HomeMy WebLinkAboutBuilding Permit 00-1036
~~
OATl=Rl=r:!:Wr=n.
JI.2o.OO
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
licant
Permit No.
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS
/7,,;?-Y,6 ~A-A.o ~/I/~ ~
3. LEGAL DESCRIPTION
1. DATE
,//-,? -PO
R/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
.3
BLOCK
..;?~
/
PID Zr=:;-677-0n-z.,-Q
13. TYPE OF CONSTRUCTION
ADDITION V.i&;Z~~,,&:V~
14. OWNER (Name)
15. ARCHITECT (Name)
6. BUILDER (Name)
to."'{. .JsroAfr<?;1/, ~
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
(Address) (Tel. No.)
.,,-y~yAv~~ ~ ~ d?~'1t'
~.;n/V ~/;;?,;;! 6S/-....~- 7/$";
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New construction}l
Chimney LJ Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished information on this application which is 10 the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can revoke this ~ for just cause. Furthermore, I hereby agree thai the city official or a designee may enter upon the property to perform needed inspections.
X ~~ Signature~ c;Jfde?eJ~~~ .....:/~;PO
Fireplace CJ
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNAL~
,~~~~
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
.,OJ<
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA [)
PILING LOGS [) PERCOLATION TESTS CJ
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
S~A
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~'5j ~. 0.-"
PLANS & SPECS CJ
SURVEY CJ
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $ ~ 'i"'Cl .l!)G
SAC ......................................... $-1,.1 00 .t:1 0
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
'illS!... en
~. I/O
i.I'7.so
Pressure Reducer .......................... $
<:6.^c>
Issued
Meter Horn ................................... $
Wate' Mete' ................................. $_JZ5. 0 lL
Sewer & WalerConnection Fee ........... $ '6:l t}l!) .15JI'
WaterTowerFee ........................... $ "7 on 6 ~
Water Tap ................................... $
Builder's Deposit ............................ ~ - 0 -
Other ......................................... $
Total Due .............................. $4/5.. So 4f)
Paid Receipt No.
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Date
By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when
Sign~nner constitutes a temporary Cert!~ca~ of Zonin}J complian~d .allows con. st~n to c;lmmence. Befe. fe oM-Certificate of ~pancy m~t be i~ed. k\.
~ _I~M. >>2..7 /l9O ~'te.L"r'lO tJ~~ \r ~-'- ,,~ .'AQ ~
...... city Planner Date - Special Conditions ff any
24 hour notice for aU inspections 447-9850
'3~~
00 - I D3 (0
Thf Cfnlerof lhe I..keCounll'}'
White . Building
Canary .. Engineering
Pink .. Planning
,BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D p, /It;,,'71.'1\,/
J/2-r:..C)
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7 '7 /11/., L )/.' ~;-:-
/- '-r Lt uF.~ F, l/ ;..:-; /..: 7 _ / /./1<::: . ~....: C' .
Accepted V Accepted With Corrections
Denied
Reviewed By: ~ ~ANJ
Date:
/,l!2-UcQIl
~-'c~Ie.L~ \k, ~ (' ~yt:'tM~ t9f:
{Jt{J,eJ ~ 0f&~~ ~U
~r;:- t-Bo/\. .
"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..
~1
00 -ID3(P
Thr <:~.nlfr of lh. L.kr Countl')'
White - Building
Canary - Engineering
Pink - Planning
WILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D12. Ifo~ /O^/
I J. z - () 0
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7L4r;, J::)bl-:JZF/F;J~{) 0/2. S E;
- .
Accepted Y
Accepted With Corrections
Comments:
Denied (~/Xl f
Reviewed By:~~
/'
Su- 172l{Z DDO"r.~
Date: ( / - ('3- a.....;.....,
4:1
\f1"-c I ~J2ac.s; ~ru.o Zk
"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 -( D3 ~
Thr CrnlC'r of lhe Lakr COUnl'1'
White - Building
Canary -Engineering
Pink - Planning
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTME~T CHECKLIST
. . I
D.p. Ht)/277JA)
//.2-00
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/77-4&
-/
/)6F-PTIF;7 _f)
0/2. Sf:.
Accepted
Accepted With Corrections
Denied
ILL Date.. J 1- ,13 _rYl
Reviewed By: _ lA./
Comments: ~ /JJ/lJ//) 5.hccl n;e Gm/7?G'7/73
"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."
Fuel
'.0'< . '_Vl/~ CITY OF PRIOR LAKE
o 7 ~
Ib~~ 16200 Eagle CreekAv. 5_E. Permit No. 00 - I 03 ~
.... Prior Lake, MN 5.5372
. . HEAnNG APPUCATlON I PERMIT
1\"" .1 ~
vi.L- CI .
. (\-
Site Address i12.% DtLvtle_ld n v-
Lot ~ BIDck --1- Addition
Owner's Nama ./')12-. Ht> (fl. n
Address ~t51 W(L<;,hwwdUl'Ll)fit21A fC1tjQf)
~.. ~J' ,'. '
'\'ll.", f~j)"I'lI.iV1.'- ( -'
Healing Contractor Ii. \A.vv'U It b...LA' <!lL " t Il 0,-
Address ~SO . K.u'JfitbttUI,.:J:I;.f f51Nln f'vlJ\J rJC:jr2~L
T elephon" L!0J i L/<52 - L 175 J
FUrrlllC8 Make & Modal . &rvV!J:JJ TYPE OF SYSTEM The priee of your healing permit indudes o"e rough-in and one linal inspection.
'1' A iJ VI \ II. _ ,/~.., ". Warm Air Plants
Modai Size .')y., iNn tJ L II v I U Grallity . AcIdilional inspections wil be billed at $35.00 each.
Conn. lDad -.1../ c:; L!0 MeChani~l: u., ~ J., ~ouse Haaling Test Record must be submitted with blIiImmIlWlI!iI ~ before buHd-
.. till' i B Air ConditlOnmg "Vuw'1f- L- '"'1-. Ing eer1ilica1e of occupancy will be issued.
fJC\ -r Rue Size '1 (AUSS Vent. System 1..-5'fJ(r;-~1L J1.tItJ FiU1S
. l:IEAI CALCULATIONS REQUIRED with number 01 supply and relUm openings rlSted per
8 HEATING OR POWER PLANT room w~h CFM's per opening. New struclures Of eddilions send floor plan with supply
4. Steam and I8fUm localions shown. HEAT LOSS CALCULATIONS, PAYMENT AND
. I-lotWaler APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
Radiation CREEK AVE. S.E. PRIOR LAKE, MN 55372.
Special Devices
TYPE OF STRUCTURE
J..P.i1lk
~ en...
J. YdlII...
F;lo
Oty
c..ttac1Dr
,
,
,
.
.
.
Shgle Family
Two-Family
Industrial
Multi-FamIly
z.----
Date
"10 II
Commercial
Public
Other
.
c
"
Fee Schedule
.
.
Indusfriaj, Co.." ,,",";~I & Multi-Family
Residential, HeaIi'lg & AC
. Resi~ential, Heamg Only
IvVJ 5:!122Residential, Gas FlfllJllace
Residential, Add"lIions & Alterations
Residenlial. AC Only
Remember to add the State Surcharge on !he bottom 01 this application.
1%.01 job cost (SS9.50 minimum)
$99.50 PLEASE NOTE: ~
$64.50 Air Conditioner Units Canm c
$39.50 Encroach Into ReqtIired Side ~
~
S39.5C Yard Setbacks. ~
$39.& ~
~
'"
.
c
("
~
~
~
Supply Openings
c:
..
Clm.
() I'"..
DL-L/
Other Devices
CIIy Hall business hours are S a.m. - 4:30 p.m.
.,
'"
~
c:
'"
..
..
~
Return Openings
Input I D. bC, [>
OUlplll 5/.(', {)OC;
Edr.
TYPE OF WORK
ALl WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447-9850
Repair
Est. Comp. Date
Bu,lding Perm. # .
() 0 - /03 (p
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; Ihatthe work will be in conformance
with the ordinanC<ls and coaes of the city and with the state buDding/mechanical
codes; thai this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with !he approved plan in the
case of all work which requires review and approval 01 pians.
A" lJ"iA 1Jfnrr__JLJUtUv [Miff:,)
~Pljcar;m1L
Building O"fal'S Signature
~
2- zjrO I
A~eralions
Replacement
New Construction v
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
PAID '/'J\.\H
R . eU\\..O\NGr'c.;-;""
seepf #\
Date
~
e
e
....
PL. FA){ 447- 424S-
'"
o
o
~
'"
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o
CITY OF PRIOR LAKE MC
16200EBgleCreekAv.S.E, Ps/milN...W- I 1:>31::>
Prior lake, MN 55372
'"
Dale
m
'"
~
N
..
~ I
~_m~
~-,
FIRESIDE dba FIRESIDE CORNER
ROSEVILLE. MN 55113
Add,...
'"
"'
z
'"
o
l)
TYPEOF"I",m
WallO Air Plants
Gravity
Me<:hanicaJ
Air Conditioning
Vent SrSlam
HEAlING OR POWER PLANT
Sleam
Hal Walsr
Radialion
Special Oevice.
"'
'"
H Conn. load
"'
~ fusl ~ Flue saa
"'
~
m
m
m
SUPl'ly Openings
Relum Openings
lnpUI OuIpul ~DlD
Edr.
OthGr OGvlcGS
M
M
'"
Clm.
~
'"
'"
TYPEOFWORK
\--
'"
o
AfteraUon.
Rsplacemsnl New ConsIJuction
'-fInol
M
~
Repalr
Esl Cost $
Est Comp. Dais
II 00. .:b
,
~
o
o
N
BuDding PSlm~ W
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
RllCSpl #
o
M
.50
.
PAID WITH
BUI\.DING r-c;.m"llT
'"
0:
:c
TYPE OF STRUCTURE
L Pifll:
1.......
!. fdhno
Ak
01,
c___
Single Family
Commercial
Two.Famlly
Incluslrlal
Mum.FemIlr
Pub6c OVlsr
Fee Scheduls
InduslrjOl!. Commerclall!.. Multi-Fam~y
Residenlial, HeaUng & AC
Residential, HealH1g Only
Residential, Gas Fireplace
Re&iclential, Additions & A1lll{atlons
Residelltial, AC Only
1 % 01 lob COSlj$39.50 minimum)
$99.50
$64-50
$39.50
$39.50
$39-!iU
Remembe/lo add the Slale Swclwge on the bouom oIlhfs "Ppncalion.
The pri"" 01 your healing petmlllncludes one rough-il and one IIna! inspectiolL
AddiUonOl! inspeclions will be b~1ed al $35.00 nch.
House Healing Tesl Record Illusl be Sl.t>milted wilh I!l!ii!irm 1!mIllil~ balme buld.
ing CBrtirlCata 0/ 0CCIIpaIJC)I will be issued.
HEAT !lAlCULATlONS REQUIRED Wllh number 01 supply GOO noIum openings listed pe
roOm with CFM's por opohlng. N.... slruclures 01 adatlions send IIoor plan with supply
and telurn ("call""" ehown. HEAT lOSS CALCUlATIOns, PAYMENT AND
APPLICATIONS MAY BE MAIlED m ltIE CITY OF PRIOR LAKE. 162.00 EAGLE
CREEK AVE. S.E. PRIOR U\KE, MN 55372..
City Hatl buslnoss houre are 8 "10. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND ANAl) - CAll CfTY HAlL
447 -423Q
I hereby IIpply lor a mechanical syslems permll and I acknowledge lhlllthe
In'ormation above is complele and accurate; Ihalthe work will be In co"folmance
wllh Ihs o,djnanoes and cades ollhe clly snd wilh the stale building/mechanical
cede.; thai this 'arm does not become a. pelmil unlil signed by the BUILDING
OFFICIAl; lhallhe work will be in aceD/dance with the ""pro.....d plan In III..
ca~::ork which requires rev,ew and s.pproval of plana.
11~ .il-3J/{)I
AppliClllll's 5ig~ . / Oltla
. ~ Lj-J-- /
Iluijdinll Onica!".. SlgnalU1lI Dale
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor .Draln
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stsil
Sinks
Bar Sink
Water Closet (toilet)
JAN. 9.2001 12:37PM
,.... Cnll'" '! lilt ....II! C.umrr
QlIBn!lty
._,
,:1
GENZ RYAN 6513226147
NO. 225
P.13
CITY OF PRIOR LAKE ~:: ~
3. Y_ Appli_
PLUMBING PERM" # ()()-/03to'
Applicant: C ":"lI11f12..- ", ...., "., Phone~2.~-1 (4 4
, Address: .l~:r..I~,~ .p;"/a:i:r r"J~ flr:J:.I,rrd, I...,r.~ .
Signature: .J.b.JU, ~ L I
L.egal Deer;rlption: L.a! ~. 810ck \ SUb~~Q ?~
Site Addreu:~ ''''"..u.I.~ ~t:.I D ~ 51='-
Building Permit #I ..PID #'
NOTE: Th'- permit w,i11 ~at be precessed without complete information.
FIXTURE UNITS
. ,
Quantity
Type of FlXlure
RQugh'ina
Water Heater
Water Soflnet
I
,
,.
Stand Pipe (washing maphinl!)
Sewage Ejector. . ,
BacJc/klw Assembly (RPz. Cauble Chllck, PVB)
ElackflQW Assembly Test
Lawn Sprinkler
Other
. FEE SCHEDULE;
... . industrial. Commercial & Multl,Family
('~ of job QQlI, $39.50 minimum)
Fleaidenl1al, New One & Two Family
Residential, Additions & Alterations
Stale Surcharge
. . ~
,to..",
,
,"-""
$
$
$
$
"
-i
$99..50
$39.50
GRAND TOTAL.
$
150
. '1M
; PAID W~~""N\I-r
. \\\;.O\N~ .
t)u. .
,
This pe""lt i. granted updn the exp..... ooDdition that ..Id
eODtrlCtor, .lWI eomply 'n 011 r: pa<1I willi ClIo anlina_.
o~ CII. S..~ Plumbi"1 .;.CIldme9; thereof.
~ -q -V DATH
A 'I'T'IlST
Call for all inspec' n5 24 hours in advl,nr:e.
.,
16200 Eagle Creek Av. S,E.. Prier Lake. Minnesota 55372/ Ph. (612)447-4230 I FAX (612)447-42~5
, AD Equal Oppartunily Employer
JAN. 29. 2001 12:32PM
GENZ RYAN 6513226147
NO. 037
P.12/13
_......
n:uDW.~
__ . CIT,
CITY OF PRIOR LAD: NO. 00 -( 03h
SEWER AND WATER P~RMIT
NOTE: Sewer and Water
contractors must
be reqistered
with the city.
APPLICANT:J:l.....V1.:;>.- ~." Ph..lIl't1'oIL>r.- u.n>n...)('~ PHONE:j.,6I-I.,j.2.~-I'~
ADDRESS: 1&.I'l.iE:.s.y~..p'''''':''n-r 'f -r:, t(r...t.nm,.".r ~s-C<Jit DATE: II~ If) I
SIGNATURE: u.. .x ~ - BLDG. PERMIT # OIl~LQ3rc
SITE ADDRESS: \17_\..1.\1"1 ~ \ 'l2P. !(-Bn (\~ \ ,,--'I PIDtt
1.
Estimated length
of water service
,I
I
FILL IN THE BLANKS
40'
feet.
z.
3 .
Size of water service
inch(esl.
Location of any couplinqs trom s~ructure
feet.
4. Type of sewer pipe. ABS PVC ~ Cast Iron
5. Estimated length of sewer line~1 feet.
6. Clean out (if requiredl. located at feet from
structure.
~-~===~-~=======-====WE--======~=--------------=-------------==
Thi~ application bJi~ our permit wnen approved.
BY ./j )lL DATE: 7/1 4- -() 1
=~----==--=======Jj"=~=----------=",,.._~--==--_._- -.------======-==
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharqe
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued. WITH
PAID c'-RMI1'
DATE PAID AMOUNT PAID ....e1J}LOING..1:o '
RECEIPT 11
REC'O BY
. 4629 Dakota Sr. S.E., Prior Lake. Mlnnl!Sota 55372 I Ph. (612) 4474230 I Fax (612) 4474245
AN EQUAL OPpORruNrI"f ~ltlVElI
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS P721.4l. C)..o,..~;~\.& Or-
NATURE OF WORK ~1
USE OF BUILDING ~ r:=A
PERMIT NO. ()n. - /O:;5&J DATE ISSUED 11-13 - '2.<::>00
CONTRACTOR j')....r-~-c-lcJ c.S7 - .25"'-- 7/3<"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING I b:t.INSPECTOR I 1/'5/ ;;E
. - .
I FOUNDATION {Prior to Backfill)r~.,.w. I~, 1/12. ( 6 I I h. I / I ~ I b I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER / WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING /...fr, U.I:t. ~,JfZO{CI
HEATING (if required)
FIREPLACE .
GAS LINE AIR TEST ~
~t\
4holo/
1/1 (/"'1
'i~ -~;;. 1/'1/01
't, t~~ .
'il u- ~\l /1)10
~ ~/JdID/
/1
~--c~:::z /.
._-<-:/ ~)'t'(
LO ~1.
.
. .
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1#~ tfJq. I J.Is/o/ ~. )!Jp/OJ fu-. 5/2-8/01
. ,
FINALS
V/tta; 14
GRADING (Prior to Sodding)
BUILDING T.C.o.-ci.U q II f5/6/
ELECTRICAL
PLUMBING
HEATING
DO NOT
~. -; r &jIb I
. 1
~
ffi;r
OCCUPY UNTIL ABOVE
NOTICE
.5/30/0/
7/0; /M
,
HAS 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, card sl;tall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
-
MAKF
Mod.1
Serial
INPUT.
JOB#.
J",,//; ,,/,d
/
.0".
HOUSE HEATING TEST RECORD
SUBURB
DATE HTG. INST. 11-/:-h7
APT. _FLOOR
t'lWNER
CITY _
ADDR ESS / I;) f//
OCCUPANT.
HEAT LOSS.
SOLD BY
Electrical Work By
TYPE OF HEAT
INSTALLED B": ~//;'7 _f;:'
I';oS Line By .
GA_FA_HW _STEAM_SPACE HTR. _UNIT HTR. _OTHER_
/.;; ,;1;/.d ,~GAS DESIGN
~"""Y//A' .
r(( r / /'J,le) t/'..J C'"i.
Sir"O/7'>-'I,',
,~Fcr~1
CONTROLS
THERMOSTAT 1/ ,~//. Heat Plug
Valve _ / I?
Limit
Limit Setting
Fan Setting _
Pilot Type
Pi lot Make _
Pilot Mod.1 _
Pilot Timing
L. W. Cut Off
Pr.ssur~
Input CFH
Stock Temp.
Form 235
/7f'
/~l (~1
/ / ------.
!~ . .
~ / "7 {J (... Percent CO i:, j;
2 ----,.-
Percent O2 .;. I
--/ / P (
} !?' Percent CO
CONVERSION
MAKE OF BURNER
Model
Max. 8TU Rating
MAKE OF FURNACE. /
Mod.1
1/
/1
Vent Size '->
KIND OF LINER SIZE NONF
Draft Hood. Regulator .I:?/ r' --'.-
Fi Iten Size .I /. v.-/ d / Number
Chimney Location !~,sid.. Outside
Chimney Construction ./r, ,.;., /
Smoke Bomb_
o,alt .
Door Pres sur..'
Wiring. 4
Test Tag
Lighting Inst.
v
Dot. T .sted
Company Testing
Name of T.ster _
1/ I j /,-,
Fred7~ Heanng & Ale, 3650 Kennebec Dr., Eagan, MN 55122
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
Ilti.{(.
Of2(~ 12
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FDUNDA TlON
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
(",.}-..d / It y-('<! 5
{
COMMENTS:
--'--
~ ,
( //
u l cIS c
~
---
---~
DATE TIllE
/-J.--o t(
11 ()~/()J (;
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~" \
r,Gt )
/
~~
B-woRK SATISFACTORY, PROCEED
o CORRECT ACTION ANO PROCEED
o CORRECT .~K~ ~ FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Conlr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SIIFETY!
7-1-01
) 7 'J 4~ 'De~e-\i
CITY OF PRIOR LAl5E.
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
DATE
TIME
/0,,3,0
() -ID.Zk
o FOOTING 0 PLUMBING RI
o FOUNDATION @ 0 MECH RI
o FRAMING r1 0 WATER HOOKUP
r::l)NSULATION '" 0 SEWER HOOKUP
.l: FINAL m 0 PLUMBING FINAL
o SITE INSPECTION 1(!5J 'Jil MECH FINAL
COMMENTS:
ti'I ~ ~ ~ffi rJV'- ~ ~
~ ,~~..f-~
W)...A.-mQ q,~Jk-J l.fJ.A A~r
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
./
'--2,~.n '
-'---...,--...
Cf/ (s: 10--:;
~ ~",JJ
--"".
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
1zy\
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
DATE TIME
SCHEDULED .s . ;}... 9 -0; ,;) i of)
/7d.tj{.,- LQ~ Or
CONTR.U
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
1)-'"' /o3~
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULA nON @ 0 SEWER HOOKUP
o FINAL ,elPLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:(Q JJ-- ~~ -Iv.-tr o-iJ ~,
C4J ~~ ~kL,j:f:'
t^~,~~,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
~ 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.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!