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I'" ~ ;0 " Zl"'>-O- z (Jl :::!" t'l I'" m CIl m en -I~)o-~ 9 CIl ):J t o > Z 0;0 -I -I " - -I z- t'l -i m 0 - zO K:l ~ )0- - o z 0 I o en en 0;0 S co -I ." -I Z co - > (5 ::!!; ~ UI o 0 0 Z -I Z 0" ." )0- 0 mm ~ 0 z ~ ;0 o _ ~ -I ." " " ~ J: 0 ;0 ;0 ~ m ;0 0 0 000000 z ;0 0 0 ~ m m m m 3I:"en~3I:" >< m m -I Z 0 0 mr~>mr en OC -IOC ~ ~ z ~ " ::x:3I: m::x:3: " 0 (Jl ~ CIl m .,,!!!;o;o;o!!! m 0 0 ~ " :J 0 zz::x:::x:-z ;0 z J: ::! m Cll -I >C)oo G') a: -I m :::t (5 ~ 0 () 1"'.,,00 ::a =t ;:0 0 -l 0 Z -"" - z C 0 ~ Zcc I'" ~ III ~"" 9 m Z m C C ." ~ N 0 ~ J: ;0 m ~ 0 0 C ;0 0 < 000000 CIl m C(\ ~ Z ::a G')"''''o~ ~ g > Z >;;;:;0 \ .... Roo G') ~mm3:G') '" ~ m C ~ ;; -"""~ ~!;>!;o ~ z >OOZ:;; 0 ~ !T1 _mm-l_ ;0"';0 I'" .... -1-_ I'" i CIlZ Z m -I~ C) CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec' d c",. ZC;- 00 I White Pink Yellow File City Applicant I PERMIT NO. (p -1 { (, ZONING (office use) ADDRESS A-:~I' .ez. LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID.2.6: qoz. _ 074. 0 OWNER (Name) eh~-'(!h , or ~ T. /+Ai t!..1I -. <::. C. (Phone) (Address) I (, II "tJ~ CoC'f": A-1.It: se ,1),.0/ ~~-r'" BUILDER (Company Name) ~ fl.t... (Contact Name) t!.1L..,pj.. (Address) I Ii.tJ"S, $"'''v/~-t' r"e. Den,. c;.-cA. (Phone) (Phone) 9~;J" W-,.2 - ,.~ ~ 1;1" .1 'J.~ - " J? TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing OAddition 0Alteration OUtility Connection CODE: DI.R.c. ~B.C. Type of Construction: I Occupancy Group: A B E Division: ORe-Siding OLower Level Finish o Fireplace o Mise. @ F 1 III H 2 IV I 3 V M 4 (E) R 5 B S U PROJECT COST IV ALUE $ (excluding land) :l ~a ~O I I hereby certifY that I have hlrnished mformatIOn on this application which IS to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the abllve-mcntlllned property and that all construction Will conform to all eXisting state and local laws and will proceed in accordance with submitted plans. I am aware that the building "tllClal can r::'ke_thIS{lmlt for Just cause FllIthermore, I heleby agree that the CIty offiClalllr a designee may enter upon the plOpelty to pel form needed inspections X C?~~ &,- :lCf-o~ Slgnatur Contractor's License No Date Permit Fee Park Support Fee SAC 50/" /551-:- # '3 # $ $ $ $ $ $ $ $ $ '2...~- 0 - ;;;;7:::::> 4 f.; 9:J Permit Valuation Plan Check Fee Water Meter Size 5/8"; 1"; Pressure Reducer State Surcharge Penalty Plumbing Permit Fee ~echanical Permit Fee Isewer & Water Permit Fee 4~c;oc) - {JaJ- Builder's Deposit ~ TOTAL DUE -r .:/ rA '- ~~ t~1,f~ I Receipt No. ~ 3 By ,. ,./ 7-/1-(jb - Date 24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245 16200 Eagle Creek Avenue Prior Lake, MN 55372 5e~ c'p,... rrfe" t ~/e~t;- Special Conditions, if any White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED PeL o . -Z t. 0 &:, The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: I~SII DuL"UTH IlVe- )"& Accepted ./ Accepted With Corrections Denied -mfl 6/o~ Reviewed By: Date: , Comments: r e t-ec-TIL I c..+<- f tfl/~ p~ tv "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 BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED (~-_. (/ ihe Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: I j I /; \. L. r- ,-' Accepted x Accepted With Corrections Denied #~ ie'Dale, _7-11-06 , .Jn~eY'/'r f/4/Ot"k.. OI1Iv. AJ; dlZ::Je.5 ~ ex t:-t:t"I't" {;o C-,-}r/~ r aye.- JfIlV:~ unler d,J /Jerl'H /"t'. I I Reviewed By: 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." .>,,,,,,,,,,,.=~;..~,.,...,,,,,.='.,,,,._..,,,=,,,,.,,,,...,":,,~.,~:~_==:....,~"_,,,,"-~,..,==.,:,=,=_=','='C.~' I 'bq/t./,^- AvG 115-, White File Pink City Yellow Applicant ZONING (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION 1~=RLk~ SI-. r1,elod . (Address) ~ _ BUILDER Q / (Name) JW(f\(r\/1 rW- K--c)+-tch~ (Contact Name )---p o..uJ )J e1 t<}(/v"-- (Address) I/o taJ PID zs. '1(/2,. (J7~. 0 (Phone) (Phone) t.P5/- 25/- /ffO (Phone) TYPE OF WORK o New Construction ODeck ORe-Roofing ORe-Siding OPorch o Misc, OLower Level Finish :vIL~ o Fireplace o Addition JZiAlteratiOn PROJECT COST IV ALUE (excluding land) $ h - - OUtility Connection 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 I am the owner or authorized agent for submitted plans. a enter upon the op e above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may to perform ee i pections. x Permit Valuation () 00. 00 Permit Fee $ /~7.2S Plan Check Fee $ qS. 7 I State Surcharge $ 3.$ Penalty $ Plumbing Permit Fee $ Mechanical Permit Fee $ Sewer & Water Permit Fee $ Gas Fireplace Permit Fee $ en Approved t-075' tf -/7-04:/ Contractor's License No. Date Park Support Fee # $ SAC # $ Water Meter Size 5/8"; I"; $ Pressure Reducer $ City SAC and WAC # $ Water Tower Fee # $ Builder's Deposit $ Other $ TOTAL DUE $ 2. ." h. ~~ 5 2--2-. c. () ~'o M~:# (IA/ r~) _ 8.J8.0' 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 issued. 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 PRIOR LAKE INSPECTION RECORD I b 311 uu L u 11+ A v e- c:;: ,6- ' DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS NATURE OF WORK ~ \~--p-~ .01'-1 USE OF BUILDING ~ v . I I PERMIT NO. t9b "7/" DAT ISSUED f>>/to!O(;) CONTRACTOR -P(....L- PHONE r:; 2. f!8z,., 96c:b NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE I i01)TIUG I ~Y'41ij~ '(Prior to Backfill) I I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS _we.., w.. _riA f tilrp"QC.. " n/lN FRAMING JNSULATION ELECTRICAL ,PLUMBING HEATING (if required) NltcIIIr __ ~ P A GAS LINE AIR TEST COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I 5\/ R-fAJ lC-L-g)- I. I FINALS - .'-~""~. . .- ... ~ -... ~.:".~~::..~ '- BUILDING ELECTRICAL PLUMBING HEATING DO NOT J- -/ t-f17 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. FOR ALL INSPECTIONS (952) 447-9850 ~ ? \\-.'- SUMMIT FIRE PROTECTION Ii \"! li.l \ 'I ~j \' i l~ II I - ... \ I AUG 1 8 Z006 \ il] i L_J By Letter of Transmitta To: 08/17/06 CITY OF PRIOR LAKE 16200 EAGLE CREEK AVENUE PRIOR LAKE, MN 55372 Send Via: ~ Mail UPS Delivery 1-hour Enclosed is (are): X Shop Drawings Close-Out Documents X Product Submittals Change Order Letter Request for Proposal X Payment Application Other Attn: FIRE PROTECTION PLAN REVIEW Job # 339551 Job: CHURCH OF ST. MICHAEL Copies Date Description 3 08/17/06 FIRE SPRINKLER PLANS 3 08/17/06 PRODUCT SUBMITTAL 3 08/17/06 HYDRAULIC CALCULATIONS 1 08/17/06 PERMIT APPLICATION 1 08/17/06 CHECK FOR THE AMOUNT These are Transmitted: X For Approval As Requested For your Information Approved as submitted Approved as Noted For Bids Due: X Return One Set Rejected Revise and Resubmit X For Review For Your Use Remarks: Copies to: From: Doug Bultemeier PHONE: 251-651-1865 o,~ CORPORATE: 7301 ApOLLO COURT LlNO LAKES. MN 55014 TEL (651) 251-1880 FAX (651l 251-1879 760 LIBERTY WAY NORTH LIBERTY. IA 52317 TEL (319) 665-4330 FAX (319) 665-4331 3026 40TH AVENUE NW ROCHESTER. MN 55901 TEL (507) 280-0622 FAX (507) 280-0577 418 GREAT OAK DRIVE 5T. CLOUD, MN 56387 TEL (320) 257-6390 FAX (320) 257-6392 AN EQUAL OPPORTUNITY EMPLOYER OEWGE L PREACTlOt; V~~'-ir.::::: I rJ /Ii /~, / j TESi OESCRfPTI(it. 1~::;7':: ~l r 8L.ANf: TESTft<C GASKETS V'~Olh'G CtJTO'lfT:3 (o:S!-:S) OP;::fV,T10N o PNRJMflJlC o EL.ECTRIC ," 0 KYORAUUC I 0::: I cCTlNG MED~ SUPCAV:SEI> OYE::: ONO OYES ONC P(rJ1N':::;- SUPER\';SEr eYES' o NC DO;::S WJ. VE oPER/<TE FROM THE MANUA!- TRIP NmlOR REMOTE COh'TROZ- SWlOr,S IS THERE AN ACCESSlBLE FAQUTY IN EACH ORCUrT FOR TESTlNG o YES ONO - .1;= NO, EXPlAiN tN'.f-:E MOO2.. DOSS EAOi ClROJ!T OPERi'T:: SUPERV:SI()N lOSS ALARM yES NC DOES EACH OROJrT OPERIJE VN.VE R8.EASE YE:S W.J IMAXIMUM TlME: K' fopEflliTE R9.EASE MIN. I SEe i HYORO.::::;7':'l1C: Hyc:.ro::;talK: testS Si1211 De ma0€ a( not ~ss ttlan 2C)(J psi (i.3.E bars) lor t.....-o flOUrs 0:-- SO psi (3.4 bar.::;) a.t:>ov'C s.....31\C prf,3::;sure in e.xce:::.;: 0' 150 pSI (10.2 barslloc two hour:;. Difterenliai ory-p<pe va'", dapper:; shall De ren open ouring lest \0 prevent damage. All aDovegroun<J Ploins iG<ll-:.39fc; slla!1 t.Y3 .:;:roPp&::. Pt"EUMAnC~ E::>1abk;n 40 ps:i (2] ba.'SJ air pressure and measure orop willCh Sh.a1l not e..x.c.e-e-d 1\':.;: psi (0.1 cars, in 24 nour::;, Te$l pressure taw..--:=; .::.: n0fT1131 1h'"'21{" (qvol 2no air nres:su(€ ana m.e2..Sur€ .air prGssur.e drop ~icrl $11,aJi no:.. ex.c.&:-G 1 '/.<: psi (0.1 bar:;) i., 2.:. POV;:: ALL P1Dlh\~ 1~'OR-:JSTAT1c:A.LlY TESTED N 2..D.D.. PSi DP'',' PIPING PNe:Uf,v,llC<'LL;' TES'T'ED fJt~ YES 0 NC' }/, EOUIPtJlEI"j"" OPEf'i.ATES PROPERL':' YE:3 0 NC:.' FOF ~ HRS I !F= NG, STATE REASor< ~b 11, \oc, i DO YOU CCRTiFY .AS THe: SPRINKLER (X)NTRACTDfi THAT ADDITIVES AND CORROSIVE CHElvllCf..LS, SOOIUM SIUu..TE: OR OERIVATIVC:S i OF;;O[)IUh~ SIUCf..rr. BRINE. OR CITHER CDRROSlVE CHEMICN..$ WERE NCJT USED FOR TESTIN-G SYSTEMS OR STDPPtNG LEAV,S" ~'{:== nun DnA':; fiEAOIN(; 0" GAGE LOCATED NEAR W.0Cp. SUPPLY TEST PIPE I RESIOUAL PRESSURE WfTH VN.VC 11, TEST PIPE OPEN WIDE TES- Sl/..Tl': PR::::SSURE PSi PSi U nocrorounO m3in:; 3nd ie3d in connecfions to S)'S1em nser:: lleshed belOre connccl1on maoe to sorinkler piping. 'YES Ci NC' Vl:/':\IFIED SY CXJP'{ OF THe U FORM NO. e.5S OTHER EXPLAIN r=U...,ISHED It<STAUER OC ur"CJEt~- G;=tOUNC SPRINKLER PlP1NG I S:'YES - ""~- L. "___/ I-iUI,,2Ei'I USEe:, /JOfJE. j lOCATlOt<: / ri Ye:~ 0 NC NUMG~M REfJ.(JV:::~' v..'E.~OED P!P(N~ F vcc:: DO YOU CfhT!::=-,]' rS THE SPR1t~KLER CDNTRAcrDR THAT ~VE!..J)lNG PROc::EDURES CO~PL: W:Th ThE REQUfREMEf'.'TS OF AT LEAST AWS 01O.S. LCVCl. AF;-:: r0'ES ONC 00 YOU CERTl"\' THAT THE: WELDfNG Wf.,S PERFORMED BY WELDE;:lS OUAuFIEiJ fi< CDr"C'UAN::::E wm,{ THE REOUIREJ.f.ENTS OF fl LEAST AVI'S 010S. LEVE!.. AFi-c '-- CO YOU GEirrr'i:y.~ WELDING W.AS CARRIED ouT IN CDMPUANCE WIT H A DOCUMENTED ~OL PROCSJURE 10 INSURE THAT ALL OISC:S ARE RETRfEVED. THJ;T Of=....NINGS IN PIPING mE SMOOTH, 11{AT SLAG AND CITHEF, WELDING RESIDUE ARE REMOV:::--o. AND TI-lAl THE INTERNAL DlAMETERS 0" P1Plr.,!<.3 kh:: r~c:r;- PENETRATEr I d" YE: CJ fer ~ES ~E5 o t<,~ 00 YOU GEm-IF,' ~)QU HAVE A CONTROL F'cATURE m ENSUR':: TH"., f",,~ CUTOUT::; (0;Sr'3) I-RE RETR!8/ED 01< IF NO. EXPc.Arc, HYDRAULIC DATA NAMEPLATE REMARf::: r;/.~,E.:JLATE PROVIDED rty:::::: 0 f>J<=. Dl..TE: i...~r- I th! SEn~IGC v:rTH ALL C()NffiOL VALVES OPEN: NAtvlE OF S<'RfNKLER CDNTRACTDF, S!,:;N.4";.URC=~ rT:~H,'J<_ C'':;:'.~/.;< ~f's +l'~ 5ysi~ ~ Metropolitan Council Environmental Services July 28, 2006 Bob Hutchins Building Official City of Prior Lake 16776 Fish Point Road Prior Lake, MN 55372-3323 Dear Mr. Hutchins: The Metropolitan Council Environmental Services Division has determined SAC for the Church of St. Michael's School expansion to be located at 16311 Duluth A venue SE within the City of Prior Lake. This project should be charged 3 SAC Units, as determined below. SAC Units Charges: Classrooms 1792 sq. ft. @ 30 sq. ft.lstudent @ 18 students/SAC Unit 3.32 or 3 If you have any questions, call me at 651-602-13 78. Si~Lj Jessie Nye Uf Administrative Technician Environmental Services Division IN:kb: 060728Al { \0- .CJ I l,t V\ J cc: S. Selby, MCES Tad Ulrich, PCL Construction Services www.metrocouncil.org 390 Robert Street North. St. Paul, MN 55101-1805 . (651) 602-1005 . Fax (651) 602-1477 . TrY (651) 291-0904 An Equal Opportunity Employer CHURCH OF ST MICHAEL Robert Hutchins City of Prior Lake Re: Occupant Load for Education Center Alteration August 7, 2006 Dear Bob: By this letter please be advised that the number of students utilizing the S1. Michael Education Center addition will not be increased as result of the alterations being made to the building. The 2001 plan called for 10 classrooms with 250 occupants. Our enrollment has decreased to the point where we are planning for only 150 students utilizing the 10 classroom spaces that the alteration will provide. Sincerely, !2JtL !:r-~~~~/lcL Rollie Brouillard Business Administrator Cc: Chuck Deniger Judy Menden 16311 Duluth Avenue SE., Prior Lake, Minnesota 55372-2423, t ph 952-447-2491, fax: 952-447-2489, info@stmichael-plorg ~ -- ~RECH, O'BRIEN, MUELLER & ASSOCIATES, INC. . ~Ohm A"", I"" G,,,,,, H,igh. Mio",ooto 55076 651.451.4605 Pho", 651.451.0917 Fe> www.kornw.com July 12, 2006 Bob Hutchins Building Official City of Prior Lake 16776 Fish Point Road SE PriorLake,MN 55372-1714 Re: Church of St. Michael Education Center - Cafeteria Remodel 16311 Duluth Avenue SE Prior Lake, M N KOM&A No. 05171 DearMr. Hutchins: The attached layout was received from the Church of St. Michael for the new second floor addition. This room is considered a reading room per the!BC 2000, Table 1607.1 based on this layout. The structure, as shown on the drawings produced by KOMA dated June 21,2006, has been designed to support the 60 psf live load required for a reading room. This structure has not: been designed for future increases to this design live load. The design load and room definition (reading room) should be permanently posted on the room to avoid overloading of the floor structure in the future. If you should have any questions or require further information, please call. Sincerely: i -1~)-If MatthewJ. Van Hoof,P.i. Krech, O'Brien, Mueller & Associates, Inc. Enc. Room layout received from St. Michael CC: Brady Mueller AlA, KOMA Paul Krueger, PCL Construction ,A.RCHITECTURE STRUCTURAL ENGII;,JEERING IhlTERICR DESIGI-.J tqeD !Fire & /SimPleXGrinnell Security FIRE ALARM TEST/INST ALLA TION ACKNOWLEDGEMENT 100 Simplex Drive Westminster, MA 01441-0001 U.S.A. I PAGE_OF -J 1=" CALL: # : : : : ~c:J SERVICE AT CUSTOMER NUMBER TR COMP. DATE NAME _ /0' -f -- /17 - ( /7/_ / t.. 1/ c'L ADDRESS (OR ATTN. OF) ADDRESS TRAV - REG. LBR - OT TRAV . OT ARRIVAL TRAV - REG. LBR - OT TRAV - OT DEPARTURE / 0" THRU TYPE OF SIGNALING o GENERAL ALARM o SELECTIVE S'GNALS o COOED POWER o PRE-S'GNAL SOURCE DEDICATED CIA Ov ON BATTERIES DNOTE#_ VOLTAGE WITH CHARGER 0 0 NORM _VOLTS VOLT WITHOUT CHARGER DONIA _ % CHARGED TROUBLE RESPO!i~ TO ZONE TROUBLE CONDITlONSBNORM 0 NOTE # CUSTOMER OPERATING INSTRUCTIONS PROVIDED TO: STR TR lSIGNATURE EARTH GROUND o NORM 0 NOTE # TR # CUSTOMER,SIGNATURE "( -! /..4' I / /(/ S.EE"NOTATION NO. r _.- FIRE ALARM LICENSE NO. - STATE CERTIFICATION NO :2 ~:;-. N,ALS SOUNDED PER CUSTOMER REQUEST YON TYPE o INCAND. o LED o GRAPHIC 0 CRT o DROP DOOR RELEASE DEVICES, INCLUDING CLOSERS AND LATCHES o NORM 0 QW 0 NOTE # RECALL TO PR'MARV FLOOR o NORM 0 NOTE # ON/A ANNUNCIATOR MODEL ON/A VOLTAGE UNUSED PTS. RECALL TO ALTERNATE FLOOR AUX FUNCTIONS D LAMP TEST D REMOTE RESET o DRILL SW 0 REMOTE ACK o NORM HVAC SHUTDOWN o NOTE # ONIA ELEVATORS RESTART ~~~~~~~ ~V~TOMATICALL y D yON AIR HANDLER SHUTDOWN CITY CONNECTION OR CITY RESPONSE TO ALARM OFFICIAL CONTACTED SPECIAL LIST ANY UNIQUE FUNCTIONS CONSIDERATIONS - TO BE AWARE OF BEFORE TESTING o NORM o NOTE # AIAHANDLEA(S) o QTY ~~~~~~~A~~TOMA TJCALL y D YON 1. CENTRAL 51 A T10N MONITORING 0 NORM LOCAL FIRE DEPTJCENTRAL STATION o NORM 0 NOTE # CITY RESPONSE TO TROUBLE TIME OF DA V 2. o NOTE # OUT OF SERVICE FD. BUS. PHONE NOJCENTRAL STATION IN SERVICE 3. NO. OF XPNDRS TESTED LOCATION NOTE # STATIONS POWER SUPPLY VOLTAGE NOTE # LOCATION NOTE # HEAT DETECTORS 2 o NORM SMOKE DETECTORS CHARGER VOL TAGENOTE # LOCATION NOTE # 3 ANNUNCIATORS o NORM GROUND FAULT NOTE # LOCATION NOTE # DUCT DETECTOR 4 Ov ON H~~ "If'" BATTERIES VOLTAGE NOTE # LOCATION NOTE # 5 BELLS o NORM POINTS TESTED NOTE # LOCATION NOTE # CHIMES 6 o NORM SPRINKLER SYST OTHER NOTE # LOCATION NOTE # NURSE CALL 7 NOTE # TYPE PROGRAM PRINTERS RELATED TR RELATED CALL # PROBLEM'CODE CO~CTlVI" ~YION IF DETAILED TESTING IS REQUIRED - USE CONTINUATION SHEET MC24-2-005 CLOSE DATE SERV. COMPL RSN AUTHORITY HAVING JURISDICTION MC24-2-022 tqCO!Fire ~ /SimPleXGrinnell SecurIty 1-800-746-7539 FIRE ALARM TEST/INST ALLA TION ACKNOWLEDGEMENT CONTINUATION SHEET I~' ! Ii L I BOOK # I I I~'" P~~" I OF I DEVICE DEVICE LOCATION \ TR 5E NOTE ANNUN. ZONE ALARM ZONE DEVICE DEVICE LOCATION A TR 5E NOTE ANNUN. ZONE ALARM ZONE TYPE Ou N NO. OR OR TYPE LON NO. OR OR A R s 51 TELEPHONE SIGNAL A R Us 51 TELEPHONE SIGNAL M lE T ZONE ZONE M lE T ZONE ZONE ill;' 7'( ( r l~ c .. t /<.' l~ - - i 1 ,..A. <' - I" (J .- i ,( j 1 V ~ .. '- i~ ! ~I l 'v k' I d.i1t/ \.....- '. ~ ,/ ,/ , 1.,," , . I / / H -)cj' ;1,1 ~;) (, P5D = Photoelectric 5mk Det ISO = Ionization Smk Det POD = Photo. Duct Smk Det 100 = Ion. Duct Smk Det DHS = Door Hldr & Smk Det S5D = Sgl Station Smk Det BD = Beam Del. P5 = Manual Pull Station B = Bell Only T5 = Tamper Switch CPS = Coded Pull Station H =Hom~ WF = Water Flow Sw RR = Rate of Rise Ht Det C = Chime Only DH = Door Holder HT = Fixed Temp Heat Det S = Spkr Only FP = Fire Phone MD = Mercoid Heat Det NV = Audio Visual PJ = Phone Jack FD = Flame Det V = Visual Only NCS = Nurse Call Sta. FAILURES AND SYSTEM DEVIATIONS FROM NFPA STANDARDS: . None . As Follows (describe fully) AUTHORITY HAVING JURISDICTION MC24-2-005 CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT \ ~\~~ Date Rec'd I. Pink File 2. Green City 3. Yellow Applicant ZONING (office use) } ~H LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION (Address) c.Jn~~\..'~ \ ~\~ PIDZ5/!()2.. 07~. () (Phone) ~t..'eJ't~'""'~") OWNER <Q.;. (Name) ~ \ ""\C\\\\~\.lf ~:;~~ANT(~~ ~ \~~ (Address)~L \,.l~\~~~ \\A; (Address) (Contact Person) (Phone) ~~<\.\-\~~ ~~\\\\'~ 'M~ S(-Yr (~ity) (Zip Code) (Phone) APPLICANT SIGNATURE .,,- APPLICANT PLEASE COMPLETE BELOW NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS FURNACE MAKE A~D MODEL B~~ ~ 1=\)1 ~\~ L.'t<\. FUEL ~ FLUE SIZE ~ RETURN OPENINGS ~~~ INPUT U~~ OUTPUT \ ~~~ TYPE OF SYSTEM HEATING OR POWER PLANT ~ann Air Plants DGravity D Mechanical ~ir Conditioning DVent. System D Steam D Hot Water D Radiation D Special Devices D Other Devices PLEASE NOTE: Air Conditioner Units and Fireplaces Cannot Encroach into Required Side Yard Setbacks. Fireplaces with Box Additions or Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL Estimated Cost $ FEE SCHEDULE I % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 Residential, Additions & Alterations $64.50 Residential, AC Only 2. 2.k,"O;)~ ~ Building Permit # $39.50 Industrial, Commercial & Multi-Family Residential, Heating & AIC (New Construction) Residential, Heating Only (New Construction) $39.50 $39.50 #1 Bj.Ol. 'D qY /1/ ~ O~: s~f6' r- HEATING PERMIT FEE ST A TE SURCHARGE TOTAL PERMIT FEE $ L2J~ ~_\1 $ .50 $ 2.. '- -, 3~. .) PaidZZ7.30 Date8..IS,O , Receipt No. S 22..2. 4- By hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue, Prior Lake, MN 55372