HomeMy WebLinkAboutBuilding Permit 99-0221
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'Job Address ~. ~
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'Testers/Signature _
Pounds
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'Gas Line
jt.ressUrized - -
Inspected - -
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'Percent O2 ~ 'Stack Temp. 2.Rt-
Final Inspection.
--
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DATE TIME
CITY OF PRIOR LAKE lo~ov
INSPECTION NOTICE SCHEDULED (,-10-'19
ADDRESS 4571 H (Nth, i'h-, ~ b tr d TiL
OWNER CONTR.
PHONE NO. PERMIT NO. qq - '2.:2..1
o FOOTING o PLUMBING RI o EXC/GRAD/FILLlNG
o FRAMING ~ECHANICAL o LKSHOREIWETLAND
o INSULATION WATER HOOKUP o COMPLAINT
o FINAL EWER HOOKUP o SEPTIC FINAL
o FOUNDATION o SEPTIC INSTALL o FIREPLACE
o DEMOLITION o PLUMBING FINAL 0
o FIRE PREVo o SITE INSPECTION
COMMENTS: ~ ~ ~ tL
3" \ ~~
40
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Inspector: Owner/Contr:
CALL J7-423dFOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~EMENTS ARE FOR YOUR PERSONAL HEALTH & SAFET~!
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
P/7/rJ I:~
457/ H(jI'1I'-1INqe/~
i
SCHEDULED
OWNER
CONTR.
'--
PERMIT NO.
99- ZZ/
PHONE NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL n"\ 0 PLUMBING FINAL
o SITE INSPECTION l:!:5/ X'MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: ~ /.VA-- ~ ~
( ~..;t;$ R., A ,
A I e.., ~ .4ft- -A\.U)L., ~
~~~J ~ a--fJ ~ .LtI~ JIJl&d-.
u p~ ~ I~~~_~
.. . c/ ..Ld
~ l.~?TJI IA fiJI,
~ .~ ~ ---~
o ~RK SATISFACTORY, PROCEED
~';RRECT ACTION AND PROCEED
o CORRECT W~' CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~I Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 4511
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED ~~ q: eo
\-t u.n:::~ b.HA
PERMIT NO.
'l't- 2z.,
o PLUMBING RI
o MECH RI
o WATER HOOKUP
It~E~RHOOKUP
f\ PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
.kOMMENTS: f \
W~-t~~~
(;)~
r~ f')~
W~
r.
~~
~rv
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o CORRECT W RK, CA L F REINSPECTION BEFORE COVERING
Inspector: 7 \ Owner/Contr:
CALL 44~850 FOR E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REi ?UIREMEJS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
"--/ INSNOTl
CITY, OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
if3/rl
'111
ADDRESS _i./51 I J/""'JIU~/dJ "7:i:4,~
OWNER CONTR. .J;th"IJf,.)'(J~""1S
PHONE NO. PERMIT NO. 99- ZZI
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
( FINAL
] SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
)( EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: f!tl~
J<
AUf..Pri#IJiL
CJun8jILJ ~
1<;
Ol'tP.itr/cMJIIC
S,L-r
~
IAJ 7Ft.& ~A~tJ 11l'rr1l~ (.J!J-J 5
IE. J?EPAIP.ED ~Il 7f> 6,.".AL ~/t;AldR=
f'I/FI/Nfit-I,J .fk...-;- ~ lJt..mc.... ~f1JJ~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
)( CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ &...~ ~er/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
10/' 1/99
I
&1
ADDRESS t.J.57 J utJtfl/tM."V~OlfUj Mill/(_
PHONE NO.
CONTR. ~1..J006 J:J o/ME:S
PERMIT NO. t.}~ - l.Z./
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
'l5.. FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
)!!. EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
Sot) I N A o:mct...n- 1...0'- S
I~
RCPAlIlq,.
)( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: /dk J ~_. Ilw.DecIContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
SCHEDULED 1~/2.~ )l,1'L-
RtlHtm IAla b/~
, ......J
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~S-7/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ~f o-,.JJ t...^ JLtk::;
~ J-o ~.
DATE
TIME
99-22..-1
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o SO,:) - TjF..€;c-,-
C7'-1.fL..
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-
-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT wo~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: /tf!- r Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
BUILDING PERMIT,
MAR l. 6 1999 TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. D~~~~
IZ-I
DATE RECEIVED
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SI4S1iESU; AA/YIIJNft:,s-, ~
I PthL-
.
3. LEGAL DESCRIPTION
b
JJ:,:-
PID~~-3Lf4-o0fo -0
I
~
PDB9i
LOT
j{AJ~8
~RS
(Name)
(Address) . ^ _ ^ ~ j. -.J (Tel. No.)
'243 2-~ . 1H>f'~\I~ f\l /IJ
(Address) , t (Tel. No.)
ADDITION
4. OWNER
W,ftJfJWotXJ
5. ARCHITECT
6. BUILDER
(Name)
(Address)
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq - Z7/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
B'i,-4tt (
(Tel. No.)
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
16. PROJECT COSTNALUE
/.30 {)~(}
17. COMPLE~.~ fc N DATE
yzt;S/q~
. that I ha d 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
property and at all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform neede9 inspll/"ons.
. Rt~7 3/F~/~'
License No. iOate '
7. TYPE OF WORK
New constructio~
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft. /3. (Pl~
10. CULVERT SIZE
No
9. PROPERTY DIMENSIONS
Width ,,9 Depth J1q I " it
Yes
x
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
. .--,
r_ __ II
FOR ADMINISTRATIVE USE
PILING LOGS 0 PERCOLATION TESTS 0
------- --
PLANS & SPECS 0 SETS -----
SURVEY 0 ~
\'5?J,OOO.OC PLOTPL~
Amount Brought F~ .................. $
Park Support Fee ........................... $
SAC ......................................... $
SETBACKS: Required
Actual
Back
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
,
USE OF BUILDING -::::H)
TYPE OF CONSTRUCTION: I II III IV (~
Occupancy Group A B E F ~ I M'-4( S U
Division 1 2 ()J 4 r-
Permit Fee ................................... $ \ I \ '1.11 - L""")
7-1,,5.22-
7'j.oO
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty. ........ ......... ..................... $
Plumbing Permit Fee ....................... $
~\
~f:
Mechanical Permit Fee ..................... !t.
[(')0.00
I.f)().OD
3s- . nO
Sewer & Water Permit ...................... $
Gas Fir ace Permit ....................... $
Thi ~Il ti Be~our Building Permit 'y'V,h~Ap.Pf9.ved.
By r Date 't --.J. -'1'1
Certificate of Occupancy
Issued
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
~~(J .00....
() c:;n ~O
Collective Street Fee ....................... $
Sewer Tap ................................... $
~'. ~
Pressure Reducer ....~.................... $
Meter Horn ................................... $
Water Meter ....1'f>......................... $
Sewer & Water Connection Fee ........... $
45 .() 6
'- '2. S- .00
It 2-Q 0 . t) 0
700.CJtJ
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $ I, C)o tJ ~ DO
,
Other ......................................... $.-- JI' / I~ q - (~
Total Due .............................. $~ .
Paid Receipt No. 3S / /0
By '-It.
Date 4-:~ - 0 c:
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
signe~r~~rary Certi'tte~l~Pliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. .
_ C ~er Date Special Conditions ~ any
24 hour notice for all inspections 447-9850
......-.---...----. . - .. .. ... .-.--.-......-.-
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"'. I , ur rlllU" ~a,.. Me
16200 Eagle CreellAv. S.Eo Permll Nra. qq... 22--/
Prior Lake, MN 55372
~C~'.g
~ -.,.'.
u ,- en
. .
.....
- I
HEATING APPLICATION I PERMIT
Dale lP -ol-'1r P'ID' .Z5-3tjq- OOCD-O
Site Addtesl 467/ -IJu1'llff}frJ.'1b1rt:JL Jr. AlL
lot .Jo- Block -dJm ^ddil~. kr0b Ifill I3r/ Indushial. CGmmel:i~l & MulU.Family
. ,I ~ _.rJ .1 J,. ,(' ResIdential, Ilea1in'l & ^C
Own.,', Name, In, A ~/ aru 1\f()fYJt'j Residenllal, Healing Only
Addlessfl) ~~'-I va /1'171. mN 'di"J7rZ-tJ/ Residential. Gas Firl!p1ace
_. , . I Residential, Additions & Alleratlof'l. $39.50
Heating ContractoOJ,.Id/[llll./lJ ifLl.-- rM..... f/J1!, c;.. Residenlial. AC Only S39,50
AddreM/qK8 ~. W lf~m#!diIf.YJJAl7f),V'
/ rd~/"1~_ .A??c..-r} (' I I "'-:SUl?f;iemember 10 add Ihe Sta\e Surcharge on the botlom ollhls appllcalion.
Telephone' (D{"J --rd"J .-./ / _J /
Furnace Make &. M~" ~.r~~{ -/00 TVPE OF SYSTEM The plica 01 your heating plfmillncludes on. rough. in and onelina) inspecllon.
. Warm Ai,Planll
Model51z.1 JI1(j, fJOO Gravity ,
MechanIcal V'~
t-Jr Condillonlng. r:l ~
Vent Syslem . -- - .
Conn. Load.
Fuel ^h flm r Jill' Slll l1) II
Supply Opeol. . o'l.~
I/J..J
OUtp\lt 7'! /) /J7) .
Fl.tum Openl".,
Input I /)I) fYi)
,
Edr,
elm.
~
~
'HEAliNG OR POWER PLAHT
Sleam ,
Hot Waler
RadiaUofl ,
Special Device. .
Olher Dlvices .
o
~
A1teraUolll
TlPE Of WORK
Aeplacem.'" NIW Conaltvctlon V--
Ell Comp. Oat. ,
..
0')
o
Repair
ElL Cost .
HEATING PERMiT FEE.
STATE SURCHARGE .
Building Permft. 99- ~ I
f~O~:n
eU\\,,01tlG ~
P.ecaipl r.
Ol
Ol
"-
C'oI
o
"-
(g
o
TOTAL PErJMT FHS .
.50
TYI'ti. U~ s..-n. 1~"I1I'"
..;*
Singl. F aJT51y
~
Two-Family
Mu1U-Familr
Olhlf
C~mmerclal
lndusll lal
Public
Fee Sell edule
'"h or job CDS I (S:l9.50 ninimum)
S99.~O
164,50
$39.50
Additional im;pK\lons will be billed at $35.00 each. -
House Healinll Tes1 Record mus1 be ~ubmilled wllh l1l1i~r..~ ","'I'!1"!'-1llIlIdIII beloll buikl-
1"9 certirlcate at occupancy win be i~ued. .
HEAT r.Al.r.t It ATlnN~ q~p, ,Iqt:n will number at supply and retum ot:Ienlngt .lteel 1*
room wilh CFM'. P'J opening. New slNCIur.. at additlonl send Iloor plan wilh supply
and relum locatlons shown. HEAT lOSS CAlCULATIONS. PAYMENT AND
APPLICATIONS MAY SE MAILED TO THE CITY OF PRIOR lAkE. 1820lt EAGlE
CREEK AVE. S.E. PRIOR LAKE. MN 55372.
City Hall business hours art 1..1ft.. 4:30 p.m.
ALL WORK MUST BE INSpeCTED tROUGH.IN AND FINALI- CALL C'TY HALL
447-42.30
'''.reby apply lor a mechanIcal IYltem. p.rmll and. Ictlnowledge \hallhe
Info.matlon above Is complete Ind accur.t.; Ih.' lh. \YO" w61 be In ~nlormance
wilh the ordlnancl. and codel of the elly and with lh. I,.t. buUdlnWmlchlllllca'
code' hallhll form doea~ot eame a p.rmlt unln IIVned by the BUILDING
I~IA . the.lhe work wI! e accordance wltb lh. approved plan In Ut.
as. 0' al work which req review and ..,oval of ptan..
&" -() (-qcJ
Dat. I
(pll/qq
ca>>
CITY OF PRIOR LAKE
I. Blue
2. Gold
3. Yellow
File
City
Applicant
PLUMBING PERMIT
Applicant: Va/!I /' ( 4//?'~~-J/j/ ~Phone:
Address: ~ .'/iI/;;//j~/j /7 ./~
Signature: ;!!/ /Z//J ./77//7 /Z.U~
Legal Description: Lot " Block I Sub
Site Address: ,)-/51/ jJ_,hA'N/7WI~///L!A/~ h
Building Permit # 9'1- 22- / / PID # z.5-3L/Ll- OO(P-b
NOTE: This permit will not be processed without complete information.
# QQ-2Z /
~~;;?-7/2/
The Cenler of Ihe Like Counlry
Quantity
f
/
'-q
)
J
L
3
FIXTURE UNITS
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
,9'
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
)
FEE SCHEDULE
( P~~:~~n-
\ 6U\\"0\
$
$
$
$ .50
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
GRAND TOTAL $
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
- . _~J%fI?'.)Jo. '-/..3 /t:1q DATE
~~~~ - ATTEST
(/
Call for all inspections 24 hours in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
GREEN - FILE
YELLOW - APPLICANT /
GOLD - CITY V
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
NO.qq~/
Sewer and Water
contractors must
be registered
with the City.
APPLICANT: DILeS JiE/l... E ~C--.
ADDRESS: J' 11 J :r Ofl~ wA '7
SIGNATURE: ~ ~ .-
v
SITE ADDRESS: i/ s 7 I
PHONE : ${'~.2 -, ~ 1Jt,
DATE: .5/S/'1
BLDG. PERMIT # qq-d~/
II ~ Wi r>'{ J:;.,-..J C (j ~.o TR. PI D # ;:)')- 3 L(tj - D~ -6
LIL UL.
FILL IN THE BLANKS
1. Estimated length of water service
If.r
feet.
I'
2. Size of water service
I
inch(es) .
3 .
Location of any couplings from structure
-
feet.
4. Type of sewer pipe. ABS
PVC X
Cast Iron
5. Estimated length of sewer line
LIS
feet.
6. Clean out (if required), located at
structure.
.-
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
ThiS~ aicat' b~co
',' I..-,#,:'
BY i
'. . '. - "."....." ,'_.,,~-_....
w- . ,_ ''''~. _~.
your permit when approved.
1;-1--19
DATE:
------------------------------------------------------------------
------------------------------------------------------------------
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 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
issu~~"-fj9 ( . PAIDWITH~'" uti
DATE P~D \ BUILDING PERMIT AMOUNT PAID (f~' .
RECEIPT # REC'D BY ~N~ ~4:....
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
.....
o
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~
CITY OF PRIOR LAKE
16200 Eagle Creek Av. S.E. Permit No.,
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date I 14 qCf PID, ~5-$iftt- 00"-0
Site Address 4cn'll +1-l,Hy,m\no.h') rei lira -I I I< /
' \..]
Lot ~ Block, I Addition_ /<./\/08 #/L,t- 3120
Owner's Name ( A.)', r-d UXY1c1 +hvne s...
Address
~"re.p'\uce. . . \ '7:l.',./
HeaIiAg Contractor C""111l1 eye::.. r>ud LItre:::.,
~ Address, '~5 I.S\+h n I~ nl',tf
:J Telephone # ( D I A. ' ~ ~ IL\L\6
Ct: r.~. (1"
8 FtI "ace Make & Model N 1 ()f Y I t\Y
Ct: . ,
~ Model Size D~SI' R..N N S
~ .
o
~ -.ceAA. lea". ~\: lflJ 16lU
Fuel 1\\l1t~ Flue Size ~'l
TYPE OF WORK
. Replacemenl New Construction y.
, Est. Comp. Date '[ 2.0 qC\ /
......
u
In
"'"
C\l
"'"
I-
"'"
"'"
C\l
.-t
co
~
-.:
~
I-
0
..
co
.-t
;::J
::E:l
E-<
ClO
Cl
"-
If'l
0
"-
C\l
0
\
Supply Openings
Return Openings
Input
Edr.
OUlput
Cfm.,
Alterations
Repair
Est. Cost $. \,7rt).(S?)
HEATING PERMIT FEE $
STATE SURCHARGE $_
TOTAL PERMIT FEES $
~\L' [)r.f S~
\
'"\)11 J IV) ~ J'tV'\
'J
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Waler
Radialion _
Special Devices
Other Devices
Building Permit # .
99-- 22/
.50
~AiDWITH
BUILDING PERMIT
Receipt #
9tl-ZZ-!
I. Pink
2. <neen
3. Yellow
File
. City
Conlraclor
TYPE OF STRUCTURE,
Single Family 1
Commercial,
Two-Family _
Industrial
Public
Multi-Family
Olher
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
, Residential, AC Only
~tN $l4 \
Remember 10 add the Slale Surcharge on the bottom 01 this application.
1 % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
The price 01 your healing permit includes one rough-in and one final inspection.
Additional Inspections will be billed at $35.00 each.
House Heating Test Record musl be submiUed with buildina oermit number before build-
ing certificate of occupancy will be issued.
HEAT CALCULATIONR REQUIRED with number of supply and return openings listed pe
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
I hereby apply lor a mechanical systems permit and I acknowledge that the
inlormation above is complete and accurate; that the work will be in conformance
with Ihe ordinances and codes of the city and with the state building/mechanical
codes: that this form does not become a permit until signed by the BUilDING
OFFICIAL; that the work will be in accordance with the approved plan in the
ca.e ~~ require. review end approval of pla,n..
d. I, ' . " :: . ~ l 14 qtf
· ~ ..~ 7/zDa;h9
Building Onical's Signature . Date
..
I, ::
I
.'
White - Building
Canary - Engineering
Pink - Planning
Th~ ernler or Ihr Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
/
~
//
NAME OF APPLICANT . I
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
v-
Accepted With Corrections
Denied
Reviewed By:
~~
Date:
L(- ( -q~
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."
Qt;-2'L I
White - Building
Canary - Engineering
Pink - Planning
Tht etnl.. or Iht L.kt Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI.sI
NAME OF APPLICANT ~J,ncJW(xy;{ f-Irrvt-u./J
APPLICATION RECEIVED :3 /2- 01C(c)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
LfS 7 I bh1.l/1AJ1/Lt"-vtdot'vd TfC
J
Accepted
Accepted With Corrections
Denied
Reviewed By: ~;s--
Comments:
/ _ 90JJ ~ (fU2tU) ~ ~ "" () . ~" 4-Ci:lJ" ---=;
v ,~ \r /
7-:- MllJ V\ ~~ '-^-- ?1-D"'5 L~..A ~
~ - -
~,f.aJ ~ 0 ;;fZt- ~I hJ ~
Date:
t/-2...-fcy
~(
liThe 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."
~ It I - (' (. I
White - Building
Canary - Engineering
Pink - Planning
Th. c...., ollh. lAk. Co..lf)'
BUILDING PERMIT ,APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT \ \J, i,\ri\"j(-('.~ f---hlt tL)
APPLICATION RECEIVED ...) I ( (-. It?r,/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
i 11':.-::'" I I L I I, ( -TJf,j..
_,./ .J ;-if ({ (/ (I Lf ',1<lJI 1'(' 1/<-
)
Accepted
/
Accepted With Corrections
Denied
Reviewed By: jJALTf:1t.
~~~E~~A"'I\J
Date:
-,- I_~
;:$/:S01 71
Comments: R\J~~ {\'\\1s-r ~ (l&olVuE'((;A "-0 AN~ A&-ON~ D~AI,JAIie:
,
~ r!:I::U:U:-v ~ASe:M~~ A~ l"4.ucK AS ptC.Ac.:ncAt..-,
~t'- (!Av'TI-.J wH6J
C()~~T'Cl..x,TIOrJ ACT'"luITY ~c.c.vj(,S
AJ t:A tl. .,- H E:-
CATCH aAS'N ON 711&
~
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-nlJS LA'" AS -ro ~.-r
j)A/IotA6fO- oCt. t)fST"~i!..
.1":
f"i N~'" G>ItAOf:,
MilST 3e:
.f"L"S ~ v.>ITI>4
CATCH aA~I^,.
SEE Il\Jfo4.MA"fIO,.,) ON Rf""Ett..:Sf: S,~~
Sf:~ ATTACJ.l"'~: /. F:"...H\t... G1?Atmvt'o /lJsP€eTltJN 1....,~rt'"'J4.r1~ I Z. alt~/ft PfLNJ
3. Eoll.< ,f)^ It'... AI rlt.tJL- "iostJtt.~S'
t/: &.~ CONntxec... tL+tv
liThe 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:'
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 4t;, ~ I Ht JLM~I\""d bl't-t:f 1J=-t:{('1
NATURE OF WORK f).pL.,) ('rlV\.Q~NJcL~
USE OF BUILDING SFf)
PERMIT NO. 77 -2L\
CONTRACTOR vJ"~\.UMol ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING I t/jTOR I Cs>_D!~CV(
, FOUNDATION (Prior to Backfill) I C::)J ee!fl/q1 I
PLACE NO CONCRETE UNTI~B6vE HAS BEEN SIGNED
ROUGH - INS
ID ~/loJq'l
r ~
7/~1111 \ )
DATE ISSUED
C( ~ 2 -Cf1
"1I!F
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING (;]) '1/isjqCj .
HEATING (if required) U 1\1 Pl.-/. 7 /~ /9c1
FIREPLACE '{IJ 1....~ qq
GAS LINE AIR TEST ffl/J-r/./! f. p. l ,ell. 74~ /1<1 .
-J
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
WE
~l
1,t,(,-QQ
. . -
GRADING (Prior to Sodding)
BUILDING -r 00 TO 1Il'Sl,;;q .::r.~, ~- \~_O ~
ELECTRICAL
PLUMBING
HEATING Iv jJ/- ~,
DO NOT OCCUpy UNTIL ABOVE
NOTICE
iofllfqq
(J. D, \()'-l&' '79
r;;) 'h J 1'1 . Cjy
~- "
. g'-/7-t],
H S BEEN SIGNED
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 (612) 447-9850