HomeMy WebLinkAboutBuilding Permit 00-1064
8~~
QAT" """"'V"O CITY OF PRIOR LAKE
11-/3'00 BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
Permit No.
(Depth)
DIRECTIONS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print arTypa and sign at bottom) /~Z/p.()
2. SITE ADDRESS
;' 7';?'Y'? V],Q1<~"_,,,-,-X<:7 \G1t?"Ve:-- ~ 12-1
3. LEGAL DESCRIPTION
11. SIZE OF ST
(Height)
12. NO. OF STORIES
LOT
.-Z. BLOCK
~~
(Name)
----<
.--x ~
PID Z,&:; - 372- - na..:F-O
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
15. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.)
v:7.Jf. ..<c;4?~~. ~ ~<'#~A/ 10"1" ~~
~ -?>;V \$5;'.;;?~ ~sr~ ~7"""~;
Septic 0 Deck 0 As-roofing 0 Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New construction)(
Chimney 0 Misc.
lB. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for
the above mentioned property and that all construction will conform 10 all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
X 6.\..:k2 ~ =<_~S-7 ///z/_
, Signature License No. - [)ate
Fireplace 0
Alterations 0
SEAT~
16. PROJECT COSTNI\UJE
<1"3 Pt?!i
,
17. COMPLETION DATE
r
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
c:::, ;::- A
OFF STREET PARKING
SPACES REQ.
SPACES ON PI.AN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
B'ifYY).c90
.
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II 111 IV V
Occupancy Group A B E F H t M R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $ ~'50.00
SAC ......................................... $--41 00. OeL
Collective Street Fee ... ...... .............. $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee .................. ......... .... .... $
"7A? 2C;-
C;// .if
If'). 00
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ...................... ......... ........ $
I DO .00
I en .tfJ(J
3S".~
Ga~" erm~... ..................$ l{O.oO
Th t n our BUilding perm~t pr ed
,. .
By ~ Date
Certif1cate of OcCtJlLcy
Issued Y"
Pressure Reducer .......................... $
Meter Horn ... .... ................. .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
q~.oo
Plumbing Permit Fee ....................... $
f2~.oCJ
I. "00 . On
. -'C/'). cD
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid T~6u3~$....~~;~i~~~1 ~t:.
Dale fL.-7 /K B~
This is to certify. that the request in the above application and accompanying documents is in accordance with the City Zoning ordinartce and may pr~'requested. This document when
s~ ~qty~anner constitutes a temporary Certif~t8J'.f Zonjng compliance..,And allows.~ction to com~ence. BffO. re occu. .pan~ Certiflca of OlX\lpa~must be issued.
~,~ l'l-/' /dO c....,.~ k ~ ('~V-~I--<P..r ...awU\'~C
.... Ry Planner Date u-' , Special Conditions if any
o
24 hour notice lor all inspections 447-9850
~1
White - Building
Canary - Engineering
Pink - Planning
Thf Cfnlr. of Ihr La". Count"..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1") J2.. HoQ. I ()tJ
I
~-n()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1724-5 DE~~FIE1D Df2..
Accepted /' Accepted With Corrections
Reviewed By:
~
/
~h'elJ
Date:
/1-2/- 'Z'-<.J
Denied
Comments:
~...t1 n L If''s
p f..r .
.Gr ~\""--"
,
,
'3 u t\1'-4.. .
v
~s.
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
White - Building
Canary - Engineering
Pink - Planning
Th" C","U or n." Lab Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
. , J
D r2. f-or2. ( ON
I 1- I <. - on
. I -
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1724-5 DEF,:I2.FIE\JJ
./
Dg.
Accepted
Accepted With Corrections
Denied
Reviewed By:
J-../-../-.-.
Date:
/2-(g-K)
Comments:
.5ec mRIN 5f/cc: / (/7243 ~EzO) FOe. 6lr/l$&l//5-
"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."
.~~
White - Building
Canary - Engineering
Pink - Planning
Th~ Crnlrr of Ihe L.ke COUnlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/)
k~
11-
Hi
, / __. I
(j I<. I n f'.J
1
1 2, - (;{)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1724-5 !)FF~2J~IEU )DQ.
---
Accepted
Denied
Accepted With Corrections
~
Reviewed By:
~~
Date:
, 2-/6/BJ
Comments:
~ I~~ ~4 ~Jk ~_<~
~ j~:~~3 ~~ W; P&v--C~t-~~
rJd- ~WI'9..J;d2 , .
"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."
CITY OF PRIOR LAKE Me
16100 Eagle Creek Av. s.E. PIlrmit No. ~4-
Prior Lake, MN 55372
HEATING APPUCATlON I PERMIT
Date 1\-2.6\01 PIO#
Sits Address '111j'\- S l)pQff1 (/l d l)y-
Lot 'Z- Block '2- Addkion
Owner's Name DQ \-ItV+U VI
Address 346'1 \i'~ as,hi tllt'\Hm, ur :tvA 0uwr NUJ
1I\\'D,tA.i-iAt.!"'" I ,j ':J~IZ-z...
Heating Contractor VI.. \ }.A fI 11 \f,U ilLf'J aU
Addr8SS~~f5D k1.nVlfj?f( /urH:: i Ul.J)vUl II/IJJ 55122-
, co' . I C'~.'7 /) -rlC: J .
lel.phonll' _11' J \ "t' J t- - t.- r -.J
Furnace Make & Model 6 I'V1LlrtI- TYPE OF SYSTEM
. 'Ar.[:2.in'1\JI(j~d070" WarmAirPlants
Model Size ) 0 j !'.J1 L- "t Gravity
'):1 .'7; 1/1 Mechanical
Conn. load ~ .:J -r-" A< Co di" \.<.',.r. ,~.. ,.,.L. .
\ ' 4'l/'1 .. ",r n ftlll/llng ).JVV"A-YU 1_.,...V1
1\)(Yd-' FIueSize ua.S'd13 VanI.System.1_-66 CFfA..'K/~..Y1.('
Supply Op"nings S HEATING OR POWEll PLANT -"
L1. Steam
. I HatWaIllr
RacIia1ion
Special O&Vices
Fuel
Return Openings
'Ir, 1\l~
Input. "I'UL
outPIJl_6I.I i EDt,
Edr.
Other Devices
C1m.
0'--"
oDL'
TYPE OF WORK
Alterations
lIIew Construction
v
RIlplac&mant
Est. Comp. Data
-, -<17' ,-,.
.'), i i L\ L', 0(; SuHding PermB ,
Repair
()()-IDw4--
Est. Cost :;
HEATING PERMIT FEE$
STATE SURCHARGE $_
TOTAL PERMIT FEES $
.50
, pP-IO \f\iIlH . ..~
. B\J\\,.OING \-'~",,\ \
Recelpl C
TYPE OF STRUCTURE
1. PiDk
2. 0.-
3.\"e:llilw
F;Io
CJry
OIal:l::lldOc
Singie Family
Commercial
Two-Family
Industrial
Fee Schedule
Imlustrial, Commercial & Multi-Family
Residential, Healing & AC
Residential, Healing Only
F~..~olI. Gas FlI'llpIace
Residential, Addilions & Alterations
Residenlial, AC Only
Multi-FamUy
Public Other
~
1 % of job cost ($39.50 minimum) "
$99.511 PLEASE NOTE; ~
$64.50 Air ConditiDner Units CannL 0
$39.50 Encroach Into Required SidE:
$39.5C Yard Setbacks. ~
$39.5C ~
.
.
Remember to add the Stale Surcharge on !he bottom of this appUcation.
Tbe price of your heating permil includes one rough-in and one final inspection.
Adclilional inspections wDI be billed at $35.00 each.
House Healing Test Recore must be submitted with bulldina Il!l!I!il ~ betore buftd-
ing certificale of occupancy will be issued.
!:lfQ: CALCULA.TlONS REOUIRED with numbe, ot supply and rlllUm openings fISted per
room with CFM's per opening. New structures 0' additions sllnd floOr plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. 15200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City HaD business hours are 8 a.m. - 4:30 p.m.
All WORK MUST BE INSPECTED (ROUGH-IN AND FINAL). CALL CITY HALL
447-9850
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the cily and with the stale buHdingfmechanical
codes; thai this form does not become a permit until signed by Ihe BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work which requires reVIew and approvei of plans.
_A.>>., ~[) v. A .1/ Yl;fvI..Ul.rAJUJr~~) llzLi )/)}
J ; ~iflflBture '- Date
Z/?r, .. () I
Date
Pc. FA>i 447- 4248"
,
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,
.
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FIRESIDE CORNER
#4549 P.oo4/oa5
Date Rec'd
~ =- ~~..., I P~T-N();h-_ - /iJi,511
I Z~,G(offl~.~ I
rplea:Ic ~ Qr "rint aJ1d.llhm. at botmml
ADDRESS
/?,;) "/5 /Jf}p-"f',fJ ~ ..Q'
. LEGAL DESCRIPTION (ollle!! .Ie only) Ii . "
LOT-::YBLOCK d-' ADDmON 'Xl t?OvbuJ(Cf 9-wd.
U .
OWNER
(Name)
(Addxess)
~;2 ~M.-
(phone)
APPUCANT
(Namel ALLIED ~IRESIDE DBA FIRESIDE CORNER
PIDd-5'- 3Io-CG'-I~O
(Phone) 651-633-~1
(Ad.d.n:;s) 270Q N. ~ArRV>>:W JlYfmJ'" 1>nSEVTT.T.F. M1-'
(AddJOI!) (Cily)
(Contact Person) BRENDA HtlS'1'alfl ~ (Phone) 651-633-2561
APPUCANT SIGNATURE ~ /i,.J!:;;:. DATI! ---C'Y~~_.'_-:__-
, ~
. APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REPLACEMENT 0 AL TERA TrONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OP SYSTEM HEATING OR POWER PLANT
oWonn Air PllUlts 0 Sl<8m
oGravil)' J Hot Willer
o Medtllllical J RaIliallon
OAir Conditioning J Spc<iBl Devi...
OVen. Sy.tc:m 0 Other Oe1/i"",
FIREPLACE MAKE AND MODEL .iJa; Al..Gr;;, .s L - ?fllJR.c..
Inrlu~. Commercial &. Multi-PlItIlily
FEE SCHEDULE
1 % of job ..,'" Raidund.l. Gas Firepl""e
$39.50 minimum
$99.50 R.esldential, Additions &< AIJeI'mon.
$64.50 R....ldr:ntIal. AC Only
Resldendol. Huoling &< AlC (New Conslnlction)
ResIdential. Healing Only (New Construction)
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
5
.50
(orne< 11.< Only)
This Application B"",,"'''' Your Bul/dlng Permit Wilen Approved
I Paid ____
I Dale 5 15 0 I
Building OfJid.t
D...
Z4 hour nntf... fnr _/lI..pectlnD' (95:) 447.'850, rOJ (!ISZ) 447-4Z45
s~~"
(Zip Code)
PLEASE NOTE:
Air Conditioner Unj~
Cannot Encroach into
RequJred Side Yard
Setbacks
S,9.~0
5>9.50
5,9.50
/3lJ. PAID
1I.D"^, VI'-;,>-
I'VG "1,'1
Pt.>.
"r-
111/.,/"
~eiptNg. __
J-1/ ,I
BY~
/
JAN. 9.2001 12: 36PM
GENZ RYAN 6513226147
NO. 225
P.7
I. 1100
2. GoI4
:I,yol!.-
I'iIe
ClIJ
AppIiaat
# () 0 - fOrA-
Phone: ID~I-4Z~-~
',at..- ,e~ W"IrrrLJIr ~tl
,.
,
CITY OF PRIOR LAKE
. PLUMBING PERMIT
Applicant: em 'Z- - , J .a.;') :
'C'~. ~
. Address: --1Y::J.J,),~ -"'l "_'I
SlgnatIJ,.: \1 .in ~ . .
. Legal Description: Lot '-..J z... Block 2-. Sub~ 1"- Zk1.o
SiteAddreSl:J:l..7J-l~ 'l'.t1,V'~ f"') I)z.. ~ .
Building Permit /I PID II
NOTE: This permit ~i11 not b8 plllceBatd without complete infolTMlIan..
FIXTURE UNITS
.
'"" ~l'r -! ,lie -"11.. c.llftl" '
Quantity
I
I
I
'2..
\
\
I
-~
'c'.':..1 2-
,>
-.'
Type of Fixtu re
!'lath Tub with or wtthout snower
Dlshwuher '
Floor)),.in .
!-&vatory (bathlllom sink)
I-aundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
Quantity
Type of Fixture
.\
rG; I \:
:1
Ro.ugh.lna
Water Heater
llliater Sollner
~and Pipe (Washing machlrie~
Sewage Ejector. ,
Backflow Assembly (RPz, Double Check, PVB)
Baclcflow Assembly Test
Lawn Sprinkler :
Other
.'
. .
FEE SCHEDULE
._ IrlCfustrial, Comme~a1 .. Multi-Family
(1% of Job cost, $311.50 minimum)
Ruldential, Ney.t One & Two Family
Re~identlal, Additions & Alterations
state 8urellarge
$
-.
$99.50' $
$39.50 $
$ .50
"
GRAND TOTAl. $ f!I\IO \NXB.\'JI\\
.. . " eU\\..uING .
i
.
Thil permit il IfIInlCd up~n ,he up.... ilOnaition Ihat Hid
oonln<:tor, shall <empty ill 11I1 rOlpccti wll/l ihe ordinances
o(tIle Stalll Plumblns~. j:~drnO~ ,ho""'f,
~ R!! ~".-()( DAm
:..Ii . Ai 4Qa)1.
Call fDr all insPect-ons 24 hours in ~vance.
16200 Eagle CreekAv. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 44742~S
An Equal Oppart1lDity Employet
.,,,,,.',,
':J
' .
..~
JAN. 9.2001 12: 36PM
GENZ RYAN 6513226147
NO. 225
P.6"
--. ....
...~ .-.0..,
..... . on
..
"
NO./)(J - &&4-
CITY OF PRIO~ LAKE
SEWER AND WATER. PERMIT
NOTE: Sewer and Water
cgntractors must
.be reqistered
,wit.h the City.
APPLICANT:..&n.;o~ "trn PluWlIoIL"'- UonT'lAJt'_ PHONli::~I-(.4.'2..?-II..p.j
AD""'"" 'J.Y:>>l'" ~':;:' ....;.. DA""~l
.SIGNATURE: \1\. "," 0 ~ ". _ """", '.RJIIT ..
SITE ADDRESS:...l:l" ' fV <f.:.. PIof," :
., .
FILL IN THE BLANKS
401
1.
Estimated leh~th of water service
I I'
Size of water service inchee.).
I
Location of any couplings from .~ructure
.feet; .
2.
3.
'feet.
.
.~.
4 .
Type of sewer pipe. ABS PVC X
Estimated length of sewer 11n~~'
Clean out. (if r~quired), located
structure.
. Cast Iron
feet.'
: ....~.~i
5.
6.
'at
feet..
from. "
. ";
,
:;:' :;;;::::;:~~:-::::~::::::::prov.ii~-~.' '
..~",==....=---",---.-IJ--~...;.=:_,----- "===--'-'-~---,--==. ""---....==="'~= --,--.-==
. . ~
,.
FEES:
$
$
$
35.00
.50 t
35.50
Sewer and
:Surcharqe
TOTAL
wat.er line connection permit.
"
.
"
* Fee for either!.ewer or water individua~ly 'is $20.00 plus
$ .50 Bureha~qe" --
.
* Sewer and water 'permits issued for new const.ruction must b.
recorded on thebuildinq permit card at the t.ime of issuance
to insure that rio duplicate sewer and water permits are
issued. I' i' .
~,- .'l,
.DATE PAID
RECEIPT f
, ;
AMOt1lf.I' PAID "
REC'D BY
o~\O ~~~N\\i
.eU\\.O\N'" .
" . ~
, ...-'
.
, 4629 Dakota Sl S.E., Prior LUll, Minnuota 55372 / Ph. (612) 447.4230 ./ Fill< (612) 4474245
AN EQUAL CPPOIlTUNITY EMPl.CYER -
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /'I~C/t;"" 6b-, 'T"C-dJ. (fJr.
NATURE OF WORK -.AJf>L.)
USE OF BUILDING ...._ SFll J" _
PERMIT NO. ~DATE ISSUED /1- '2/-2000
CONTRACTOR D. It. R.;.r~ Ul-"'2SG.-713C
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING I 1P:r. 11/9~/
I FOUNDATION (Prior to Backfill)~~: 11;.J~ ~. 1!2.4fOI
PLACE NO CONCRETE UNTIL ABdvE HAS BE-EN SldNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING a..., (/ (8'/0 (
v
INSULATION fa:tr M (t.. 1M
ELECTRICAL /),
PLUMBINGS'~ uG. ~ 11J.~/rJf I;);-n f5/:9--'1/bl
HEATING (ifrequired~ ~ 1'""~ 6:r, 1..!;:j.3!/;J ~ ~/i'/~'
FIREPLACE' ~,ft; {KI "I ,.
GAS LINE AIR TEST ~\. f,PI ~ 6f(f~I/'
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1"~--III_fArT ~ I h 1573d'/llJ
FINALS
GRADING (Prior to Sodding) ~ 1'\;1(,(1.\
BUILDING "fC-i:>.ilO '1 ((51/) I ~,//.IL!hn
~ '
ELECTRICAL
PLUMBING
HEATING
DO NOT
'1
./&.
I:A-
OCCUPY UNTIL ABOVE
NOTICE .
,?!(q/[))
l~LIf/ .,. i
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 nD 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
ADDRESS l...~)'1 <;
OCCUPANT
HEAT LOSS
SOLD BY
Electrical Work By _
TYPE OF HEAT
JOB #
HOUSE HEATING TEST RECORD
f)'t"-f'/ 1.'..( ILOr <; ,; APT. _FLOOR _CITY
'1WNER
DATE HTG. INST. _ ?-1O-0 I
SUBURB
INSTALLED BY A II. ....,- ~-I fl)-f'C /.,
''";os Line By A 11. '... -' -I J'1'1w/(' J.,
GA _ FA ;L-HW _STEAM _ SPACE HTR. _UNIT HTR. _OTHER
GAS DESIGN '- CONVERSION
MAKE (S,.-HOr" r
Model ?'1 ~'I Llu CJ3GCT=F(:)
Serial ?1'.:v?1A.ri/1/1' ")
INPUT _
Limit Setting _
Fan Setting ,.
Pilot Type
Pilot Make
Pilot Model
Pilot Timing _
L.W. Cut Off
~ c ,. v<- (
Pressure _ . ? '
Input CFH
Stack Temp. ~ v( ~
THERMOSTAT II
V.lve 1/1/, fl
Limit
Form 235
H
CONTROLS
\A-"...../f
- Heat Plug _
MAKE OF BURNER
Model
,.'('
Max. BTU Ratinr'
lilt- MAKE OF FURN~CE
..,.t Model "-
'..1. Vent Size I '-1
KIND OF LINER
,
.
_-("c'
Draft Hood',
Filters
Size _
/'"
'>
-=-
r
I/'
Chimney Location
Chimney Construction
Smoke Bomb -~
---
Draft
..-- -
Door Pressure_
. Percent CO2
_ Percent 0
"
_ Percent CO
{.,.(.
~.7
ij
Date Tested ~-IC)-O
Company Testing Frederi~cJson Heating & A/C, 3650 KenAebec Dr., Eagan, MN 55122
Nome of Tester -......,
'Ok
~-------'
~
)-.- ..
-
...
....
....
SIZF
_NONE.
!
RegulaTor
Number
y"']./.'.,.. .
In'Side
C/o.:,..,.-,
A
Outside
_Wiring
Test Tog
Lighting Inst
>-~/
/
~-
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/--2-0:../
ADDRESS
n/-4j-
!k+'r-h.c IJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
n- /C/&<:.(
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
Sn.J 17~~;\
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
.-
( C'
~
-
r ~________
( OS c /'1.; SJ
---
----
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~R~LL FOR REINSPECTION BEFORE COVERING
Inspector: YU Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INS1IOTI
OWNER
DATE TIME
SCHEDULED 7 ~ 1: ~ c
~,RdJ
t;
CONTR.
PERMIT NO. () - J n t~ t/
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS I 7 d '-f .5
PHONE NO.
o PLUMBING RI 0 EXIGRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP @J 0 FIREPLACE RI
o SEWER HOOKUP ,lit' FIREPLACE FINAL
IiIi\ 0 PLUMBING FINAL -"8 GASLINE AIR TST
~~ MECH FINAL 0
COMMENTSff') ~ ~ L.." --j--,J H 2-0
~~(
~'b~~~
o FOOTING
o FOUNDATION
o FRAMING /J
o INSULATIO~
)If FINAL
b'SITE INSPECTION
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I 1
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~ Je'~
o WORK SATISFACTORY, PROCEED
W CORRECT ACTION AND PROCEED
:S::~O:ECT WO~L FOR REINS~:~::::n::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
DATE TIMe
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
'7j/9/cJl /J.!.-&o
ADDRESS
/'7.:;.<f~ ~
.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
DD - {D c;, <j.
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTSffl ~ ~ ~
@~Af' ~ rn- ~
~tIJJ,V. J
(6] ~ ~.0~~~~
~~~r> J~~~1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~ 0 SEWER HOOKUP
~~ PLUMBING FINAL
o MECH FINAL
~~~.
~ - F'fA.,
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT W~FOR REINSPECTION BEFORE COVERING
Inspector: ) Owner/Conlr:
CALL 447.9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI