HomeMy WebLinkAboutBuilding Permit 00-0588
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BLOCK
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CITY OF PRIOR LAKE see~ I.:,:"
TEMPg~~~~N;E~~~~~~TE OF Aa #JiiA/J Y,llow
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No.
I-Utk
\
1. DATE
Co ' ~ ' Od
12/$0
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
PID 2'f5 -.<f.A- - 02/ - 0
File
City
Applicant
13. TYPE OF CONSTRUCTION
~ CiA t). 8:ok' If~~ (Te9;d:l-8~- ~300RAREAAPPORTIONMENTUSE
(Address) (Tel. No.)
6. BUILDER
IName)
s~
7. TYPE OF WORK Fireplace 0
New Construction ~ Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA 0
Sq.Ft.
x
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
SPfl
(Address)
(Tel. No.1
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Septic 0
Addition 0
Re-roofing 0 Porch 0
Rs-siding CJ Finish Basement 0
SEATS
16.j'ROJECT COSTNALUE
~ I ~O lL.
17. COMPLETION DATE
Deck 0
Finish Anic 0
9. PROPERTY DIMENSIONS
Depth
10. CULVERT SIZE
Yes No .....--
this pplicalion which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
rthermore, I hereby agree that thEI ~ official or a ge~nflS!nY enter upon the property to per1o~ ~eeded inspecti9.qs.
-?OC30!:."7 <t7- S--~
License No. Date
FOR ADMINISTRATIVE USE
Baok
Side
MATERIAL FILED WITH APPLICATION
SOil TESTS 0 ENERGY DATA 0
Side
OFF STREET PARKING PILING lOGS LI PERCOLATION TESTS LI
SPACES REO. PLANS & SPECS LI SETS
SPACES ON PLAN SURVEY LI COPIES
PERMIT VALUATION /BO,ooo PLOT PLAN LI
Division 1 2 3 4
Permit Fee ................................... $
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee .... .... ................... $
SAC ......................................... $
Collective Street Fee .... ............. ...... $
Sewer Tap ................................... $
~" $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
$ewer& Water Permit ...................... $
.........$
I. ?A'? ...~
. 83f&,.trl
~D.oO
100.00
100.00
3.S. SO
qt; .00
You
ermit 1;e~ro,2.ed.
Date' -~
Certificate of Occupancy
Issued
eSt). eo
/, I 06 . Od
t./S.Q")
I ~S:oD
I. 2 DO . etO
.. 71'J(J .~tJ
(;) -
Paid
Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin nee and may proceed
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to. commence. Before occupancy, a Certifica
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections (952) 447.9850
i~1
,/ (.,
( (_,J'( C'
ThO' ('t'nll'rnf lh.. L.k.. ("ounll')'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
_.-----
I / {, L '/-/ (. (
'..' r f
'o' / _~/ // /
I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
- ,.-..-...,
/1. /
.<> ~-I' (: I
/ ~ ,
.-
,~- //-..~-~"
, II/-- )
I
'.. ^ ~
" ~.,~... I~"" , '.
/ I (I "-
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Accepted v/
Accepted With Corrections
Denied
Reviewed BY:~,fA~~
Date:
7~ /:?- -C9Q
Comments:
/SiV-~~ ~)kJ<::L\<qo ~ ~yvl~~< r
~~~~~S
---1k ~/P>~~-; o.r-e- fWI.4U-ffed
~~ (ffi;~
t-b ~ DIY KJ~~k: 4km~< ~\U<.~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."
&~1
00 -o5f1e
Th~ Cenler of Ihe I.akt Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
H/L-t- Cl26S (
&/~/()O
I I
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
it? ttf-07 /II ( L-DS 0 If KS f:;;jf:.,e;j (!.i~: .
Accepted
Accepted With Corrections
Denied
Reviewed By:
Date:
Comments:
"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."
-..
Th~ CrnlH of lhr Lah CoulIlry
00 '06~~
While - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/-//LL. CKES (
rei 5/()O
I 1
The Building, Engineering, and Planning Departments have reviewed the building pennit
application for construction activity which is proposed at:
104-()7 WIL-O:.5 {)11;CJ itj(::,eI7(!.b
Accep!ed. / Accepted With Corrections
Denied
Reviewed By: Gf"M+ Cllr(son
Comments: 5t:e i It fd r I'l.. h'ol1
Date:
haJ/t>>
, ,
0"1 +I.~
r... V'J'"t;L
<;id~.
5aa.4...cJ......el\-h;', I, nM( C>r<..J.c r~sfcd;.~ ..:r;.t:v,....I-t.... R. ".,...,.1,':1 f/a-t
3 Erm;"n. 6:,,,\-'61 K~Q.~v..re..s If. Eros i ",,- G",+n\ P(t:V\
"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."
,~
y
10/04/2000 15:43
612-8947972
LAKESIDE PLBG
'f'
~
.CITVOF PRIOR LAKE
Appl\~ant: ;JJ,~~';B~Z::
AddreSs;,~: '~J~ ~~ ~A~~ .h1~=
SlgnaturB, ,~ ~ n. . '..,...
Legal Oescrlpllon: Lot;Lf Sleek I su.. 'r JJ~t
SltaAddres.; e;.!-Io7 L.. JAJ./ D".//A 7Jj~ v _
Building Permit #.. PIO # ,')0' ,$ if- 0 0' ~
NOTE: This permit will not be processed without complete InformBtlon.
#
Phone:f-5.)cff Y" 7 b06
PAGE 01
I. I:UU!!.
1. OClld Cit"t
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O-'sW
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TIr~ C~ifl~( o( {fI;- lAh (',"'1/1''''
--,
fl ,~#A4~ j JI.~4A FIXTURE UNITS
I Quantity I ype 01 Fbrture Quantity I Type of Fbdl,l,e
.:< Bath Tub with or without shower ~ Rough-Ins
I Dishwasher J WatBr HBater
I Floor Drain Water ~oflner
S Lavalory (bathroom sink) j Sland Pipe (washing machine)
Laundry Tray (1 or 2 comPllrtment sink) Sewage EJeclor
/ Shower Stall \ ,~ - ':;'1. " Backflow Assembly (RPZ, DowblB Check, PVE
I Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
,;L Water Closet (toilet) Other [}.>tW"'~
FEE SCHEDULE
-'.'--
Industrial, Commercial & MUlti-Family
(1 % of job cost, $39,50 mInimum)
Residential, New On",.& Two Family
Residential, Addltlol)s & Alterations
Slate Surcharge
$99,50
$39.50
is
$
$
$
1" .p
.50
GRAND TOTAL
$ /C)O'"
PAID WITH
""-DING PERMIT
~
Thb pennll i. granted upon lb. ""pres. condition Iba, .ald
contractor, ihall comply In all respeet. with the ordinance,
of ,h. State Plumbing Cod. and 'he amon""'.n" theroof.
~1P'TNO, /O-lf-LJOOATE
. ATTEST
Cal r all inspections 1.4 hours in advance.
16200 Eagle Creek Av. S.E., Prior Lake. Minnesota 553721 Ph. (612) 447-4230 1 FAX (6]2) 447-4245
An Equal Opportunity Employer
--'
'..""
..... . P....1l
Ws,~cnw , APP\h:A.'
001.10 . OIT"
Y OF PRIOR LAKE
AND WATER PERMI:T
s.w.Nu.CD- (~y
.NOTE:
Sewer nnd Water
contractors must
bo registered
with the City.
SIGNATURE::
SITE ADORES
PHONE: 81?"Cj-~//f9
DA'l'E: 8-:J.o--dd
BLDG. PERMIT I CJO .-QS(f8'
PID # 60-";364 -09.1:- ()
FILL IN THE BLANKS
1.
~~timatcd length of water
,UICV lee rs--J
L1-I
_irlch(es) .
teet,
I'.
2 .
Size of waL~~ service
3.
Looation ot any couplings ft''''1n structure
teet.
4, Type of ~"we~ p.tpe. A tiS PVC~ cast .lron__..._
5. ElOtlmated .length of sew..r line ~c;) toet:.
6.
Cl<'!;'1n t:(uL
stt'uctur~ .
(if requirad),
,Located at
feet
r~om
___ ... ........"""'!'!i'!'!!'!!!!!!'!!!!!!!!!!="-_"""_....=_=~.... _--'""""____======~;;;;;_;OO;;======"'=i ,,======!!!:!!=!_-;O;;=::;::=::::l= =~_==~""'l:
co eo; YOUl.' p"l;mlt when I:lpproved.
81' .', DA'l'E: ~/:~--~Ur.J
.._ __.....__""'_::I===!!!!!=='=;;;;;:Il:Ii;::;z=.;::ll=====:;:;''i'Z===;::!l~!!!!~=='''''l;=':o;:;===:..;: =:.:.;.:
$
$
$
15.00
.50
35 :15'6-
S....,er and water line connection permit,
SUrChll.rge
'rOTA 1,
* F",,,, for. eith.",. "ewer 01:' water individually i:o ':;7.,/,1SfI) plus
$ .50 sut'charge. -
* Sewer and water pcrmi.tG issued for new constl-uction must ~)..:.:
r..<::orded on the b"ildinq permit C~d at the time <;>1' ~5$U,"1':;C"
1::0 in!::Ul:'a that no duplicllte ~)fii:i ana waL..,. P""I1I.Lt." tin'
issued. ,~~~
DATE PAIU n~().:>..0 AMOUNT k'AIO --L i
R~:C[.;T,PT # ---. ~~... REC'D 81' ~'-----
~ /
16200 Bagle Creek Av. S.B., Prior Lake, Minnesota 55372/ Ph. (612) 447.42;m / FAX (612) 447-4245
hn I:'.qual Oppo,~uolly t!lnplc)yc,'
c0d Wd(c:( 000c Sc'5n~
96(9c68 Cl9 : 'ON 3NOHd
:JX33H:J3.r LJJO..l~
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File
Cily \
Comractor
Pink
G=,
Yellow
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J.
TURE
TYPE OF
0-5fS'
MC
Permit No.
CITY OF PRIOR LAKE
16200 Eagle Creek Av. S.E.
Prior Lake, MN 55372
Multi- Family
Other
Two-Family
Single Family
Public
1 % of job cost ($39.50 minimum)
$99.5O I~ [] ~ ry: ;~:,
$6450 II) 1,--- '-~-=--= _
. J I Ji
g. Gla.
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this application. .-..
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your heating permi.
inspections will be billed
House Heating Test Record must be submitted with
ing certificate 01 occupancy will be issued.
the State Surcharge on the bottom of
Remember to add
PERMIT
I
HEATING APPLICATION
Industrial
Industrial, Commercial & Mum-Famiiy
Residential.
Residential.
Residential
ferallons
AC Only
Commercial
Fee Schedule
0;).( -0
PID #
lo~
o
o
Sile Address
Lot ifl-
Dala
Address
one final inspection.
rough-in and
$35.00 each.
includes one
The price of
Additional
!lIIilQing I1WDiIllIll!!llID: before build~
at
ajTYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical _
Air Condilioning
Vent. System
Telephone #
'f.'D
~Make & Model
Model Size
Conn. Load
tlEAI lI. REQUIRED with number of supply and return openings listed per
room wilh CFM's per opening. New structures or additions send tloor plan wilh 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.
HEATING OR POWER PlANT
Steam
Hot Waler
Radialion
Special Devices
Flue Size
Fuel
Supply Openings
Openings
Return
Cily Hal 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL)
business hours are B a.m.
Output
Input
Edr.
CALL CITY HALL
I hereby apply lor 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 Ihe cily and with Ihe state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFlkIAL; that the work will be ance with the approved plan in the
'o~ all work whi.!;h requillls d approval 01 plans.
447-4230
x
Other Devices
NBW Construction
TYPE OF WORK
Replacement
Clm.
Alterations
I!iiiI
o
o
'"
Date
PAID WITH
BUILDING PERMIT
Comp. Dale
Building Permit #
Receipt #
50
Est
HEATING PERMIT FEE $
$
$
STATE SURCHARGE
TOTAL PERMIT ~EES
Repair
Cost $
Est.
Fir.
GlJ
Collb8cter
Pi..
c-
Yellow
I.
2.
J.
~8g
E
Multi-family
Oilier
Two-Family
Industrial
.x
.
Singla Family
Commercial
CITV OF PRIOR LA~E Me
16200 Eagle Creek Av. S.E. Parmil No.
Prior Lake, MN 55372
HEAT1NG APPLICATION I
TYPE OF SYSTEM
Warm Air P lanls
Gravl1y _
Mechanical _
Air Conditioning
Venl. System
Public
ob cost ($39,50 mlnlmuml
~
.C PLEASE NOTE:
$39'~1_Air Conditioner Units Cannot
<"'f~[1 @1(' .1' J ,- "
., ..\L" '.-
, I ',1--"
L./i;'l c:t:." '-' .
\ ' OCJ - a 'lMCl
: \. ' I 1,JIoN:
:,':t\ . ",
"...\I~\ " ..--J,eI;
"~I \L-- v
.U --'
The price of your heating permit includes one rough-i~ and one final'
Additional inspections will be bille<i at $35.00 each.
FIMl Schedule
Industrial, Commercial &. Multi-Family
Residential, Heating &. AC
Residential, Heating Only
Residential, Gas Fireplace
Rf''':idell.ti-;.l, A('lrl~;,.-~ ~ "
dememl'-€r
,
,
c
lu
L~O
PERMIT
~ p,:
0>
=
-
:;:: Telephone /I
~
~ Furnace Make &. Model
~
'.~
Dale 0 -3'
:: SII8 Addr_ ..J 0,
~ Lot d-I Bleck ~ Addition l;J jl
~ -
! Ownefa Name }{i..UcA<-S+ /-It>Y'Vl.J2.-S
Addr85a ~,O. \2,ox LfS70
1l?cibgContract(,~ P.l_~(f\C",'.I'\~_I,
0$ \2.l'rn ., 00.
'11'-1-000 ~
PIO.
1J1-,.,
. \ \_'.i-.
,0
House HeatIng Tast Record must be submilled with .bu.iI!fulg Illll!DiI !!YIll!l<< before buiid-
6.1'.. ..,.Jng certificate of occupancy will be issued.
l:IfAI CALCULATIONS REQUIRED wi'" number 01 supply and return ~nings fISted pel
room with CFM's per opening. New structures or addHions send floor plan with supplV
and relurn locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPUCATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are B a,m, - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUG~IN AND FINAL)
441-9150
CALL CITY HALL
HEATING OR POWER PLANT
Steam
Hot Wale, _
RaGiation _
Special Devices
Other Devloes
~"'o
x
MOOel Size
Conn,load SVOOO
,
Fuel (IJ Ill- . Aue Size
Supply Openings
Retum Openings
Input
Edr,
~
(p
, rb. {)OD Outpul
,
I hereby applV for a mechanical systems permil and I acknowledge that the
information above is complete and accurate; thai the work will be in conformance
with the ordinances and codes 01 Ihe city and with the state building/mechanical
codes; that this form does not become a permit unlil signed by the BUILDING
OFFICIAL; that the work will be in ac<:ordance with the approved plan In lhe
case of all work which requires review and approval of plans.
---
New Construc\ion
TYPE OF WORK
Replacem elll
Est. Comp. Date
Clm,
Anerations
Repair
Est, Cost $
~
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~
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- 7-00
Dale
(0 - 3-00
Date
/t)
PAID WITH
BUILDING PERMIT
......
Building Pe'm~ /I
9' 9'. Sl:>
Receipt.
50
()O
$.
$/OD
~
=
~
HEATING PERMIT FEE $
=
=
:!: STATE SURCHARGE
,
=
- TOTAL PERMIT FEES
PRIOR LAKE ~~rtD~~~~N:D~~S~~CTION ~I\
INSPECTION RECORD ~;~~~~
SITE ADDRESS ~4D? LJ .. IL ~ l.ejO...e.~ I{
NATURE OF WORK ~ew
USE OF BUILDING ~N'\
PERMIT NO, 00 - o5re DATE ISSUED (p. 2"3- ~C>
CONTRACTOR --Hilt (\ r-e4 ~ "-" Pf'lONE" %:2 - e'18 - 1 (. (., 5
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING H;
FOUNDATION (Prior to Backfill) . Il 2. r9.& ~
PLACE; NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH -
SEWER I WATER I SEPTIC
FRAMING
INSUL~TION ~ f L.L.
ELECTRICAL
PLUMBING
HEATING (if requi d) tID
FIREPLACE L.~ ~ t.. p ~5 p-a
GAS LINE AIR T /f;:;, If) { trl' .{JI ~ .tIlJ
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I....W.Rfl ~ ~IeL ~ ~/ ~~
FINALS
N.6 "'Z.2.~
GRADING (Prior to Sodding)
BUILDING f.t.o. -tJt t>(
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEE
NOTICE
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'~IJ be placed near main entrance,
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
,('#7
OWNER
DATe TIME
SCHEDULED ;I~~
Uh"// (!/-r/ "7epr,
CONTR.
PERMIT NO.
Lt:? -_stfr
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
.P'1'JNAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ /
//--7", /
/"
yc
----
.~
--~-
A' WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F 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!
l/'tSNOTl
DATE TIME
CITY OF PRIOR LAKE 2./z.( 01
INSPECTION NOTICE SCHEDULE[) U:3C
ADDRESS III L./ () 7 uJ,LtJ !) AILs
OWNER CONTR.
PHONE NO. PERMIT NO. (J-S'g"8'
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
&.. 0 PLUMBING FINAL
~;q MECH FINAL
COMMENTS: (2e - w....<:;.~ A ,t." ~
Ccff)l~ ~ ~, c~,
~ ~~J ~ ~ -fI "'"" ~ ~'f-o~
. ~ ~ ~-:;Q u.r:t:J
o FOOTING
o FOUNDATION
o FRAMING (i?J
o INSULATIO
J(FINAL
o SITE INSPECTION
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~~.
'-<7
.
,.....
....~;:;:
~;~-.-
":-, -~)
,.---""'
o WORK SA TI CTORY, PROCEED
l CORREC CTION AND PROCEED
o CORREIT WORK, CALL 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!
INSNOTI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUlEC,
/1-2-tB
()!01 vv, 'td fhks, Tr-rFe.{('
CONTR. 1-1,' II c..."5f--
PERMIT NO. 06 -~g 6
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.;S f>UlJ L
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
(;r(.LcU.5 - Cl K
CvrS &~r -0 IL
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~~ OWner/Contr:
CAll 447-9850 FOR THE NEXT INSPECTION 2:4 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .t SAFETY!
mstW"
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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OWNER
CONTR.
PERMIT NO. (3 - 585
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
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o WORK SATISFACTORY, PROCEED ~
o CORRECT ACTION AND PROCEED
)C CORRECT WORK, CALL 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
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
1-1<..-0 t 3'<cro
ADDRESS
&4-01 INII.AJ Oli/G.'S
~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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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
~PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMM~TS: (7) ~
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o WORK SATISFACTORY, PROCEED
Ii CORRECT ACTION AND PROCEED
:s:::o:EC~C~LL FOR REINS~:~::I::n:,~FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
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BVRNSVILLE
Heating & Air Conditioning, Inc.
12481 RJoode 1slont/ Ave. So., Savag., MN 55378 . 894.()1J()5
Orslat Test Report for Job# /}.. ~(Z-
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Date of Inslall 12' u -C~
Type of HT. F/A .......-' HW
Other
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Space HT
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Make
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Stack Temp If 0
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Date Tested I ~ :) - ~~
Company B'vl!(P
NameofTester 81<-
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