HomeMy WebLinkAboutBuilding 02-0406
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H EATING TEST RECORD ('\. ... 1\
\J"lCI( ~1'LZ_
APT. -,-~~O~_)~CITY ~ SUBURB
OWNER lAJOOc)Ue..-
,'J
INSTALLED BY (<'\ CC G,r--
Gas Line By
GA - FA l::.-HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
? "/ c-{
ADDR ESS ::;'~::J ...,
OCCUPANT
HEAT LOSS
SOLD BY
, r' ~ HqtJS\
~/J() (A~ \'f'
I
DA TE H TG. INS T. C/O 2-.
Electrical Work By
TYPE OF HEA T
J:~~6 90 pAS DESIGN
MAKE . 'Y\
Model Q6M- 1?8",v'rn
Serial (j~r7()7F~c7CJC lt4{t.1
INPUT >0, 000 trl. ~
I / CONTROLS
THERMOt~7'-"" Heat Plug
~;~:: -t ~. ~""~l
Limit Se~ting.' "/-
Fan Settmg ------' "-_
Pilot Type ,
Pilot Make (j\.iVJ"'-'.sr~
Pilot Model
Pilot Timing
(~("
L. W. Cut -9ff I,
Pressure.)";) W...c_
Input CFH tco,<XQJ f
Stock Temp. '/O? "
Form 235
s:~ G'
Percent CO2-M
Percent 0 10" Of
2 -;>12
Percent CO '--U (ffo/1
CONVERSION
MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE
Model
'(>(1
Vent Size J
~o ~
KIND OF LINER
Draft Hood
Fi Iters Size
Ch imney Location
Chimney Construction
SIZE NONE
RegulaTor 32'55'../1 ~
Number
Outside
Smoke Bomb
Draft
Wiring
Test Tog
Lighting Inst.
Door Pres sure
Dote Tested g ) !f~O \'
Company Testing \ \l-( ,,-
Nome of Tester G
'--
Form # 5
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~
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
L/-/-GJ~
1. White File I PERMIT NO tfO I
2. Pink City .O? -0 '/~
3. Yellow Applicant ~ W
d3S~
tlJl
ZONING (office use)
leD
LEGAL DESCRIPTION (office use only), . }-/J /J
LOT /S;LOCK / ADDITIONvk tI)oJh d~ (j) j.ka-O PIQ:;25 - .3 ~3 - GiS--o
OWNER
(Name)
(Phone)
~ (YJ/V
(Address)
BUILDER
(Name)
SrJ/YYJ e...-
Dave- f3C)~
(Phone)
(Phone) 1;;5/- ~ 3" - ~ 3,5:
c~ C( (,\ z:~(;~ - ou J
(Contact Name)
(Address)
TYPE OF WORK
ODeck
ORe-Roofing
New Construction
OPorch
OLower Level Finish
o Fireplace
OAlteration
cP;}.S
OAddition
o Misc.
PROJECT COST IV ALUE (excluding land) $
S~/Jd-'
ORe-Siding
OUtility Connection
)OO,O()
x ~Cf~ro
Contractor's License No.
Permit Valuation 5~ p(K).00 Park Support Fee
Permit Fee $ SAC
Plan Check Fee $ Water Meter Size 5/8" 1 '.
.
State Surcharge $ Pressure Reducer
Penalty $ Sewer/Water Connection Fee
Plumbing Permit Fee $ Water Tower Fee
Mechanical Permit Fee $ Builder's Deposit
Sewer & Water Permit Fee $ ,SO Other
Gas Fireplace Permit Fee $ . t!JD
#
#
#
#
oiJ/[;I: Vom "uililing ~:;_: Approred
~Idmg 1'fficlal Date
'-r' - a-- -(7 d--
Date
$
$
$
$
$
$
$
$
$/1 e44-. (p2-
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 sig d by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to co mence. Before occupancy, a Certificate of Gccu ancy must be
,sue
tt/lA1 J,y~
Oaf:' 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
~
CITY OF PRIOR LAKE .
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec' d
~::ir:.. ~!~. I PERMIT NO.) 1_ /JtJO/1
3. Yellow Apphcant . . ./ C""l U I' tJ .
ZONING (office use)
\ YO-.-t
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
I ~'Z':e~R Llb~cU~
(Address)
(Phone)
(Address)
(Contact Person)
(Phone)
DATE
c9-
APPLICANT PLEA COMPLETE BELOW
w CO~UCTION 0 REPLACEMENT n AL TERA TIONS
FURNACE MAKE AND MODEL 'f\()Q ((\ ~ - \ dP f\i Jt~ &_fUEL 'A. 'oct-
FLUE SIZE -5 I I RETURN OPENINGS INPUT J ;::J()) CXY1 OUTPUT I J (3 an
TYPE OF SYSTEM HEATING OR POWER PLANT
, . ~arm Air Plants
TIGravity
~echanical
~ir Conditioning
~ent, 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
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1% of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
Estimated Cost $ -9~ . \~ Building Penn it #
$39.50
$39.50
$39,50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ Cft.CD
$ .50
$ JeYj,CX)
t"'! !',' it'.."
_. '- . i " .'~
........'-0
....;.;-
, '--
. .'.
. I
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Recei t N
Building Official
Date
lJl.) r. 0 '
,1\,
\.,.i
By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
04/30/2002 13:19
7632592299
SCHULTIES PLUMBING
PAGE 03/04
, .
. . .
.... '.
) .. ~~" .~
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
. Date Ree'd '
~: ~~~; I~'ERMIT NO. ':{ ~ ~.) t1
J. Clold ....PPlillllll ~. 0 t'
f~'~:"::Z:V
AD33";(.. ..' . ~~ 7//// I ZONING_~ I
LEGAL DESClUP'TION CalHCIl use only)
tOT 15BLOCR: I ADDITION
J~
Pro
OWNER
(Name)
(Address)
(Add.rC::~5)
55
(City) (Zip Cedi!)
(phone) 7L".?-7~-'Im7
r
DA TB
{Contact Per.iOn)
, .
. APPLICANT PLEASE COMPLETE BELOW
Size of water service ...L.!...... inches. ,
Location of any couplings from structtue -e feet.
Type of sewer pipe. 0 ABC t8. PVC 0 Cast Iron
Estimated length of sewer line~feet.
Clean out (if required) located at _ feet from structure.
Estimated Cost $
FEE SCHEDlILE
S3S.SO Industrial. Com'l &: Multi-famUy 1% of job cost with a $39-'0 mini.l:nunl.
;J;i7.So Water Conn~OD wly $17.50
Building Pmnit #- _.-,. .
%$idential sewer and water line connedian
Sewer cgnnectiCln only
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTALPERMlTFEE
$ .
$
$
'so
(Office USe 0111)')
This Application Becomes Your BuUdiug ~ermit When Approved
'.
r~:;:~:D tlt,:f:'_J ~ -.,
':"D:t,,'3 I;~', :..,.
BuDdrn, OSilllll1
na~
~h~
Date
~l;;~N..
~. "~0G
:1
Z4 hour Rotice far aU iDs;pedioDI (952) 447-9850, r.s ~5%) 441..Q4S
1...,
1001eJ
~V1 HOIHd dO XlI~
stZtLtt219 XVd tS:Ol an~ ~Q!OC/'O
04/30/2002 13:19
7632592299
SCHULTIES PLUMBING
PAGE 02/04
CITY OF PRIOR LAQ PLUMBING PERMIT
' . I , ,
Date :Re~'d
. >". I. Bw~ Fife
~....... :z. Gold C:i"
,. Ydlaw "",,_
(l'1_~OrtJriataal1~ .
rn;;50 ~~-&-~, ?7./O.
LEGAL DESCRlPnON (ol5c:e Wlf on?" ., . '
Lo~5BLOCK / 'ADDmO~~ a.::r-~ ~
fPEJCMIT NO. ;:? -If()~
I I ZONlNG~,., 1
PID
OWNER
(Name)
(Phone) 6S/-~5&-;?3~
(Address)
(Addrl!!ss)
(Contact Penon)
(Phone)
1///
DATE
Qaabtity Type ofFinure Q~tity Type of FiXtgre
,;;; Bath Tub with or without shower Rough-i~
I Dishwasher J Water Heater '
I Floor Dnin W ater Softii~
~ Lavatory (Ba.tbrQom Sink) I Stand Pipe (Washing Machine)
I Launc1ry Tray (lor :2 compartment siDk Sewage Ejector
::::;J Shower Stall Backtlow Aa$embly
I :SiDlc:s Backfiow AIlSDntbly T~st
I Bar Sink , I Lawn Sprinkler
<../. Water Closet (Toilet) Otlier
APPLICANT PLEASE COMPLETE BELOW
FEESCBEnVL:E
[ndustrilll, Commercial &: Multi-family 1'" Qt job I:Qst with '" SJ~,50 minimum Resldenrial, New One &. Two-Pamily 599.50
Rcaidlmtill. Addiuons & i\lttnltians $39.50
Estimated Cost $
B~ilding Permit #
(Orner Use OIlJ)/)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
,....-,
,-.:, "', ~~,') '~,..~......
. ,
T~UP:::._V..':1~~~'~i~:h..4P~m r= APK 3 o,~:~ l
24 hOIlt' noti.... fDr allln'pcdlolJ5 (!P!U) 441-'850. falC (95%) 447-4245
~ooleJ
~ aOIHd dO X~I~
gt~t~tttT9 XVd tg:O! anI ~O/OC/tO
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~::n ~~:y I PERMIT NOo}._ ~//)61
J. Yellow Applicant c:.;:::-< ! (..; .
ZONING (office use)
3356 WILDWOOD TRAIL NW
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
WOODDALE BUILDERS
(Phone)
(Address)
APPLICANT
(Name)_ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone) _651-633-2561
ROSEVILLE
(City)
(Address)
2700 NORTHFAIRVIEW AVENUE
(Address)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
6/5/02
APPLICANT PLEASE COMPLETE BELOW
X NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
o Gravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
OAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEAT N GLO ST- TRC AND SL-750TR-C
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
.50
$39.50
$39.50
~ 'X ()~
d l, \}l
Y '[)IJY
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Building Official
Dat
/()O
By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
White - Building
Canary - Engineering
Pink - Planning
The {'f'nler of the Lab Counlr}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity Which is propose:l
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Accepted
Accepted With Corrections .x
Denied
Reviewed By: C2/l ti/- Date: tf - <<-62-
Comments: ~
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"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."
:;
Tht" Cenlrr or Ihe tek.. Counlr)'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OFAPPLlCANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
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Accepted
/.
t.//"
Accepted With Corrections
Denied
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Date:
L( Ii ~/02-
Reviewed By:
"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."
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White - Building
Canary - Engineering
Pink - Planning
Iht ('tnltr of Iht 1..1it Counu")"
..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/1) tJ de)! uJe /3/ ~ r C;
L-/- j-();) -->
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed ~
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X
Accepted
Accepted With Corrections
Denied
Reviewed By:
/J1J8
Date:
L/- :22 - 0 ?.
Comments: See Reverse Side for Additionallnformation1
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ForJ 1t1.. (rJi/(r" /""
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See Attachments: 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.permiMor,.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."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 3:5SG, W tl& ID~d'..Q. -,-;=.
NATURE OF WORK J1eL/)
USE OF BUILDING ~
PERMIT NO. () -0 ~ DATE ISSUED t.f -t( --<:JZ-.
CONTRACTOR I. 2:--- ~ "]oiIJms PHONE G.~/- ~&!; -2~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING "b \J
FOUNDATION (Prior to Backfill) 1:>
PLACE NO CONCRETE UNTIL ABOVE H
ROUGH - INS
I 62-
S BEEN SIGNED
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE V
GAS LINE AIR TEST ~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
IStuxo~ I I
FINALS
GRADING (Prior to Sodding)
BUILDING1.c...o.tJj D s ~
ELECTRICAL
PLUMBING
HEATING
DO NOT
G?
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electricf'1 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