HomeMy WebLinkAboutBuilding Permit 01-0253
~~
DATE RECFlVED CITY OF PRIOR LAKE
.,3- 2/-01 BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
2. SITE ADDRESS
/~ j' z.. S /JtJlIE.- Cov.e:r AJ. Z:-, 1<./
3. LEGAl DESCRIPTION
IS- BLOCK ! . PID Z.5-3~/tJ/5V
pJtJ6/ffU-.' .t:Jn-I MIJ/nON
(Name) (Address)
~z:. A-5 A(jIUJ~.
~~ib~~'JMM!ama) 6/itvco (Ad~~b1~ ~.5L';.5"'2-o7Z'?
';'~P,/~~af~~"';fi';r
DedkCl
Finish Attic !j
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
LOT
ADDITION
4. OWNER
Rr~mc~ Se~c!j
Alterations () Addition LI
1. DATE
3-/7-0/
(Tel. No.)
Re-roofing LI Porch CI
Re-sidlng CJ Finish Basement CI
7. TYPE OF WORK
New constructl~
Chimney LI Misc.
8. PROPj...~:':. ~REA OR ACRES /9. PROPERTY DIMENSIONS '110. CULVERT SIZE .. 1/ L-
Sq. Ft.~ /3J / Z7 Width 'ItJ J DepthA'I/tJl-JlIfo Yes No ~I..f I{ /It',y<Ox. il1J{/1, ZCXJ (
I hereby ce Ished Intannation on this application which is to the best of my knowledge true and correct. I also c81\hy thai I am the owner or authorized agent for
the ad property rJl construction will confonn to aU existing state and local laws and will p. rocaed in accon:lance with submitted p",ns. I a~are that the
bu king 0 n revoke nn just cause. F~hermore, I hereby agree that the city officla~r ~ ~fj ~~ell!!'r upon the property to perfonn ~ ~ppons.
X . ~~5S , 2:c..v "1' ,1$.< '"5 .3, 'd/
Signalure License No. . Date
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
01-02-53
BUILDING INFORMATION
11.SIZEOFSTRUCTUR~ 'hut \
_3tJ1 ~1/' ~~/~~)
12. NO. OF STORIES Z
13 Wa(j)JN~gf)
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATS
16. P~i3 ?~S;;~L3
17. t;OMPlETIOW DATE
SeTBACKS: Required
Actual
~... -.-
.,- ..-
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $~
SAC ......................................... $ " 115O..h n
Collective Street Fee ....................... $
Sewer Tap ................................... $
t:tL. f' $
Pressure Reducer ...11'-.................. $
MeterHom................................... $_~
Water Meter ................................. $
Sewer & Water Connection Fee ........... $ II ~(!)O . l!l.O
WaterTowerFee ........................... $ .., 00 .f) n
Water Tap ................................... $
Builders Deposll ............................ $ [ I C}{)tJ . DO
Other ......................................... $
Total Due .............................. $.8 ~2.. OS
Paid B,tlOL.()S;t2ece ..3fS>SZ-
D.te 4- ~-o/ By
request in the aboVe;....,,:: ..;,.'. and accompanying doCuments IS In accordallCEl with the City ZOnI~ Ordinance and may pr as requested. This document when
consthutesatemporaryCe~~p;7A1~.I~ ~~J)structiOO~cor'nce. ~r:~~~~teof~ed.
CityPl8l1ner Dale -- ~ ~- C h_
F<ant
..ok
Side
BOIlDlNG DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING --SFlJ
PERMIT VALUATION
I 8C!. oon
TYPE OF CONSTRUCTION: I " III IV V
OccupancyG_ A B E F HIM R S U
DivisiQn1234 .-
PennllFee ................................... $ I. q~Z .ls
"l f1"J."O
~C4 SO
City:
Plan Check Fee ............................. fit
State Surcharge ............................. $
penalty ....................................... $
100.00
~
Plumbing Permit Fee ....................... $
Mechanical Pennll Fee ..................... $---10D. fJO
Sewer & Water Pennll ...................... $ 3s-. S"z:>
Gas ArapIace pe~nnn ...... ................ $ 4() '(>0
Thls~ gullOlng ;:;;;;;~ When APproved.
By . Date 3.2(.. ?<<>I
Certificate of pancy
Issued
24 hour notice for all inspections 447.9850
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS Cl ENERGY DATA Cl
PiliNG lOGS LJ PERCOLATION TESTS LJ
PLANS & SPECS Cl
SURVEY LJ
SETS
COPIES
PLOT PLAN
Cl
l{~.on
t 2.5" ~
~
$~'i
J.
o l,6;).-~) >
The ern I" of lllf lAb Counlry
White . BUlldln;
canary~:::eer!!)a
Pink II
.a.UILDING peRMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
B,E!.(-:, j\/ IV EJ~ to NS772- .
3.2/-0/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4325 D~VF., c,1. ;Ie:
Accepted
Denied
x
Accepted With Corrections
Reviewed By:
NA-R
Date: 3-~3-ol
Comments: See Reverse Side for Additional Information!
tt/fiil"J....,'" dJ'V'tt" ~%Wvl,it, "Gf~S y",J
"
~ee Attacnments: 1) Grading Plan, 2) Erosion Control Measures
::n Frosion Control Plan
"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.....-."JJ1J.~ ",",;;0....11.111. t.v.,...... ~... ~p,.,..--........- --., ....'1..-
......... _, ......... _........l...i.......... _10 ....i.... ....""........ ,..... ....,f: """.''10\' ,,+hop ^rrli"~.......^ _10 tho illriol"li,..tin.1"\ Oor"",i+~
~~
U~et
Dt ~ 01..-\'1
Thf C,olu of lh' uk. Counlry
White - Building
h \ Clr!fi8iYl- Engineering
\.J Plf1l< - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
&t:../VNE/c::... Cc AiS772- .
3.2/- 01
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4325 DC I/F..- c:r. II e-
Accepted
v
Accepted With Corrections
#'
Denied
Reviewed By: a~ L ~ -- - ~ 2<. Date: :5 / Sore? I
/ ~-
Comments:
~Ljfi ~;tu1M.(A ~\M~ &JtJJi;;-
A--~' t ;~ ~1Y~1 tAM.e ~Sf7~u
{J...O l I-J ~ ~.
',,~
<l
-A/c- *-~ ~ '~M
~ f.I^" vJ}!;~l..1 :sr~"M&-- ~~ ~ #
\
"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."
l
GRH. - PIL!
YelLOW - APPlICAIIT
GOLD - ClT"
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
s.w. No. Of - 0253
Sewer and Water
contractors must
be registered
with the City.
APPLICANT: P;NI/-L r:;.~IJ:jJE XAJG
ADDRESS:__-j}jK /JJMIk 5/, sll!fl<\.nP'..I==~
SIGNATURE: ~~.e).i( 7'$-.al~~
SITE ADDRESS: FI..g~5 /'J/)vE r.OU Jf!'r
PHONE: q'~~-~~-J~
DATE: "//91191
//
BLDG. PERMIT # 01- 0253
PID# 26-34PJ-O./5-0
FILL IN THE BLANKS
IACJ
1. Estimated length of water service Id~
feet.
2. Size of water service
J
inch(es) .
3. Location of any couplings from structure
feet.
4.
5.
Type of sewer pipe. ABS PVC)(
Ie /
Estimated length of sewer line ~
Cast Iron
feet.
6. Clean out (if required), located at
structure.
d feet
i'
from
-=========================================
your permit when approved.
BY DATE: 4-9-()/
==============~~======::=========================================
FEES: $ 3i.oo Sewer and water line connection permit.
$ .50 Surcharge
$ 35.50 TOTAL
* Fee for either sewer or water individually is $~~ plus
$ .50 surcharge.
* Sewer and water permits issued for new construction
recorded on the building permit card
to insure that no duplicate sewer and
issued.
REC'D BY
DATE PAID
RECEIPT #
,
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
CITYo~~UflJ1~.otr-lU!i #4228 P.OO2l2.2.~A___
HEATING/AIR CONDmONlNGIFIREPLACE PERMIT
~:=. s....1.a!.N4ITNOO!-~53 I
_~_ ~ or orinlllJl4llmlll:botInml
ADDRESS
It.; 3';;5 ~,. th.t IJG
L.....J,".......G (oftia:uae)
P,/
. LEGAL DESCRIPTION (alike_GIlt,)
LOT /5'Br..oCK (AO~........ 0./ob IJ-; II ~tJt
PID
OWNER
(NlIIlle)
. (Ad.dr5l
~_L ~.
(Phone)
.'{
APPUCANT
(Name) ALLIED PIElESIDl!: DBA FlRESIDE COl!lNER
(phone) -W--fi33-"~l
(At.IdmI,) 2 'DD N. FAIRV'IEW AVEIIUE 'lOSElTTT.T": ....
(~lIIl (CIly)
(COnlBC1:Pet$On) BlilllllIDA IIllElTZ' (Photic) 651-633-2561
APPUCANT SIGNATt.1lU3 rJL.~ H..A-- DATE _
APPLICANT PLEASE COMPLETE BELOW
~wc...,....^UCTlON OREPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RlmJRN OPENINGS INPUT OUTPUT
TYPEOF..~......", HEAl1NGORPOWERPLAm'
~Willlll Air P111\ll1 3 S"'lIl
Oravl1y HotW_
Mechlllieel :J IladiMio.
Air CoudillonlnS :J Special Dcvl"",
.JVOIll. System :J Other Devlc..
FlREPLACE MAKE AND MODEL /J.I- N t:fD ~(. ~--'"
'll"1 '1
(Zip Code)
PLEAn: NOTE:
Air CondlllDllCr UrlllS
CIII1IlDt En_ch infO
Required Side Yard
Setbacks .
FEI SCL :,,, . c.E
lnd.'ltlal Com",,,,,,fallk. M.llI.P....Uy J% arJob """ kcsldaltlol. G.. Plropl....
$39.50 IIllnim1llll
lUaldenll.l. HoalIng &. Ale (N- CollllrvCliGII) $99.50 R.oalde.tIaI. Addltionl &: AlIInIions
F.csidontial. Hoarln! Onl)' (New CartIllnlcliOll) $64.50 R.oaldtll1lill. AC Only
539.'0
539.50
$39.50
E5t1matD4 Cost S
Bulldlll& Permit /I
HEATING PERMIT PEE $
STATE SURCHARGE $
T01'AL PUMIT FEE S
.so
~ Bu/~~G vrtn-! ,
EF;,v,/7'
(0111.. U.. On1r)
I
Tltl. AppJlcatloll Be<01llCS YDII' ..Odlll, Penalt WIle" ApprDYlId Paid
o.te ~-K-OI
~No.
8on"'.. O"'dII'
Do..
8Y/
30A _ ...d.. for ,1I1n...-... 1!IS2) 447-91150, r," (lIh) 447..u.d
, 'CITY:~()F:PAIOR LAKE
, . ., ..:.</,PLUMBINt3PERMIT
'. '. .' ~. . .: . ... '. . ",.'.
. A~pllo~iU::la&~~ /J..;.IJI~j,l;"
. .A.i:tdl'8.8~: .~. ~'....r;".?~U~
.. ... -- .... '..'.
... Slgrtatui8: ... ..',... ..... .'
.L.I O~8c~ptl~ni:t;ot'?;.' ... Block . (~Ubi'~C/1J II 1/ ~l.i-
s~eA~:ii;1~S 0"" tfh;':J. -
.aJijdlng\F>.rrhlt~.;. .. , pjD tto/5--::V(JR'-O/YO
. NOTE: :.thla P.milt WIll notbs.piQCe...d.wlthout complele lIiformf!:tlon.
.. . .. '~I)m)'RE'ON'ITS .
. . ~ . . .,'
05/04/2001 13:26
9528947972
'rr
~
,'('
,'.:
....
Th. C~"l.r.' III, I,.a.r C:ql,l.l",
&r erl "l-e....
I Quantity I
I 1-
I I
I I
I ~
I ;),.
I
I }
I
I ~
. .. .ii.Ji. of ,F.;lxlUr~ <>,<
Bath tub wll~ Q(withoOf.8hQwiir ......
.' ... "\ . .
Dishwasher
. ''',
Floor Drain ,.:.': ..,:;.. ..
..... . "'.:
LavatoiY (t>8t~fooni, link) . . . . :.:. .
LaundiY Trl1y((pr 2c9mpartirieritalrik)
ShowerSlal1 . ''''.\
Sinks.;
"', ','
...
..
BarSlri.~..?;. .. .
Water Closet <fijil.I)':
.., .. '........' "
",'
. ,
, ; . . ~i, . . .', . '. .
t.. .
. ,.
',~: :.','
, '
FEE SCH!i:)ULI!'. .
. .
Industrial, COrilm~~"~\.IIII~F~~ili
(1 % of jobp'olt; $~:SQ mlI11murn)'f.' .
. ., ',1 . '::,1"
ResldenU.I~N.y.. One & :tWo FalT1lfy
Rllsldentlai;Addlti~ba a. ~ltoratlo'ii:a\
. ,,',": . '.. ....
State SUrc.lia~8 "', ,'" I,. ",
,
,.
., ....;..
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'.,'
...
. .... ,,'
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. .~
.;.
LAKESIDE PLBG
PAGE 01
I. BII>> Fila
'Z.Oold Qry
3. YeUo" ^.fI.:l,h:....
#6/-;)53
PhO~'l:_"'~. .2. - ~"<t::...Z/. ~ (,
':. . .~:Q1l8j,tllY
Type of Fixture
..... .
'..
V:J
..... .. I
. ..:.;'
Rp~gh.ln~ . ..
W8i~r Heater. ;.
Welllr S~flher .. .
Ste,nd Plp~ .(W~8hlng machine)
s...".gl'i..EJei:lor.
',' '"
Bllcld.low AS.serilti~ (APZ, Double Check, PVE
Bacli;llowAsiiili!1bly Test ./
Lawn Sprh,kler
other 2. .~,,~.... b: bb.
l". ':OI~~:JDo.IJ
". '.
....
,'....,
(,
.. .
n.:.,: ,.?;-':\
: '"
. ......\ ,;
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,'....
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,,' "
....
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.......
.......
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S
$
s
s
.so
"",'
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.... ~
,. tiC;
. ',',. .
'..'.9&.5Q
":', , ....:.' .
. .;'39..5Q
....
: .... ,.
.,'.'
,',
,
"'.'
.. .; 100 C!J
i.' Q:~Np TOTAL
:,',
....
:,' .:'
':'.
. ....
'.: , .:\' f. .~ .. ,':'1.:. .". .
. ... '. . .
:Th!~pcnili,.ii ;.:1il.1!!d upOl!(ho e~proA:~ndtdDn dill ,"l.il .
. oqJ\l!ICl!,,:. Ihali comply.IOII" mpecu .wllli' tho ordl~. ,
, , .~ : .: Qrt;b.'i,,~~um~niCod':lnd~'uncltdn)'ea\tllhoreof.'.'"
I .: .. > ~~N~7~/ .DATE
. , ..~...; "<i'i. :'. .-,. .,: .~~r . ...... ATTBST.
. ... . . Catlf~raU i~~li6ri~ 2.(Jt~;;;;; advance. ....
.: .' ':',: "',.. ',. .::~ :,,:,' :'.. "'.... ,: ", :', "" . '. . '. .
16200.Eaglc Crccl\'Av:S.E;. PTi"otLak~,Mi!l~c$o~ 55372 r;P~:i(612) 447-4230'IFAx (612) 447-4245
. ..... . :{ ^",E.quaJ !Opp~flunio/,Employ.r . . .
..
" .'.
.~::..::...; .
.,:......
.. 6.. PAID
,..vILtJI,.,,,, 'Wrn"/
. . 'Y~ ~"
.... ..:FiMrr
","
'. ','
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONlNG/FIREPLACE PERMIT
I. Pink
2. Green
). Yl:lIow
5,,,,, I PERMIT NO. {)1~0253 I
(Please .!VD~ or orint and sUm at bottom)
ADDRESS
Vt32~ Vbv{. t.+- lJ E:
LEGAL DESCRIPTION (olliee use only)
LOT /5 BLOCK I ADDITION /:::t-iOI3 HIU-- 51li.
OWNER--n.~,_ 1l~.__L_ A~
(Name) nrl'J1~ UJrr:rrnA.\;;l ItJYL
. (Address) 'PD &'i IS \1\. Lo.ke"i lle.,
APPLICANTAl\'i1nt IAA...... '^ '__1
(Name) IIA,. IYILY..,an 1lZ!,..l
(Address) ~D Ktnt^ltbec ""Dr'
(Address)
(Contact Person) .:B.li\ M,i.Ll..a..r
APPLICANT SIGNATURE 8U1 ~\
(Phone)
M.tV5SDaW-
Date Rec'd
4-IQ-ol
ZONING (ollice we)
gl
PIDZS-3c..8-0/5-Q
(PhOne)~'
~~ MIJ ~~l~L
(Phone) --'..o5J 45L.2.I1S
DATE J.I/n/IJI
Sw+t I
/ APPLICANT PLEASE COMPLETE BELOW
~EW CONSlRUCnON 0 REPLACEMENT 0 ALTERA nONS
FURNACE MAKE AND MODEL 1JJ.yVLlY !5g f'fJJJd11:t> I ~ FUEL ~
FLUE SIZE I've RETURN OPENINGS /I INPUT /IJb. /)/)() OUTPUT qi ^
TYPE OF SYSTEM HEATING OR POWER PLANT
~arm Air Plants 0 Steam
OGravity 0 Hot Water
o lo,1echanical . 0 Radiation
~r Conditioning 0 Special Devices
[J;pt7ent. System 0 Other Devices
Building Permit #
;P'~
FIREPLACE MAKEAND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 mioimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & AIC (New Coostruction)
Residential, Heating Ooly (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
I Paid
I Da1e4_(Q_O I
Building Official
Date
14 hour notice for all inspections (951) 447-9850, fax (952) 447-4245
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
PRIOR LAKE . DEPARTMENT OF
". BUILDING AND INSPECTION
INSPECTIQN RECORD
SITE ADDRESS 14~?_t:; D"'-I.e. c...~
NATURE OF WORK J.l~
USE OF BUILDING SFD
PERMIT NO. n, - 07 P=.i.L DATE ISSUED "!- 2. -2....1
CONTRACTOR ~_:..-..- C""-",,,- - PHONE QS2-f'ff'Z. )71:)(
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
I tin. 7"/.:;;0}
. -
I FOUNDATION (Prior to Backflll)r~.;;:... I fm- ,{froIO! I ~_ .t.(//t,/r; I
I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~,
4.
DATE
I FOOTING
GRADING (Prior to Sodding) .
, BUILDING"[.c...o.-tJ; 'i}I-r!DI G=t. 7/3/1/
ELECTRICAL ' '
PLUMBING
HEATING
DO NOT
SEWER I WATER 1 SEPTIC
FRAMING wI u
INSULATION
ELECTRICAL
PLUMBING ~~-~~ .1 5'ltOlor
HEATING (If required) II IJ. ,t:;Jn/17
FIREPLACE 01- 5/1''1''''
GAS LINE AIR TEST~~, f'.r. fMIt.l. €.' :J/J7~1
, I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
!1Ib/J
. /:1:::r
I /
&;
I 111..10/
K/-J.. 5JnJ,,1
,"')/~.f /0 ~
I
"
p,./'7.0(
Y1i3-IIO/
,
OCCUPY UNTIL ABOVE HAS
NOTICE
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 shall be placed near main entrance.
ItPfrPG(o/
7i3!M
BEEN SIGNED
Call between 8:00 and 9:QO.A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
';".
Use Clauificatir- SINGLE FAMILY Bldg. Permit No 01-0253
'"'w"'r"'- ~.. Type R3 . Type Construction VN Fire Zone N/A Zoniog District R1
Legel Description 115, Bl, KNOB HILL FIFTH ADDITION
14325 DOVE COURT NE
Owner of Building
Contra<tor's Name &tAddress BRENNER CJ);NSTR.,
ROBERT D. HUTCHINS u.----
I( .I -r City Planner
AiJ '(7;j r"ial I
~ite Address
POST OFFICE BOX 1314, LAKEVILLE 55044
DON RYE
Date:
"-iIlli'
'ill"
~..:.i.~~il_'t-~,' ',,;t.. ,,,;.,,;"' "." ~.i.~'~;";'Ci;:"::-i \. ~
.'."
.:\'..~,,:
':iliiriI,,''/ '
, 11IM
AOOR ESS
OCCUPANT _
HEAT LOSS
SOLD BY INSTALLED BY
EI.c1rical Work By ..~ '';a. Lio. By ~'c./<. (....J
TYPE OF HEAT GA _ FA frHW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
r GAS DESIGN CONVERSION
MAKE -I 1Jt./(Le..Ji MAKE OF BURNER
Mod.1 ~'irJ!!J.Xl}J~ {::" LSJ/f.. Mod.1
Sarial <5,?L"J! I} / '2;).. s. Y Mo.. BTU Ra'io'
INPUT I ~^":> MAKE OF FURNACF
Mod.1
LJ CONTROLS
THERMOSTAT -LrW He.' Plug.
Val.,._
Limit
Limit Setting.
Fan Setting
Pilot Type
Pi lot Mak.
Pil.. Model
Pilot Timing _
L. W. Cu. Off
Pr..sur.
I""u' CFH
Stack Temp.
Form 235
.,
1~3;o
11""
HOUSE HEATING TEST RECORD
~/r
.10"'#
CITY lIt.. .
5'8~
DATE HTG, INST.. b, Z- ""7_tf>t' _
APT._FLOOR
OWNER
SUBUR"
Vent Size
<,'
{J.J~
/j..1 :>':'r '- <.R
KIND OF LINER
Draft Hood
Filt.r. Size_
Chimney Location
Chimney Construction
Outsld.
SIZF
RegulaTor
Number
_NONE.
IO'i~
Smoke Bomb
Draft
Door Pres sur. .
_Wiring
T.st Tag
Lighting Inst
3.~
10 r
Percent CO2 ---I,<?".. ~
_ Percen' 0 ~
Percent CO ~ ~ .....
Fredericksotl Hea~o9 & A/C. 3650 Ke,,"ebec Dr., Eagoo. MN 55122
S-~
Dat. T ..fed
Company Testing
Name of Tester
111~/OI
~d'i
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/ Lj $,,;J..S
OWNER
CONTR,
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
~ 0 MECHRI
., WATER HOOKUP
. ':SEWER HOOKUP
'J PLUMBING FINAL
o MECH FINAL
COMMENT!(:i)) Jtfri - ~
(~) (1p,,~ ~.I J-
~~ o-t-~.'-:.o.,
DATE TIME
1/:00
o / - ,,;)5 :5
o EXiGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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I
f
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r'l~ ~'I fII~ kf,... LQi) ~
Jj \111; '\V-.!I (l~ ~- M:l' I~
o WORK SATISFACT( PROCEED .' I-J/l ~ ~
)1tJ CORRECT ACTION AND PROCEED
o CORRECT WO!J<' CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ , Owner!Conlr:
gALL 4U.985D FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
1JISNO"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE '/zsh, 1/: tJ-o
INSPECTION NOTICE SCHEDULED
,
ADDRESS /'/3..25 .:D~rlS' cr,
OWNER CONTR.
PHONE NO. PERMIT NO. (Jt - ,;)<;;3
o FOOTING 0 PLUMBING RI 0 EXIGRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAiNT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL )lI'PLUMBING FINAL 0 GASLINE AIR TST
o SITE INSPECTION 0 MECH FINAL 0
COMMENTSm ~14-1 ~J~
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o WORK SATISFACTORY, PROCEED
Y' CORRECT ACTION AND PROCEED
:.::ECT WOR~~R REINS::::::::FORE COVERING
CALL "7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
DATE TIME
CITY OF PRIOR LAKE ({;;-9 !DI
INSPECTION NOTICE SCHEDULED A'lf
ADDRESS / </'<...::... c:- d7JVc C''r
OWNER CONTR.
PHONE NO. PERMIT NO. 6( -02-53
o FOOTING 0 PLUMBING RI 0 EXIGRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING ~D WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL . 0 PLUMBING FINAL 0 GASLINE AIR TST
o SITE INSPECTION X MECH FINAL 0
COMMENTS:@~ A-c....., -&.:.........- ~ ~
JJ.~ ..f" 2.b06 ~ .
g ,~ -7 -{.o ~ ~ /I"-Of- ~
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~ 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/
INSNOTJ
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
g -f7--OJ ? IY1
ADDRESS
1'73)!; DOll~ CT
CONTR. Bfellflt.". ~o'/t,-f.
OWNER
PHONE NO,
PERMIT NO,
eJj- :::?~
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
)a'E.~ILLING
, d'- COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
f ",h IS 0 /_ - (9 K..
X WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
lnSpectorl'/~-,y - _,,~ontr:
CALL 0147.9850 FOR THE NEXT INl'IPECTlON 24 HOURl'IlN A.nVANr.~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
~ DATE TIllE
SCHEDULED' 7~ 3 -01. 0: 3 0
Dnud2J
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/ll.~ d-~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o !ll$ULA TION
~INAL
o SITE INSPECTION
J - ;)S~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~ 0 ~UMBING FINAL
~ECH FINAL
COMMENTS:ftj K.~ fed;;. ~ ~ v-.-:r::J
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~""~"",,"~-,,,,,,,,,,,,,,,;,,~,-,,,,,,,,-~:,,""""'~~-'
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.~
./
-~-:..'
o WORK SATISFACTORY, PROCEED
~CORRECT ACTION AND PROCEED
b CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'0r1
Inspector:
OWner/Contr:
.
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANC~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4 SAFETY/
/NSNOT/