The URL can be used to link to this page

Home My WebLink AboutBldg Permit 01-1309 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE J AND UTILITY CONNECTION PERMIT jll -3/-{) 1. White File 2, Pink City 3, Yellow Applicant (Please type or print and sign at bottom) ADDRESS Ij 71d 11f/lf!e -riA/V ~.f. Pfl~ 1At~ PERMIT NO. 0/-/301/ I ZONING (office use) RISV LEGAL DESCRIPTION (office use only) LOT j, BLOCK ADDITION JEf~ .f<<4JP ~dm"".J OWNER (Name) ;( Wt~ ( /. "fJ,j ';-00 . I . ~Jfr() t7Af? Po~ 1/ 1).-),- (Address) PID JS- --r;zq~ -- D{)d-?J tJltWJvT ~ (Phone) C,Ur 0 ~2?- 0(11- d~75 9171 b BUILDER (Name) ~ tJ tJ ItU ~~'7--V(/ n~f'J ., () J 0 EMf 4'.f -A Ir(/E.- Co, (lit> . ~,t/~€- (Phone) qSZ .- 403- q,co MN- ??37tf (Address) 0' TYPE OF WORK ~ New Construction OLower Level Finish o Misc. ODeck o Fireplace OPorch ORe-Roofing ORe-Siding OUtility Connection oC PROJECT COST /V ALUE (excluding land) $ j (,'1 {)OO ' I 7~( Contractor's License No. Park Support Fee SAC I Water Meter Size to 1"; I Pressure Reducer I Sewer/Water Connection Fee I Water Tower Fee I Builder's Deposit I Other ~~o TOTAL DUE MIA,EO II, /4 - () I I hereby certifY that I h ve furnished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the own~ authorized agent for e bove-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance willi submitted plans. I are that the ilding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the pr to perform e dins ections. $ $ $ $ $ $ $ $ I (,fJ I ootJ i .' ",?', i.J _ ss- OBq~_ 'fIll- ~ Cf .00 I Ot/ ~fX!J I !O().()O 1S:. SO 40 ,tJd x I Permit Fee Plan Check Fee l <1" ~ \r State Surcharge 1.p~Rillty I Plumbing Permit Fee I Mechanical Permit Fee I Sewer & Water Permit Fee I Gas Fireplace Permit Fee OAddition o Alteration ItJl3?~/ / Da(e # # , $ A'l>.c:O $ I. 150 . c:i:J $ " 12~OO $ 'I~OD I $ I. ;J..O(), DC> " r $ 7 () '" . (!Je> $ I, tar!)/') .02 I $ '. l;cJc9 lItO 8fft, 97. 5/ . # # $ I Paid ~ '17.0:1 Rec~fJh fo9~1-- I Date /I-d S- -a-J By ~fA--/ 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 signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be iSSU~ ,A, _ _ ~Ol ~ "'~- 11t...A>.N ~~< - p~ Date ~onditions,ifany 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 ecomes Your Building Permit When Approved 113-ol Date White - Building Canary - Engineering Pink - Planning The ('tnfrr of the t.kf ('oun.ry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT hPn6LL ~~ APPLICATION RECEIVED /0-0;--0/ The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is p'roposed at: ~ 3 70 ShtYll ~J Accepted Accepted With Corrections ')( Denied /J7;;) (J Reviewed By:VV!f!J;f- Date: /I-'t.-o( ~t~2 ~-!ta~ Uex5t:;, '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. ('.nl.. of Ih. "ok. Counlry White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT I ',/ /) '// "......-- (j' , fA.--- APPLICATION RECEIVED ;0 ~3 J G / The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: fJ - -- ,,- - '. A /, =-< \ " ,/ j' " : C'J .j 70 ,c-"j' ?,:~7? f v-J Accepted ~ Accepted With Corrections Denied ! ~J Reviewed By: tY~~....-=?7 Date: l LII<-I/ol Comments: t:09~ "i ~ eR- v:'v. ~s.l-). - ~ ~ y. (W_ W'" ~ fd:vl9{~ . ~il lI'.9V\ l/t.O V\IL6V~-,,::i ~ Lf'-/~ r- ~ Mc-.:e"^ ~ ~~\ Cb ~ "hrl';4' < ~ iff> ~eA) ~ UdJ-p. ~8tM ('---bY\~y Jd~ G~.0~~ ' {Jm,\~_ ~M.O: Lb>> ~ ~~ --f;t: /)./~ 'i~ cD \\iLP.-; 'R6 Vk ~~ "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~~~.';1.'~;'~,;i~~.i;-C~~;jf''-':'''\':~:''';'''~~>.';'' '~_.'~~. ~~--::;~ -~ " 0'7.. ....,:..>, '~:~-;''-}li';.( ~t;r.'.: ,,:;-.:,:, ":':'<-'" '~-:';.{~';:'i.":;~";~""~'~il>'..",;,.,io" ~~""'~~'1."".~~~l!\I\o(h Th~ (',nlff orlhe t.ke Counlry White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT h~" ~ APPLICATION RECEIVED /0 -'3/ --OJ The Building, E:ngineering, and Planning Departments have reviewed the building permit application for cons4cti3 a;~ WhiS h~ed ~ Accepted >< Accepted With Corrections Denied Reviewed By: AI fr ,3 Date: <J-9-'" , Comments: See Reverse Side for Additional Inform~tinnl tieeAltacl1ments: 1) Grading Plan, 2) Erosion Control Measures 3) Erosion 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." ;( CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT #/&9 Date Rec'd 1. Pink File PERMIT NO 2, Green City .,_ /"::}rL} 3, Yellow Applicant r ;;J~I (Please type or print and siJm, at bULLUU.) ADDRESS 6 ~~O ~h.D('~ \\'0..\ \ ~.E., ZONING (office use) LEGAL DESCRlYuON (ollire "" only) II ' LOT (TntOCK ( ADDITION ('i.fJ1~~ d. rJrl- OWNER A_ (Name) ~_ ~J(\~~O(\ (Address) 30\0 p..0-'C:::.~ ~~~ M!0 ' PID(?5 - :;;.q3-00c)-','J (Phone) ~Q."Sd. -40:,-Q \o:J ~~'t.-u~R..~ \ ~ 00:'\~ APPLICANT ... ~. ~ "- (Name) ~\1ili\~ ~ (' \ \ f\C.; . (Phone) ~ C\~ (j.:- ~l.\ ~- \C\ C)(J (Address) 2> ~ \ bC::>~ ~\ _ l.0e~ \- ~~\l.O.oee... \ ~~ 'S:s C> ,C\ (Address) (City) (Zip Code) ~ C> \r...\~ ~n ^ ,~ (Contact Person) _ '",---)'-UUu'x' ' (Phone) ~ '-J _APPLICANTSIGNATURE \~~ ~ DATE \D-2,\-e:,.\ APPLICANT PLEASE COMPLETE BELOW ~\mw CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS FURNACE MAKE AND MODEL W-\~\~\ "e.. F&loRt \ 'dD~ 1li7 FUEL rltl+ FLUE SIZE (pU RETURN OPENINGS 6 INPUT \ 00, D(JC) OUTPUT \O~~ ~c::o TYPE OF SYSTEM HEATING OR POWER PLANT ~arm Air Plants OGravity o Mechanical ~ir Conditioning OVent. System 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 Industrial. Commercial & Multi-Family FEE SCHEDULE 1 % of job cost Residential, Gas Fireplace $39.50 minimum ~9.50 ) Residential, Additions & Alterations $04.:>U Residential, AC Only $39.50 $39.50 $39.50 Residential, Heating & AIC (New Construction) Residential, Heating Only (New Construction) Estimated Cost $ \ \ \ ffiJ r;9 Building Permit # HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ \-..~^") "- 0 .50 'vJv).Jv (J/, /) A . \"'~;',' *"l / ,(;'! 'Z) 1,1. //1/. Yt::.\ 'f/ ,.. ReceipfNij~,~ #~. "f" '", ,.~ By -'r (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Date Building Official Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 CITY OF PRIOR LAKE PLUMBING PERMIT Date Rec'd (Please type or print and sign at bottom) ADDRESS ~8JO ~~}rt 1rai! )/f,. LEGAL DESCRIPTION (office use only) LOT;::1oLOCK I ADDITION()Ai<A~~:;:) tJ::i-. , rr.})l- ~W;:~R S tJ Ildaa If) f/f (Address) ~;;~~~a/I~~ P/bIJ /?;, f){~t! ' (Address) r!po Od/~#r 11(/-1 (Address) (Contact Person) (!J//S NiJf"f/ ~ APPLICANT SIGNATURE ~ M. M~ I I I I I I I I I L3 Quantity .) I t -.3 I I ( APPLICANT PLEASE COMPLETE BELOW Type of Fixture Quantity Bath Tub with or without shower .5 Dishwasher I Floor Drain Lavatory (Bathroom Sink) Laundry Tray (lor 2 compartment sink Shower Stall Sinks Bar Sink Water Closet (Toilet) FEE SCHEDULE Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimu~ I, ~.:~ ~!~ I PERMIT NO. /-/304 J. Yellow Applicant I ZONING (office use) RIg) PIDa5" J/i3-{):)J.-v (Phone) (Phone) Cl~:2-t/IJ.;}/ ;2/;2/ ...1O"AA_. I'{~ .0J6 b (City) , (Zip Code) (Phone) 95 r2 -t/~.2. .J/2) DATE {}d c2~O/ Type of Fixture /. Rough-ins I Water Heater Water Softner Stand Pipe (Washing Machine) Sewage Ejector Backflow Assembly Backtlow Assembly Test Lawn Sprinkler I Other . Residential, New One & Two-Family $99.50 Residential, Additions & Alterations $39.50 Estimated Cost $ Building Permit # Building Official Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 .50 ,,,..... 11/. /:IA VI!..D:/t) 11. -11/1':"1 I""',. Receipt No. ii ,....,S'.:.' , PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Date /I-/b-ol By qp/ U {7~ ~NEV GREEN . FR.E YELLOW . APPLICANT GOLD . CIT'I CITY OF PRIOR LAKE SEWER AND WATER PERMIT S.W.No. 0/-/309 NOTE: Sewer and Water contractors must be registered with the city. APPLICANT: hNIJL 6gj)iJE JNG ADDRESS: 1-3") t1)1J~ ~. S#f})(dJ~ !i1AJ SIGNATURE: ~~~~~ SITE ADDRESS: 587tJ SJlctl& -r.K'/fJ1- AJ E PHONE: 951- ';;33-/.~OD- DATE: /Jj fJlfj tJ I BLDG. PERMIT # 6/-1309 PID# FILL IN THE BLANKS 1. Estimated length of water service ...:?..IJ / feet. 2. Size of water service / inch(es) . 3. Location of any couplings from structure feet. 4. Type of sewer pipe. ABS PVC X 701 Estimated length of sewer line Cast Iron 5. feet. 6. Clean out (if required), structure. located at - feet from BY es your permit when approved. / ~ DATE:, /1"., Z 7-0 . ----------- ----------- This ---------------------------------------------------- ---------------------------------------------------- FEES: $ $ $ 5.00 .50 35.50 Sewer and water line connection permit. Surcharge TOTAL * Fee for either sewer or water individually is $~~ 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 .u. ~ 'lNG PEh,J,I ~ RECEIPT Y ~\\I!-.- RECiD BY f. / 16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245 An Equal Opportunity Employer Date Rec'd :J~/:J~oL- 5 ?, 7u .s~~ 1I fV'- (Please tyoe or orint ~nri ~j2'II at bottom) ADDRESS ,. --- -,., .. ZONING (office use) ~. ~;.~n ~:~y. I PERMIT NO'Cl,I_ ~(J9' ), Yellow Applicant :t- /,...., I APPLICANT (Name) \j-.eft..t..Jt H('Lf'f/.t-~ (Address) )foJ S-1/"'1~. A ~ (Address) (Contact Person) I..tu. ~ Sc...~f..(<:. 0 (Phone) APPLICANT SIGNATURE 4 ~,r.,/'-- DATE APPLICANT PLEASE COMPLETE BELOW ONEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION OWNER (Name) ~-\-, Aut. (Address) ~-J.s- c~} 0 f:- 4~ PID (Phone) ~~~ 7Sl~ 1 ~'D3- 9/o(;;J '15L.' Civo' S''=.. GO (Phone) f^1ff J-.4 (City) ~J7t. (Zip Code) ~5 2 - o/yo- S'- Zo 3~ /!>~o c:.... TYPE OF SYSTEM OWarm Air Plants DGravity o Mechanical DAir Conditioning DVent. System REA TING 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 Industrial, Commercial & Multi-Family FEE SCH 1% of job cost $39.50 minimum $99.50 $64.50 Residential, Heating & AIC (New Construction) Residential, Heating Only (New Construction) Estimated Cost $ HEATING PERMIT FEE STATE SURCHARGE TOTAL PE&.\1IT FEE (Office Use Only) This Application Becomes Your Building Permit When Approved Building Official Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 Re~i~ent:l:";~~ eSl ential, Additions & Alterations Residential, AC Only $39.50 $39.50 $39.50 Building Pennit # ()j-(70 r vi ~ AIO tJj .50 P II ~f)~. ---- Re~ By J1&) (;tlj $ $ $ #' ~ ~ Date }."-/~---O~ PRIOR LAKE INSPECTION RECORD DEPARTMENT OF SOILDING AND INSPECTION SITE ADDRESS :5 ~]f:( ::)~~, It-J NATURE OF WORK ~ J~ USE OF BUILDING ~l=' f, PERMIT NO. 01-7300 DATE ISSUED 11-1-01 CONTRACTOR S-rA...._~ ~ PHONEJ.)) -lfO] - 1/00 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR 711 ,) DATF) , FOOTING !2k-1. I II j-zp) ~ I FOUNDATION (Prior to Backfill) I ~ .''' 111/;;-9~ I . , PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS h;n SEWER I WATERj SEPTIC FRAMING w Ie tNK p~elAJS INSULATION ~/ v .t ELECTRICAL I PLUMBING 4691~p1-eJ r ~b HEATING (if required) I vJ/(E FIREPLACE GAS LINE AIR TEST F.(3. (2.. fJ - /1/)..';"1 1/(~/0'7- 1/le/o2- GRADING (Prior to Sodding) BUILDING ,.(.0 ~ ~I { /o'L-c ~; 3/; /t7~ J ELECTRICAL I I . PLUMBING HEATING DO NOT ,/] JJ1- / /q /OZ ~ 1/ J ( J II y' ' , I ?t1:. !~ ~/#2-- ~~, ~ (/, #n-. 119hz., / I ~ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS 1l.L3 . .,--~. ./ S-z 1- 6 z:.. 7 Ii 0 It! G-;- I "" t?ff . 61ft; /8 L ~ ' '#2 th 3Ja-~2.- OCCUpy UNTIL ABOVE HAS BEEN SIGNED 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. Call between 8:00 and 9:00 A.M: for all inspections FOR ALL INSPECTIONS (952) 447-9850 DATE TIME CITY OF PRIOR LAKE INSPECTION NonCE SCHEDULED J L $l /IJ{ ADDRESS ",.t;;n-O ~i. ~Q."-tL OWNER CONTR. PHONE NO. PERMIT NO. --.fit" t 3c99 ~ o FOOTING o FOUNDATION o FRAMING 8/NSULA TION ~ ~INAL o SITE INSPECTION o PLUMBING Rl o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: ... 4V~ ~~ JiJ[~ 19k_ Cb_~ ~RK 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 24 HOURS IN ADVANCE.. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! _OTI CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION $f FINAL tJ SITE INSPECTION COMMENTS: DATE TIME SCHEDULED 7- II) - ~ II- 1/ ,. 5"370 ^~he(Q r r- CONTR. PERMIT NO. (- /~o9 o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o ~+-I - ('~ ~~~ ~.j). ~ O'~--n-~~ ~ WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING G/ Inspector: ~ Owner/Contr: " , CALL 447-9856 FO THE NEXT INSPECTION 24 HOURS IN ADVANCE.. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY! IHSHOTl CITY OF PRIOR LAKE INSPECTION NOTICE DATE TIME SCHEDULED ~-J/-02 ADDRESS 5376 ~hol'e.- -rr/ OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULA nON Dr.(!INAL o SITE INSPECTION CONTR. ~dc, (/ 0/-/30'/ PERMIT NO. o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL Dg(E)(/rr:unv=ILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o COMMENTS: LV Ib !3Cfx. 0 t< brv:tc(e--C9k ~ [f ect <1 CI rt, "1 eJ,',-f !5C,P1/ i'~ (u(6 f-GuHe/ . jlWORK SATISFACTORY, PROCEED I~ CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR RElNSPECTION BEFORE COVERING Inspector#'~ -=--~ J.vner/Contr: CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! IN$NOTI DATE TIME CITY OF PRIOR LAKE 3/u/o'l... A.I. INSPECTION NOTICE SCHEDULED ADDRESS 53 ?tJ ~ /~, OWNER CONTR. PHONE NO. PERMIT NO. tJI-/?o1 o FOOTING 0 PLUMBING RI 0 EX/GRAD/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 /i\\ 0 PLUMBING FINAL. 0 GAS LINE AIR TST o SITE INSPECTION (l.!:Y ;Ji'( MECH FINAL a.. ~~ 0 COMMENTS: &.u ~ 2fj,.....:...... ,+ - ~l '2.. - '3..S? s - 01 ~ ~ WORK SATISFACTORY. PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: ~ , Owner/Contr: CALL 447-985: ;:~ THE NEXT INSPECTION 24 HOURS IN ADVANCE., CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl INSNOTl DATE TIME CITY OF PRIOR LAKE akiJtJL INSPECTION NOTICE SCHEDULED '1:30 ADDRESS 537tJ ~ "1'IU-. OWNER CONTR. PHONE NO. PERMIT NO. ~(-/3() , o FOOTING 0 PLUMBING RI o FOUNDATION 0 MECH RI o FRAMING @ 0 WATER HOOKUP o INSULATION tl 0 SEWER HOOKUP 1!! FINAL 0 PLUMBING FINAL o SITE INSPECTION 'eJlt.. 'K MECH FINAL COMMENTS: Jt'L- f ~ -i'.' CD ()~ Lt" ~ kl~, @p.j; ~&~ ~~-~ ~ l~ ^ ' ~n-r, , ~ ~ (})~~~ ~~~~~ (&e. .~~~.) - ~.~ ~ ~ ~~ ~ eotk wU- _~ :.c, ~- fJ~ ~~ :-. L.l, (~fLM ~~ ~ f~. @) &Q.~--cJL en J~ /J ~ F"^- ,.. · _ . ~_ d ,. ) _ ~.A.a:l-~ /~ ~~004~' ,-; (!. C). i:z(f) r 11/ 0 2.- - I GI EX/GRAD/FILLING o COMPLAINT ~ FIREPLACE RI FIREPLACE FINAL GASLlNE AIR TST o ~~~ o WORK SATISFACTORY, PROCEED "'CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR RElNSPECTION 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 CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED 3-1e.-tD . 3: ao &~,~ CATE TIME ADDRESS ~8/0 OWNER CONTR. PHONE NO. PERMIT NO. /-/301 o EX/GRAD/FILLING o COMPLAINT o FIREPLACE Rl o FIREPLACE FINAL o GASLlNE AIR TST o a~ ~ ~-"-~ .p~ ~-~ (~) ~ '1::-1 (1~ jJ, I ' . p~~~~/j~, ~ .,-r;.e4id,..G /~ ~,~ trr-' ~~: COMMENTS: ,1 o PLUMBING RI o MECH RI o WATER HOOKUP o EWER HOOKUP PLUMBING FINAL o MECH FINAL o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTIO ~~~~ = o WORK SATISFACTORY, PROCEED 1!. CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ~~ Inspector: / \ . Owner/Contr: CALL 447-9850 F R THE NEXT INSPECTION 24 HOURS IN ADVANCE.:. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl INSNOTI ADDRESS 5310 OCCUPANT, HEAT LOSS. SOLO BY Electrical Work By TYPE OF HEA T S IbRI= _DATE HTG. INST. GA FA HOUSE --rRAlL HW GAS DESIGN MAK E _"FR'!\ C\ E'MlKE Mod.1 1=' ~C- ~- ~ ~ -/J.,.B S.rio I 9f> ~o '-17 F=- INPUT 100/ COt) THERMOS TAT Va Iv.. _ lirr.il limir S..tting_ Fan s",ting Pilol Type Pilol Make Pilol Mod..1 Pilol Timing L. W. CuI 011 Pre ssure 35 InpuICFH_ Slack T..mp. Fo'm 235 ilO CONTROLS - Heot Plug Percent CO2 Percent 01" Percen1 CO . ~, 9 ~ f)_ HEATING TEST RECORD APT. .OWNER. _FLOOR STEAM INSTALLED BY . Gos line By SPACE HTR. _ MAK E OF BURNER Mod..1 . Max. BTU ROling_ . MAKE OF FURNACE Mod,,1 V.nl Si... KIND OF LINER Droh Hood F i It.... Sh.. Chimney Locolion o,imney Construction Inside Smok.. Bomb Droit CITY . SUBURB_ UNIT HTR. OTHER CONVERSION SIZE NONE Regulo.or Number Outside _ Wiring. .T ..sl To... Door Pres sur.. _ lighling Insl. ~:p:n"ySl;~'Iing~/O~~~tlrAtr~ .AIR. Nome of Tesf.r /-(~ ~",t...' ".', ., i'" ",~ .~"'" ," ," . .~:}~