . .50
..
: 'roTAL PEAMIT FEES ./0 0 , 9 ORec~'
C>
I hereby aPPly lor a mechanical syslems permit and I acknllWledge lhat 11I8
information above Is CDIIlpl." ."d accu'ale; lhallha _k will ba In cCHllDlmanc.
wllh lIle ordlnanc.. and codes 01 the city anll wllh Ihe slel. buldlng/mechanlcal
codes; lIlallhla IDrm do.. not become a permit unlll 81gned by the BUILDING
OfFICIAL; lhallha work wI' be In accordanca wllh Ihe approved plan In IIle
V,aCh ,equlraa 'eWIw and approval 01 pl....
PAID WITH ~ ... _~ . . . /0/;;1. (." /C? (;)
BUILDING PERMIT -- ~)l''' Slgnah"e Dale
~ )b-3/-CJO
~g 0IicaI'a SIgnature DBIa
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~
HEATING APPLICATION I PERMIT
Date I? 1<<. lot I ~ PID' 25-3lt:>e; -009-0
SrteAddressI4~~'T
Lot ~ Block I Addrtion Jt:AIoe #/<-'- G?'H
Owne,'s Name ~A't-- n ELt. . ~(,..
Address 14~ ~f... (T . tResidenlial,
Axtcrn~ Residenlial, Additions & Alterations ~~~.or
+iIralIilll Contraclor . ,. "t:::) Residential, AC Only $39.50
AddressCl'2.IO W,,~t--l. LlU::::::d.L'hlL-
Telephone' -:.11o~~1 ~_ D 00 { Remember to add the State Surcharge on the bollom 01 this application.
~rR.e. Make & Model ~~ L TYPE O,F SYSTEM The price of your healing permil includes one rough.in and one final inspection.
Warm Air Plants
Gravity
Mechanical
Air Condrtioning
Vent. System
HEATING OR POWER PLANT
Steam
Hol Water
Radiation
Special Devices
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. Permit No. () () -OC/ 33
Prior Lake, MN 55372 I
Model Size . -;;z, ~ 'P,O'4 i2..
Conn. Load
Fuel
Flue Size
Supply Openings
Return Openings
Input
Output
Edr.
Other D""ic. ~f nlZ.l::!~
~I:li!tc.. \l~-r'
TYPE OF WORK
Clm.
Alterations
Replacement,
New Construction
Repair
Est. Camp. Date
Est. Cosl $
Building Permrt .
tJo - 0933
HEATING PERMIT FEE $
STATE SURCHARGE $
.50
PAID WIi\-\
Receipt. BU\\J)\NG PEf\M\T
TOTAL PERM'T "EES $
TYPE OF STRUCTURE
I. Pink
2. Green
3. Yellow
,...
'"
"-
,...
'"
"-
o
o
File
Cily
ConD'XIDT
Single Family
Two-Family
Multi-Famlty .
Commercial
Industrial
Public
Other
,...
'"
Fee Schedule
,...
o
"
:.-
'"
'"
,...
'"
..,
,...
'"
o
....
o
'"
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Gas Fireplace
1% of job cost ($39.50 minimum)
$99.50
$64.50
Additional inspeclions will be billed at $35.00 each.
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House Heating Test Record must be submilled wilh!lllillliD9ll1111!i!!!YlIIIll:r betore build-
ing cerlificate of occupancy will be issued.
!::!W CALCULATIONS REOUIRED wilh number of supply and return openings listed per
room with CFM's per opening. New structures or addilions send floor plan with supply
and return localions shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR lAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m..4:30 p.m.
ALL WORK M,UST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447-4230
I hereby apply for a mechanical systems permit and I acknowledge thallhe
information above is complete and accurate; thaI the work will be in conformance
with the ordinances and codes of the city and with the slate building/mechanical
codes; that this form does not become a permi until si9ned by the BUILDING
OFFIClI<Cl that Ihe work will be in Hccordance I ,ith the approved plan in the
alllwork which JIlAuires reflew and ap~ oval of Pla;J..i1 '1/k ~
Dale to>
1'2.7-(.O()
Date
BUildinralll"Si9nature
MI.EM . ...e
'YIUOW . ~tCAWT
GOLD. CIT.,
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
NO. CO~ eY133
Sewer and Water
contractors must
be registered
with the City.
APPLICANT:Jh(VYl~,. ('~ PHONE:9.~-q;~~..r7?J.:J
ADDRESS:I5rn\ \'Y'h-Y -:'" ~ '35~S DATE: J/-q-ffi
,
SIGNATURE~bhV2, r1?~O",
SITE ADDRESS :~,\n -::\YWt'... C' a,A Nf
1.
Estimated length of water service
4S-
BLDG. PERMIT #
PID;i;;l5=~- (Xy;-o
:) fL' ,-:~---_
'; L!-': r-..' rr:~ r:'~---_
, e_ ~J..... -~-:' i ;-:' - ". \ /7' r.~ -r .'-.-
'} -.,-'-:-::~-,:~ ->' ::~~ <\
feet. . Nf:N I 3 2fXxJ
FILL IN THE BLANKS
2.
Size of water service
I
inch (es) .
3. Location of any couplings from structure feet.
4. Type of sewer pipe. ABS~ PVC Cast Iron
5. Estimated length of sewer line 4~ feet.
6. Clean out (if required), located at
structure.
feet
from
==================================================================
This application becomes your permit when approved.
B~/)V2 _ rth/Y\r-P.J./\ DATE: / /- C) -(")()
========================== =====================================:;,==
FEES:
$
$
$
35.00
.50
35.50
Sewer and
Surcharge
TOTAL
water line connection perm:t
~Fd bo~-
individually is $20.00 plus
.-
* Fee for either sewer or water
$ .50 surcharge.
*
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 P~.rojts ,are
issued. . ...AILJ WITi..
BUILDING PERlv,.
~
AMOUNT PAID
REC' D BY Q(1
U
DATE PAID //- jl./-cxJ
RECEIPT #
16200 Eagle Creek Av. S.E.. Prior Lake. Minnesota 553721 Ph. (612) 447-4:2301 FAX (612) 447-4245
An Equal OppOnUnil} Employer
t~~
+
1. Blue file
1. Gold Ciry
). Yellow AppliCllDt
PP No. -D.()-f)q 33
APPlican't:'1'n"""F"" U~~"i:- Phone:q5a-9~-/"" 1"1
Address: \ ~\ N'rl ~ ~~~~ L~"\ m"1:Y ^ ~s,:>~.s-
Signature:~M fln _ T ~r.~ '
Legal Description: Lot q Block I
Site Address:~\'" -:l"vIV<" 0^-t. t0C
Building Permit # (JO .- ()Cj33 PID #
NOTE: This permit will not be processed without compiete information.
CITY OF PRIOR LAKE
PLUMBING PERMIT
DIfCtllIrfofUlifl.8kfCounlr,
Quantity
~
I
J
L,
,
~
I
I
4
Sub -K",,.,}-, l.1J15.~ ~
FIXTURE UNITS
Type of Fixture
Quantity
Type of Fixture
Bath Tl{b\~th or wit~o~"Shower
Dishwasher
3-
,
.:l...
I
'."ater EeftRElr ~. I L-
~ I c..r.r "-"c...
Stand Pipe (washing machine)
Sewage Ejector
Rough-ins
Water Heater
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Backflow Assembly (RPZ, Double Check, PV8)
Backflow Assembly Test
Lawn Sprinkler
Other di~,-.L
Sinks
Bar Sink
Water Closet (toilet)
1
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 $.
rr::;:-Y-Z
~r sa> \ 9 cij~
,,\\.. I
:i"\ V
\ 'l \ \. \ u. ___---"', v
..J \,......,_.n
-.
This permit is granted upon the express condition that said
contractor, shall comply fn all respects with the ordinances
of the State Plumbing C the amendments thereof.
___ RE q-/q-O/ DATE
ATTEST
Call for all in ections 24 hours in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 553i2/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opponuniry Employer
"U.. - ....E
'fELLOW . AH'LtCAwr
GOLD. CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
NO. ()()-oQ33
Sewer and Water
contractors must
be registered
with the city.
APPLICAN~()m~ ~,,^-'N'.b\ "-~\ ~h lJ PHONE: 'i.S"d..-<1~~1'ln
ADDRESS: \~,' m:rJt""~""ab~J :~"r~Q~ATE: q-I&-('jl
SIGNATURE~:"""- rO~~ BLDG. PERMIT # fH -oQ33
SITE ADDRESS: I~\" ~~CkM.~ NL PID;
FILL IN THE BLANKS
1. Estimated length of water service
L4S"'
feet.
2. Size of water service
inch(es) .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS PVC~ Cast Iron
5. Estimated length of sewer line 4C feet.
6. Clean out (if required), located at
structure.
feet
from
====================f=============================================
This ~PPlication bec mesd~~~npermit when approved. /
BY ~I>-O...> FOf1~ /OJJJ.J..;..-- DATE: C}-18-01 Cf-/q-Ol
===================, ,===f==============================J========,==
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection perm:t
Surcharge
TOTAL
*
Fee for ~ther sewer or water individually
$ .50 surcharge.
is . S:t "'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 permits are
issued. B Ie -P::.l.M.
DATE PAID ~ ~ 'AMOUNT Fl:tA ~~~1.
B~~~
RECEIPT # REC'D ~
16200 Eagle Creek Av. S.E., Prior Lake. Minnesota 553721 Ph. (612) 447-4230 1 FAX (612) 4-17-4245
An Equal Opportunit)' Employ"
CITY OF PRIOR LAKE ~~~w ~liQDI
PLUMBING PERMIT PP No.QO- 0'133
APplica;;ThOm ""'+\}-v, _ (' O\~ Phone95;l. - 9';',~ - '1'1 n
Address: lsr-.'\\ ;\... -R _K~_ ,-mH I>. ~c:,~4.'\
Signature: ~/o~ "- t1~rLA.
Legal Description: Lot q Block J Sub Krvb ~-5-tlQ
Site Address: 1~\o-<\""'")l'.Vl" ('f~.A- 1-.Jf_
Building Permit # PID # ;,(5- ~ I.,'/?- c..X.YI-O
NOTE: This permit will not be processed without compiete information.
FIXTURE UNITS
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Sacktlow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
~ -~-" '"1'3 _. Other j;_dJ;;c;.~~)
I!Ut~L~J~;i}g~_~ ~l
I ( ,
;i ,; M'N 13200)
\;
n. Ceo,nn of 11M! Lah Coun,ry
Quantity Type of Fixture Quantity
c;L Bath Tub with or without shower .,3,
I Dishwasher 1
J Fioor Drain
.3 Lavatory (bathroom sink) I
! Laundry Tray ~or'compartment sink)
I Shower Stall
I Sinks
Bar Sink
& Water Closet (toilet)
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
Type of Fixture
$
$
$
P~~t
$
.50
GRAND TOTAL $
This permit is granted upon the express condition that said
contractor, shall comply fn all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
- RECEIPT NO -L/ - / Lj..-ct:bA TE
( JA ATITST
Call for all inspections 24 ~rs in advance.
,
PAID WITH
BUILDING PERMIT
.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 4-\7-4230 / FA"X (612) 447-4245
An Equal Opportunity Employer
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS .1430c.., DoV'1i.. QOlJ"\-
NATURE OF WORK tJ"",
USE OF BUILDING s,~~
PERMIT NO. ()().OCJ3 -:s DATE ISSUED 10-17,- z..,.oo
/
CONTRACTOR ~I:.. - 1:"lnk. 7c..~-l{2lf-41515'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
..... INSPECTOR
DATE
'FOOTING I f?). I /~/r? /~
, FOUNDATION (Prior to Backfill) I fp,. I Ii /'j /'0-0
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH -. INS
SEWER I WATER I SEPTIC b+. ,. /~// / th1
FRAMING 1f~IAJiI "'IIf'tr '&V 1~~1 ~ I if z. /0 I
INSULATION .~~. ~ ~((nl/)',
ELECTRICAL
PLUMBING V~..,~ ~.V. . 1~lt11 00 6"'4..0 fiq ~ z/S(bJ
HEATING (ifrequired) 'B ~.\ I ~ I D I . . J?:t. ' J / &f 10 (
FIREPLACE . ~.U l"'.~ M/1~", "
GAS LINE AIR TEST ~ in.' #It I / 9~ I
COVER NO WORK UNTIL ABOVE HAS 'BriEN SIGNED
I""" I I
FINALS
~. 1((~(oJV~
I
J
GRADING (Prior to Sodding)
BUILDING 1.t.O. t~~ '\1,DlnI
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS
NOTICE
~-,I~..()~
/?
/;3;r ,
~
8/tf?1
q /IJ.-IIJ I
BEEN' SIGNED
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, ca".hhll!!-be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
(,-:. ~~"iii"'.ii"i~,,~~~......_~ ~M-.:~ .V......1Il '. ~ >1:- -.~ - ..
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i;' _ .......'. ~~ ~..,...... ~'.;-~__:~T~'.:.:~~~~...'.~' " r.1IIj ""-, .....'.,', ","l;,.'-:~llIIlrlI'."~':"'~~"."~"':""\lAAlI_- ~,
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~.' :. i ~trtifirau at ~rmpanry g;
, CITY OF PRIOR LAKE ~.~
J)tpartmtnt of .uilbing Jnsptttion
~nal Permitted D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various ordi1llJ1lces of the
City of Prior lAke regulating building construction or use. For the following:
Use Classification
SINGLE FAMILY
00-0933
R1
Bldg. Pennil No
N/A
Occuponcy Type
R3
Zoning District
Legal Descriplioo
VN
Type Construction Fire Zone
L9, B1, KNOB HILL FIFTH ADDITION
Owner of Building
14306 DOVE COURT NORTHEAST
55445
-c::,ite Address
Contractor',Namc &Addreo' NOVAK-FLECK , 8857 ZEALAND AVE. N., BROOKLYN PARK
ROBERT D. HUTCHINS[)A
_ City Planner
Building Official
Oa..: 'i'- If)" 01 Da..:
DON RYE
POST IN A CONSPICUOUS PLACE
-
--
INSTALLED BY () ,'- -c - -
\-( "---'--\.....0'\
Gas Line By _
GA _FA ~HW ~_STEAM _SPACE HTR. __UNIT HTR. _OTHER
ADDRESS I~~('jb
OCCUPANT _
HEAT LOSS_
SOLD BY
HOUSE
d-
(hve.
/
DATE HTG. INST.?iOf
Electrical Work By
TYPE OF HEA T
~\ C:i~ I GAS DESIGN
MAKE ~ \\,r
Modol C.()'~I A:\:)
S...lol F~r Ps:r:rPX',ZO<:::7Zl
INPUT leIS. rn 't: /.-0
I L. \ CONTROLS
THERM~TAT f\'-l-J Heat Plug
Valve r1.A \
L;mit r )d\\\,I~
L;ml.s."ln9 1M '" ~
Fan Setting _~~f\.
PHo. Typo OS'L
Pilot Make I hf\\u<:'~(,^
Pilot Model __
Pilot Timing
L.W. Cut Off
"S" .
Pressure "y" tAJ~ <.......-
Inpu' CFH II)';> q--}C)
Stock Tomp. fn7..<-f:::"
~<-
Po,con' C02l~1
Percent O2- .
Percent CO ) c
Form 235
HEATING TEST RECORD
CITY \t~r j~RB
APT._FLOOR
OWNER.
CONVERSION
.MAKE OF BURNER
Model _
Max. BTU Rating
MAKE OF FURNACF
Model _
Vent Size ~{(
KIND OF LINER. SIZE
Draft Hood.. _ReguIQtorll")Q')o<.~\o.\l
Filters Si:ze-'c')(z..~~l_Number
Chimney Location Inside K. Outside
Chlmnoy Con,',"c'lon ft)C' .
NON" -
<:,.-~3JIi1.-
Smoke Bomb
Draft __
Wiring _
Test Tag
Lighting Inst.
Door Pressure
00'0 To,ted R/~/()J
, I fll
Company Testing ,1<_ If' [";c-I
Name of Test.r ~
-
Form # 5
OA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/L./,~olo
SCHEDULED /~~nv
f1nx a,
/():<{~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
()- 93';
o FOOTING ~ 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING !WATER HOOKUP
o INSULATION SEWER HOOKUP
o FINAL . 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ffi (lflu",.. ~
@ p~ .IJ:hJ -,tu(u, ~ 'f-o F:
~.
ftJ f2p'M~ ~ J4~>) I~ I~
t..-tit1 ~ ~ I f-- ~
V
v-
I yl
16~ }-~y"
/\ J) ( "
z.7~~'\;11 :s'i- f..
/"-,
Lf' Nc 1kL, J/tJ ~
sM:- AT; - Jj ~ ().o
I':-rr ~ (I~ ~
~ - r-..J<l t..,.o-;..J:;;, ~
00 Qe,...,L, u'
o WORK SATISFACTORY, PROCEED
)k2 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ,
OWner/Contr:
I
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
3~L I:~
ADDRESS
/4300 DOVE;" 01
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o 0 -0933
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION ~ 0 SEWER HOOKUP
o FINAL ''1!!r PLUMBING FINAL
o SITE INSPECTION r 0- MECH FINAL /J ,
_COMMENTS:tIN ~ /Cfip/ ~ .
(~)) 8uJLI~ ~~ .vA"'? ~.
c!} ~/~ I~. ~~
~V1 Jv.Jr-~, o H"
d' tJ
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
J-f/Jo)
~.
,JJ?JJ;AJ ~k
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WO~LL 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!
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
2'QO/ 7.::u>
ADDRESS
/ 4.~()(1") O() I/F; (IT
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0- q3~
o FOOTING 0 PLUMBING RI 0 EXIGRAD/FILLlNG
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING ~WATERHOOKUP 0 FIREPLACERI
o INSULATION SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL . PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION MECH FINAL 0
COMMENTS:(j] IJI'~J./V ~~ .~~
-i. UL-.q :J..u-.../ ....~;br' ~ ~4
- II -.J
~ ~ :::tn ~~ "~O-'1-~ df ~',"'-' ,
@ 6~,,_!.~ ?fl)~~+:f!/f'~'~, ~."'"'" ....c:.L.:t:tuJ
v.. I gg" e F 1M. yv.'4~ ~ ,
. . ,
6) ,kAl1~ cJ-< ~ df..J~ ~ r.n~ if7-~
.kv!. .~O.A~~ U r/li .~.-1J? J2/~ .
ilh 61.4A1- I/MJ~...zto ~ iJ.
@J!R.J /l(~~~~ fo ~
~OA.1:6; ~o ~,..:...;" . - t-
a;J'~~ (1~.....~ ~ i-o/~~...'1
(V ~ ~IV../a.... d. -;i -'I :; v .
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
)(lCORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~. Owner/Contr:
CALL 4047-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/~3() &
~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
boFINAL
b SITE INSPECTION
DATE TIME
1/; 2-/17/
. ,
9,' CJo
6'-"
00 - 9~3
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
,.. MECH FINAL
COMMENTS: ~, @'}. '&,'7 p~ km I~
1fA~~;:" r~ (~~.
4~~ ~.)
~) ~~ 0 ~..-J - crt!-
~ ~ ;)-~
I,O,Q,
lin
~~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
o--tL- c..-,
,
0,1'30/01
I
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
V
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
OA TE TIME
SCHEDULED
9-/9 ~ I4J11
ADDRESS
1430' PnV'-( c-r
CONTR. _kJ()Irc. It rlq. t
PERMIT NO. 00 ,~.~ 3
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
)(EXlQjj.ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
GY'{I/k - r' /!
Lt J/h ~~ ~ /) I<
5./ /-
)( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:~ ~ ~",f"" ".."""~u,,,,:
-
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI