HomeMy WebLinkAboutBldg Permit 04-0975
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File
Date Rec' d
q.. B.. 04---
I. White File
2 Pink City
3 Yellow Applicant
I PERMIT NO.o"f . 0 976
(Please me or print and si~ at bottom)
ADDRESS
''-'1 30~(l'e.-ld l)rL'Lge ~ 2b
ZONING (office use)
~~
LEGAL DESCRIPTION (office use only)
LOT B BLOC~ ADDI~IOJ>~~ id ,rv--
PID $. 407. 0 rG. . 0
OWNER
(Name)
(Phone)
(Address)
LAkwl' U.e
\...
(Phoned~)98S-7833 .
(PhOne)~~,~t; f toli~ fo:L/1:.>Z.
. rh(\/ ~If( - -
,
TYPE OF WORK~ew Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
"OAddition OAlteration OUtility Connection 0 Misc.
CODE: NfI.R.C. OI.B.C.
Type of l;stroction:
Occupancy Group: A B
Division:
I
E
II
F
1
1lI IV
H I
2 3
V
M
4
A
R
5
B
S U
PROJECT COST/VALUE $
(excluding land)
P8~/ (p
I
I hereby certifY that I have furnished mformation on this application which is to the best of my knowledge tme and correct. I also certifY that I am the owner or authonzed agent for the
above-menl1oned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submittcd plans. I am aware that the buildmg
,~ci~ ca~ permit for JU~ c~~r:~1 hereby agree that the City ~~CC15esce51e propelly to perform neer :~r:o L/
J ~ Signature - Contractor's License No. Date
~,
Permit Valuation "'/4/. tlOt'), tJ() I I Park Support Fee # $
Permit Fee $ /c;:.19,5() I SAC # $ I.'? SO. on
Plan Check Fee $ c?~tf,~ I Water Meter (!n~~l"; $ UtJ. 01J
State Surcharge $ 7~ .S"'O I Pressure Reducer $ qS; 0 lJ
Penalty $ . I Sewer/Water Connection Fee # $ IZCJO,OD
Plumbing Permit Fee $ I()t}, 1/ 0 I Water Tower Fee # $ 700, DO
Mechanical Permit Fee $ IOd, f)tJ I Builder's Deposit $
Sewer & Water Permit Fee $ 3!::. SO I Other $
Gas Fireplace Permit Fee $ ~t1, tf}o I TOTAL DUE $ ~" 0..3 5 . / PL
~ro~mng;:;= IPaid~M--''''~~ Receipt No, 4iJ?S'"if I
I Date Jd/t//D .,. By ~ ' I
- I
Buildlllg Ollicial Date'
ThiS IS to certifY that the request in the above appIical10n and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner consl1tute~ temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Cerl1ficate of <iccupancy must be
iSSU~.J-~ 1h?hS/ See Main File
Planning Director / / Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
See Main File
The ('f'nln of Ihe tikI' ('ounlry
White . Building
Canary - En~ineering
C Pink - Plannln!l)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
l~:_ L. tl ( k I C r )
rj' ( ( 4-
. (' I
I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I (--1'
!! ._{, 1,/( t:_
'.
f--fl.CI
, '..-
r:IL.
. ':
.. .
Accepted
./
Accepted With Corrections
.
,.(
Denied
Reviewed By:
\...
~ ~ 1;1--
'.
Date:
9kr7~~/
"
Comments:
See Main File
.' ."'.;.
"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."
See Main File
~tli,e - Buildirl'g)
Canary - E:nglneermg
Pink - Planning
The Cf'nlrr or fhe takt Counlr)"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1) e _ H-OfG,I U~
q. B..o4-
I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
174-=V DE5tzFlbLD DY2-.
Accepted
Accepted With Corrections
Denied
~~~~
Date:
9/,.. 7~L/
,
Reviewed By:
Comments:
See Main File
"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."
See Main File
= - ~i1ding
L ~!r":I,,,:>
Pink - Planning
Th. C.nl.. of Ih. L.k. Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1 "'- ~ - I 1(, .......--') !
~ '- .::, ...-~; f("'i ; i &~, i
1./ _ 11\../--...1\.'.--
r, t. . /1
-,~l '-~'. f\~
f ~,tj I
i
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'I ~-,? /;;;_I._:-)() [--)1.-:' {:: /,,'C,' C fL'; L'-)!.,-_.'r_
. '._' ../ ,_.- '.J , ~. l l..... ,-~..' _ -- -
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
1Wf3
!Jee. !n",^- Fr'/L
Date:
9-21-0L/
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."
.~~"_.._~,._,_~_.,_,____.,rt~~,_----..._.__,....____...____~..
09/30/2004 THU 16:10 FAX 6513226147 GENZ-RYAN
I4J 004/007
Date Rec'd
CITY,OF PRIOR LAKE
SEWER AND WATER PERMIT
I. a.... File I PERMIT NO
'I.. Yellow City'
l. Gold Applic:onl
(Please tylle or priDt and siJ1;l1 at botll:lm)
ADDRESS
11 ~ VI) ~fJaj1 eI (,L 1>0--- <6F
LEGAL DESCR.u- uON (office use only) .
LOT 1.6BLOCK d- ADDITION bel~-h eJr1 I '1111
PID
OWNER
(Name) ---tll:l U~~h~~"~~ u,~~
(phone) _ O/~ -qgS- t g of\,
(Address)
208.00 KeVlI3i<..\l:te C:r SIT_1M
(Address)
, La,~\J i lie...
(City)
_'5ec~ Ll
(Zip Code)
APPLICANT
~ame) Genz-Ryan Plumbing & Heating
(phone) _ 651-423-1144
(Address) 14745 So Robert Trail
(Address) .
(Contact Person). n,lll ~i s 17 ~ I ( s
. (1 ~ 6"
':.ICANT SIGNATURE ~ A A If /1 n )
Rosemount. MN
(City)
55068
(Zip Code)
/)
'::fi1 / / /l
(phone) 651-423-1144 p
DATE q I~J[) 1c4
APPLICANT PLEASE COMPL~TE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
FEE SCHEDULE
Residential sewer and water line connection $35.50 Industrial, Com'1 & Multi-family 1% of job cost with a $39.50 minimum
Sewer connection only $17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
, '
.,. ..-
~'7),. : _ i.i<::'i,}i~~~','. -!) ," '\'
~. .~~.; ,or, "'. ~ ":1,:1~ '~.~
-\./,). ~ .. ,;',' _' \1.'<1,1>
- -~'... ; :1#/:::' ',",'-
" ~ Fi':::;:'" 1! "
...... .!i'"ff"
W"'fI'l
(Office Use Only)
,
....-
Building Official
I ~~~ ~ @ ~ 0 W ~ r~ :ipt No.
1f OCT 0 8 2004/ n:
u_ ~
24 hour notice for all inspections (952) 447-98S! , fax (952) 447-4245
By
Date
Thjs Application Becomes Your Building Permit When Approved
09/30/2004 THU 16:10 FAX 6513226147 GENZ-RYAN
l4J 005/007
Date Ree'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(please t}'Ee or print and si~ at bottom)
ADDRESS
(It! fiO i}eiitfi fi (1 D1t2 )(f'
I. Blue File PERMIT NOJt..,~. o'
2. Gold City
3. Yollow ^ppJicon.
ZONING (office use)
LEGAL DESCRll:' LlON (office use only)
LOT/3 BLOCK;Z ADDITION /)j~~-e Id I' h1
. .. j 1
PID
OWNER
(Name) DR Horton Custom Homes
(Address)' 2c~(PD IUnB~1 DEe... CO' 5,e, no
(phone)
902 - q ~ FJ -7?5l)()
uduvillG jAAN .5~Lj LJ
APPLICANT
(Name)...Ge+'''-"O:''''''' P1"","'-,,\g ~.."H...c: (phone) "'\'_lL?<_lllu'..
(Address) 14745 So Robert Trail Rosemount
1 (Address) " (City)
(Contact Person) _J1L11et m ~ ( LS - . ()" (Phone)
APPLICANT SIGNATURE j,~ )-ftb' ) m.P l/l DATE
.::7 _ _ ... ~
MN
55068
(Zip Code)
651-423-1144 I
q I?y{) I rif-
APPLICANT PLEASE COMPLETE BELOW
I Quantity Type of Fixture Quantity Type of Fixture
I i Bath Tub with or without shower 3 Rough-ins
I I I Dishwasher i I Water Heater
, I Floor Drain 'l2.T Water Softner
I .'J- Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I I Laundry Tray (lor 2 compartment sink I Sewage Ejector
I I I Shower Stall I Backflow Assembly I
I I I Sinks I Backflow Assembly Test I
I I Bar Sink I Lawn Sprinkler I
I ,;I. I Water Closet (Toilet) I Other I
!l'J!.iJ!; SCHEDULE
Industrial, Commercial &. Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
8T ATE SURCHARGE $
TOTALPERNaTFEE $
.50
,I,..tl~~ ;,;;",,1
'.:t ..t ./'il~,j Ii.i" ~~,
:", ~tJ.'" ,.;f
;'1./ ... ,., ~ ~ {O <1' i
<..... .. ~~ s-,....
.fI ~ '-'r..":;lo,~:;~ ,"~
""'. :WJ~ J
(oroce Use Only)
This Application Becomes Your Building Permit When Approved I P,,;~ ~ -;J Receipt No.
o \~~e@ ~ D ~ C \'18Y
Date I I' OCT 9 8 2004 j I
24 hour notice for all inspections (952) 447. klo, fax (952) 447-4245 ..J
Building Otlieial
,By
Cl'!'}:" OF PRIOR LAKE
HEA luiG/AIRCONDITIONlNG/1i1.KEPLACE PERl\'ul
Date Rec'd
~~03 LI
WleaseJyp~.!>r/print and sign at b....v...)
. ADDR'BSS
. \']4\~D, '\? ~ ~ '\.-',~~ \('y"("'.S ~
~:~ ~lr.icantl PERMIT,NO()f.. 0!f1S
ZONING (ofliceuse)
EEGAJUDESCRlPTION (office use only)
LQ$\'3Bl,OCK~ ADDITION S= r ~\D """' \ \
Q~R DRHORTON
<Name) 20860 KENBRIDGE CT
. \(~~~~~J. LAKEVILLE, MN 55044
~.
PID
(phone)
-,'(::,,:.;-",",,"'"
;'.'; ~/",t:,;.;.;: '"
:.'.':"f~~~~~/~~ ~r~;,/'-~
(AcldresS)~~ ~~6"P .~
.' , (A<idre' >
(d6~I#~Pe~n) . A<vaZ/4~
A1tPLH1ANTSIGNATURE --7-4.~, !--r-'_....____
0-
(Phone) '/:'5 .Aqf.,?...,f'? 7.:t- .
'~..~4.< ~.::r~-?
..,.- (ci5ii.ff (Zip Code)
(Phone)ii~ -- .if~-~ 77:5]
DATE'
:-':-,::":, : ,', , ' ,- ""., ,'---: _.....,.,,-'.'-,.-':.-...;
# A>>r:I1ICVANT PLEAS:EC()MPLETE~Jt~Q:W .
,3lNEW CO~TRUCTION . .DREPLACEMEN'r'[22]1\LTERA TI9NS . . J .'
FU. 'l\I'fAC.. E~ANDMOD~/~<..r-?/~~q'&;1q. >i FUEL . .~ k~
FLUE SlZE<0~~ RETURN OPENINGS .' ii..... INPUTq~~ OUTPUT .~-' ~
TYPE OF SYSTEM HEA'I'ING ORPOWEltPLANT
[]Warm Air Plants . []Steam
DGravity 0 HotWater .
[]Mechanical . ORadi~tiori
ilAir Conditioning [] Special Devices
mYent. System o Other Devices
.
\".~'io.
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
'~
FDmPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential~ Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AfC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ 3.5Z):2 a::> Building Pennit # ,
HEATING PERMIT FEE $~/~~W- VVIl'H
STATE SURCHARGE $ . ~ .5OBUlLDIN"G
TOTAL PERMIT FEE $ 0
(Office Use Only) 1;'\ IT' lr; i L ~"il {MI l'
Tb;, Appli",tion Becomes Y 00. Boilding Pe.mit Wheo App,"ved ! ~'I1iidI7. ! " . I!' ~ '.<<;pi "".
)D~ f 2 2 2004 It;,/1 By
Building Official Date -' l_.-li
24 hour notice for all inspections (952) 447 ~8,50, fax (952) 447-4245
\..,'-~_., -- ----.-----.-------.--., "-
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink
2, Green
3, Yellow
~:~. I PERMIT NO.,.,d 6'1-..r
Apphcanl q. ~
(Please tv1Je or 1lrint and si~ at bottom)
ADDRESS
ZONING (office use)
17450 DEERFIELD DRIVE S.E.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name DR HORTON
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone)
651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
11/18/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEATN GLO SL-750TR-D
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Date
By
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
.
SITE ADDRESS 1'I~5:D ~19~u ~/tIF
NATURE OF WORK NlsItJ ~S r~'c~ /'''t.,;J
USE OF BUILDING .s F\ A .
PERMIT NO. (Jf~ 0 97S DATE ISSUED ~A.? A....
CONTRACTOR ~. JINl~~j.JC' PH6NE~ws-"'m~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF See Main File
BUILDING AND INSPECTION
INSPECTOR DATE
FOOTING ~ /p/?/or
FOUNDATION (Prior to Backfill) .e1~vrl".1I ~~/6 C; I /:;];X:7.
, . ..-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER/WATER/SEPTIC I ,lit( , /'P?/o(
FRAMING /~7 /..2///O~
INSULATION ~ /.2/Y?7
ELECTRICAL /p Y/c..(;7! .....
PLUMBING dJ.5' /#~t( ~~ ~ /r/.,29~~
. HEATING (it required) $;. i~ J/,.. / / //.<J Ie,!
FIREPLACE ~ /.2,/JA~~
GAS LINE AIR TEST ,.It 'J c /: // ;: 1 ~ r
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
'i.AL1I~ / H"MS'.~ I I
I FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
("'""'l ./ .--fJ
C )~~h fr/e.-
~ 9~7k'"
/Ppft?S'"
i - (LQ~-- ....
9/2z/oj.'--
-- -
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
//fiV/
~
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.
FOR ALL INSPECTIONS (952) 447-9850
Olertifiratr nf (IDrntpanr\!
CITY OF PRIOR LAKE
~tparfttttuf of ~uil~iug JIusptrfiou
~inal Permitted 0 Conditional e.O. Expires
This Certificate issued pursuant to the requirements of Section 110 of the 0 Residential / 0 International
Building Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City of Prior Lake regulating building construction or use. For the following:
SINGLE FAMILY 04-0975
Use Classification Bldg. Permit No.
Occupancy Type
R3
Type Construction
L13, B2, DEERFIELD 11TH
VN
, Zoning District
R2
Legal Description
Owner of Building
D.R. HORTON, 20860
Contractor's Name & Address ~/
ROBERT D. HUTCHINS ~
/', _ City Planner_
c:? b f%~cial Date:
r/ /
17450 DEERFIELD DRIVE SE
Site Address
KENBRIDGE COURT, #100, LAKEVILLE 55044
JANE KANSIER
Date:
"......,
-~""J.
-~~._-,~~J
ADDRESS
/7rSD
DATE TIME
SCHEDULED ;I~~~
aerl!.// /Jy-
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
PERMIT NO.
~PLUMBING RI
,/' d"MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/,')d - 97,)-
PHONE NO.
- ,
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
,(']/ / /) . ~
~~d/~9 k, ...L,
, -../
rS/6' ..~y- ,~f~7 ~~/
//J--'
~~ / Z~
/-
OK
~ORK SATISFACTORY, PROCEED
/ci-- ~'ORRECT ACTION AND PROCEED
D CORRECT WO~~':)"R 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
/.L~/ 6<7"
.. ,
/ke"l!t-jj dr
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/79'.5 '()
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
~MlNG
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
COMMEtfTS:, _!..-- P
;7ecfh<:~1 ~---h d~~.
/'" - / - ,r
///C// /~C ~ /C~,-j/
/
~ ,
rY#'#7/J'
/"I /'
C//C
TIME
oy- ?'7S-
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.., /
/r/.-zs/ /oif
. / I
/
01'<:
~ORK SATiSFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK'fC~;1? REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
ADDRESS
/77150
DATE TIME
SCHEDULED 1';?~~jI'
PeR,!?cllU
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
. /
d.t/ '- 9/J
D FOOTING
D FOUNDATION
QhRAMING
~SULATION
D FINAL
D SITE INSPECTION
D PLUMBING RI
D MECH RI
D WATER HOOKUP
D SEWER HOOKUP
D PLUMBING FINAL
D MECH FINAL
D EXIGRADIFILLlNG
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GAS LINE AIR TST
D
COMMENTS:
/' / /
J~JU/~?76~
r-J /
~~/~
I
~ORK SATISFACTORY, PROCEED
/ ~ CORRECT ACTION AND PROCEED
D CORRECT WOR~, ;:';l~INSPECTION BEFORE COVERING
Inspector: f~ 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
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
(O)({~
\../
DATE TIME
SCHEDULED
/-/1-0
) ~/ \";\
,/ :--'U
Q., I~' fir lJ
CONTR.
PERMIT NO.
4- ~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
g PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/J
t7Aj-~
o )YORK SATISFACTORY, PROCEED
F CORRECT ACTION AND PROCEED
o CORREC~ "'O~Kn FOR REINSPECTlON BEFORE COVERING
Inspector: II Vr/ Owner/Contr:
I ,
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
~~--
d-eA/d a
SCHEDULED
ADDRESS
/ ?~G?
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
l:l ~LA TION
~~~~L
o SITE INSPECTION
COJUlEN18: .
g~~(
.....- /
~r4,
~r-~,~'
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~CH FINAL
r:- A
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~ORKSA~Ry.PROCEED ~
o CORRECT ACTION AND P~~C~ED
o CORRECT WORK, CALL F R 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
.
APPLIANCE
PERFORMANCE TEST
Attach to gas line adjacent to regulator
Heating Contractor
Name of Tester
Date
Ai W~~~lf
(' ~ a.rI
l')/1-7(()l/
Job Address cF4'70 I':>.p"r(::t.{~
Heating Contractor~; iv(" r 1'1
Name of Tester -" ~
Date \?,I '2 ?(oll
~~
J. r"(~
r"l, fA C :
Percent 02
Percent CO
Percent C02
Stack Temp
Combustion air is adequately supplied per
UMC Sec. 606 J ~.tC,
1.--
45~/~tf)u t) (LJ
.
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