HomeMy WebLinkAboutBuilding Permit #99-0307
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OJ'S HEATING & AIR CONDITIONING, INC.
HOUSE HEATING TEST RECORD
.Permi t No.
ownerf~: r <:J~T::;",.,., "'.... "i:
Address I -J I <",; ?~__ f~ ~.., ""j (;,
Installed BY.JJ'.,,} .~~
"
GAS DESIGNED UNIT
Make_ A j ';'-"l, ^'i "........-\,.
/"'/',,' I r
Model 7J___. <:...& ....1 "-
C:t' C"I j / . t r"
Serial 6....-, , ;:
c.... )<:
\(;
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Rated Input I../C., ~.' <..:\..
".,x
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"'t.,\,'\..,. ../
,.' I ;.,......""..1
TEST
~ .. .~.,.(."'
Pilot Timinq -... I ") C'(,_ Limit Setting,;,\.. .
'7 -"
Pressure .7 ";;1 V' <~._
~ ~.;, "i
Percent O.
.['-'1
Percent CO. _' i '"
l")/
"S ,I \}
Input CFHJ!IIIIIL;
Stack Temp 3<-,,0
Percent co
Heat Anticipator Settina '
Date Tested_ J ()
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/~
. .
Name of Tester /
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R3 TypcCoM""""" VIr F;~Zo" RIA "",""n;""" Rt 1:1
. L8, BI, PHEASANT KEADOW 41,t
Legal Description. ,... ~
17185 PHEASANT MEADOW LANE .~.
Owner of Building Site Address : .~'
. '~
Contractor's Name & AddresJ:1!LLIAMS DEV., 1535 BAVARIAN SHORES, CHASKA ;J ~
'.;;..: I
ROBERT D. HUTCHINS (LINt ". PI JENNI TOVAR . ..........'....:......
'II, anner ....
il :'~I . Buildi., Offi9aI' >t;':
~..... I J I (j Date. <I"
(~0! -, , " ...: I l Q 'i 'f P,OSTlN A CONSPICUOUS ~LACE _". . . __...... ,,:
~. . .. -'--'-- -"- ---... .--.. ..- - ,~.
(~.Y ~ .....,. . .....,.,.. !lorWI!': . ~;~ . "--' ,~- .... :F'~''''''''&';~''''''i .,..""".,~. ~ ~'. .r\.......~ . "-,.I. ; . .......-"'.,~_. .,....~"..;~7, ..~~
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Q[ertifirau of (JDrrupanry
CITY OF PRIOR LA~l\
1Bepartment of 1Builbing 3Jn~ptttion
o Conditional C.O. Expires.
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is Certificate issued pursuant to the requirements of Section 307 of the Uniform 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:
Use Classification
SINGLE FAMILY
H'.']. Permit No. 99-307
Occ":-~.'y Type
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OrE /
~;
TIME
ADDRESS
( ..., f &'C;
Prl-~,~ IJJ~""-" ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
ftf. ~1
o FOOTING
o FOUNDATION
o FRAMING
o INSU~
a,FINA It;
o SITE I TION
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 GAS LINE AIR TST
o
COMMENTS:
c.. c-o 5t!- F-r c..s..c.
,~ (~lr
htA-I'- ~ G, O.
~RK SATISFACTORY, PROCEED
o CORRECT ACTIONt~D PROCEED
o CORRECT WJ'!",J'': FOR REINSPECTION BEFORE COVERING
Inspector: rLI J \ · Owner/Contr:
CALL 447-9850~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
P/fEJ:ts/t tv! ~ E:7+ ex; vJ
~t-
1q-307
f
o EXCfGRADfFILLING
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
1'7165
I~(
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
1 0 MECHANICAL
WATER HOOKUP
EWER HOOKUP
~EPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
C~~g~NtS:_ - q' L.l
"T~~ \L ~'rF:
.. s 12". r-.. J\1...'
~v./ h, ~
../
DATE TIME
~o; Ill)'
- I' ( ~.
-~
G...J..
\-1\S.,S - t?f7 l ~kJ PVc.. - ,,, -r-~~
lL ~f,f(l1.. - S~ ~_ c.k ,
~2.' (fY'- .~ (!70-f1..2 ~ Co"'~<^"
) S;vVt... S~&t-r ~~~ 4
U;' . ~ blrko ~ ~!A- (~4.C-(_p)
~1Y(tJ(fV ~.c.S+- Afr l.. W~ Lu.k..<;
tk<ir{.. ~ ~ ~
~.tJ* w:~ ~J~AL1j;\
/
o ~K SATISFACTORY, PROCEED
~ORRECT AC 0 AN PROCEED
LL F R REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
bov} n
~t5
6v-~k
CA L 447 30 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD~IREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFET;!
.. .....,...-,- ......
DATE TIME
CITY OF PRIOR LAKE lo:-oo
INSPECTION NOTICE SCHEDULED I()-t~ ..q:r
ADDRESS III <6)" ~ ~J
OWNER CONTR.
PHONE NO. PERMIT NO. '1'1 - 307
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
~INAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION ,....J...ECH FINAL 0
<;QMMENTS:
IJ) Yrbt2O"i t1~A- t;vu,-A ~
~ rj U ~ lA.- V~ t/U~ +e.--.:::.
_.J?~.M k _ ~ V~ _ &. +2.> 'e,V \1 \1 ~ c.k.
/J1)~I.t\IJe.. ~~ ~ ~~ ~
b~~~ u
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111
7-1-~6
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CTION BEFORE COVERING
Inspector: , Owner/Contr:
CALL 447-'50 FOR THJEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQ~RE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
/rp~1 3:30
/~ E35"" ~S/I/J/" Me:m;>oW
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
.. 0 SEWER HOOKUP
" ~PLUMBING FINAL
/0 MECH FINAL
Nr:N~
r~ '~
(AI\..
1\
j\~
\, C
DATE TIME
o/'t:;~ 307
.
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/
/
/
/
/
/
/ /-
~WORK I FACTO~PROCEED
o CORRE :r A TION A~~\PROCEED
o CORR CT V' RK, CALL FOR REINSPECTION BEFORE COVERING
Inspectoo: ~. J Owner/Con':
CA.L 447-S~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
co~ REQ~MENTS ARE FOR YOUR PERSONAL HEALTH .. SAFETY I
V INSNOTl
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
,t!JJ/..f4SMIT ~OOw lAl~ IS. Cv, tl
~5-347- (JOg-O
d-.
DATE RECEIVED
MIa.
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
) 7/ ~.s
3. LEGAL DESCRIPTION
LOT
~ BLOCK
P~A-5'ANI
(I )
ADDITION
PID
~ 1i.,C)a)l.J,7 - f7~
4. OWNER (Name)
SAJ..1-e.-
(Address)
5. ARCHITECT
(Name)
(Address)
6. BUILDER
(Name)
(Address)
1. DATE
i I ~f( 9
(Tel. No.)
(Tel. No,)
(Tel. No.)
l.(J I'LL I A 1-1..1
b -( IA( Lo P A.(,('tV r ) L L a. lbt ~ tf- 'i- 1.... 'Z... "t..-'\.-IJ..
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
7. TYPE OF WORK
New Construction)(l
Chimney 0 Mis;. "-
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
1 O. CULVERT SIZE
Yes No
1. White
2, Pink
3. Yellow
File
City
Applicant
Permit No. ~l]/
,
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
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
the abo mention 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
build' . 'al revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform n eded' spections,
X \ -~-Fo^ tVI LL,A..tM..S' ~V; LlC. ~J 3rt./. Q
Sognature L,cense No. 0 -\
SETBACKS: Required
Actual
Front
Back
BUILDING DEPARTMENT VALUATION
FOR ADMINISTRATIVE USE
Side
Side
USE OF BUILDING
.~Ffl
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV (0
Occupancy Group A B E F H I M~S U
Permit Fee ..........~~~~~~...1...~~.~... $ 9 5~ .00
ft;/~.'1(
t;"fD . SO
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty......... ......................... ..... $
/(J().00
Ino .6()
Sewer & Water Permit ...................... $ ~').5 0
Gas Firepl e Permit ..+..... .............. $ If ~ (0(:)
This . Ii m uilding Permit ~,.en OOProv~. C-
By Date -!t - fj - f-I--
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
IJ3.a::o.a n
,
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
As-z) ~ CO
,I os-C> .~
Collective Street Fee ....................... $
SewerTap ................................... $
I' $
Pressure Reducer ..f8..................... $
Meter Horn .....t:d:.,,....................... $
Water Meter ...71'-.......................... $ I )..6, ()~
Sewer & Water Connection Fee ........... $ J , 2 J"J c:> ..e ~
. ,
Water Tower Fee ........................... $ ~
~1z.D ti'\
*f'
24 hour notice for all inspections 447-9850
Water Tap ................................... $
Builder's Deposit ............................ $ /: sm ~t)O
Other ......................................... $
Total Due .............................. $~~/2--. CD-
Paid 7312, JI--1 Receipt No. 3n,--::'"
Issued -'
Date 4/f.,,'J/tff1 By.1JtL-
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 '-requested. This document when
signed b City Plan r onst~utes a temporary Certificate of zoni~comPliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
_ "-f ~I fr'-4
la er Date Special Conditions n any
" ._,
q ~ , CJO
11-3C,7
... .. -. ,.
The Center or the L.kr Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
....
,"
LeU.
NAME OF APPLICANT
APPLICATION RECEIVED
/UL{{11f I 1/5
L(. C; - 9t?
The Building, Engineering, and Planning Departments have reviewed the building permit
applicatiop for construction activity which is proposed at:
" /'71 [~ (...J;ytl5tU/lt /lka/tJW LAI
-c,
Accepted,
/
Accepted With Corrections
Denied
Reviewed By: JJ~V-T'E.tt.. ~I4Re-:s~"''''^, Date: --#n.-/'"
Comments: ~E' i3\JIL.O/J~JG. ?E~....rr:rt 99- 30t..!17181 Pl-/clfS!fAJr fIIe,q.JibuJ
,
LI"\Nel
-
Fo Il.
,
'NFottM""T'"/'Q1\J I A-r-rfiCHvt-tENT.'5 ,r {''''''''MFN''~'
"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,"
;r;" r, m7'
. ~ ..-~.....
I /.:;( ,
The' Ctnttr of the Lakt Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
"
NAME OF APPLICANT
APPLICATION RECEIVED
" "
/ ,:/ //;;/,", I"~
/' /',! f ( , ~ ; r -,' t ___~.: "
.-,/ /'
'I ,/
t((;
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
, " " '. i I ,f / ,,/ i.. j
//, I . //11/"1/ I /'/""/;'//(-<(/1../ i /"
Accepted
,/
Accepted With Corrections
Denied
Reviewed By: ~!~
Comments:
JJ- J0D~ ~\.}~~<.
-\~o~~l \~
Date:
L{ -{~ .LJct
l
--~~
~~ I~I~_"
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."
T
11-307
White - Building
Canary - Engineering
Pink - Planning
TM c..... ., 1M Lak< C...lrr
BUILDING PERMIT APPLICATION De.fARTIVlENT CHECKLIST
... .
i\
UcU.
NAME OF APPLICANT
APPLICATION RECEIVED
L.UL{{/ if /1/5
LI-~ -99-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7/ [/j (;Jjyt?StU,~t/lka/tJWuJ
.
Accepted
./
Accepted With Corrections
Denied
Comments: ~
BUlL 01 AJ (. H=1l"" rr -:rt
.... . ,.1 I
uale: Yf II.~/''t
<r 9 - 30 f" ( 11/ &. I ?HCII,;Lt4-AJr f'll!AJiDuJ
Reviewed By: JJi\,-,E.#'t. E....RcS,;.t;1I1iN
L ""NEl
."
Fo it.
,
'AJ'FoR.Mt4T I'OAJ I A'rTAC Ha4t/!AJ~.r t'7...t4(MFNTS.
"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."
tff-307
Thr Crntrr of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLlSI
...."
/JeJ .
NAME OF APPLICANT
APPLICATION RECEIVED
iUJ$~5
44 -9r
The Building, Engineering, and Planning Departments have reviewed the building permit
application for c7;~c;~c,~:::;o;;d~ vi
/
Accepted
Accepted With Corrections
Denied
Reviewed By:
(?~ ~.L
Date:
CI-/~-11
Comments:
I. Sc>~ ~ f/UU> ~~~ ~
2, See. ~r:tr 11 - -;00, ~r- (iYa-v-cs, ~s .
I
~ UrV..JW'v e-fc ,
u
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."
w~
~Nt:~
MAY - 3 1999
GREEN - FILE
YELLOW . APPLICANT
GOLD - CIT Y
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. 77~7
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT: P;AJ/J~ 0;('/}tJE ;IAJc PHONE: 95ft) -/5~/
ADDRESS:;1tJ 15or/O (JJlJD~LAKE jj;A.J DATE: 6/3)97
SIGNATURE:/~...4Z/b/AuJ~~ BLDG. PE~I~ # 99-307
SITE ADDRESS: /7135 /HE//59IJr I'JEIlIhJ) I.~ID# 25-34-7- 008-0
FILL IN THE BLANKS
1. Estimated length of water service ~~
feet.
2.
Size of water service /
inch(es) .
from struct~ ifj
PVC ~ Cast Iron
feet.
3 .
Location of any couplings
Type of sewer pipe. ABS
4 .
5. Estimated length of sewer line ~
feet.
6. Clean out (if required), located at
structure.
/dO
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This applicatio~~es your permit when approved. /
BY ~~.-/ DATE: 5.6/99
(/- '/-/ '
------------------------------------------------------------------
------------------------------------------------------------------
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
issued. y.. ~
DATE PAID s-,/3,/QQ ?~O ~~t(;.~\N AMOUNT PAID
RECEIPT # ~\\..Q\~ REC'D BY P -
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph, (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
CITY OF PRIOR LAKE Me
16100 bUIe Creek Av. a.E. Ptnnil No. qq~ 307
Prtor I..8he, MN 15372
.. _ HEATING APPUCAll0N I PERMIT
~Il. ? - 2/- CJ'1 PID.25-3l.J.7-008-0
ID C
~ ,. Mdt-.. ,II { p> t; V'n,rh ~Ch'\- yY}pt:./\n...J ~ W · R..l Fee Schedule
f;j C e 8Iadl f , Addlloft, ~~NT I'1FA/)I)vV 2~
~"n.r'I Nemt lA) I J I. GVY\ ,< ~,..uL '00 mti' \- ~ . L L C
E' .,
Sdr.. ,.<;~~ ~o.v~C"".'" ~n("~ Qr\vL
lelkIg~ntIldDr \):\'~ ~A-\-i",f:'.A...( ~ L
:tdr.._~ ~~)')(. ~\1c... .~\b.rlu\ \'-". M"-' ~~~\
~ .
~MphoH..,J..J'i/- ~ \
~ JmllCl Malle & Model ~4-t ~N-G6
~ iud.1 sa"::;l h~()-=-rR
.-of ..
I.D
.. -onn. Load _
~".I
w
is vpply OpInlngs
I
l1..ielum OpIning-
Flu. Sill
lpul
:dr.
:1m.,
,Outpul
1lPE OF SYSTEM
Wum Air Plantl
Gravity
Mechllllc8l
Air Condftloning ,
VenL SY"lm
HEATING OR POWE" PLANT
Slum'
Hot Waler
Redlltlon
SpecllI Device. ,
,
OIber o.vice.
Rtp4aceniIN
TYPE Of WORK
New Oonttructlon X
'ltlratlon.
Cl
3 =lepelr
I- '
CI
~:11. Co" $ , .euldlng Penna J
~riEAT\NaPERMITFEE' ~9 ~
Q
.. STATE SURCHARGE . .50
~ TOTAL 'PERMIT FEES . Lj 0 cYO
LL
Ell Camp. 01\. .
QQ-30'7
I
PAID WITH
BUILDING PERMIT
Receipt' ,
TVPi: ni: ~m~ ~~nat:
t. ""*
l. 0.-
J. wa..r
. ..
Olr
c.....
Single Familv
Commercial,
Two-Femily
lnflJ.ltlal
'X
. MtN-F8R1iIV
Olher
Public
lndualttal, Commerclll & MuTli-Femily
Relldentlal, HeatTng & At;
RuldtnUII. Hilling Onty
ResktanUa', Gu Fireplace
RttldtnUat, AdcIlione & AIlerlllona
. RHldlnU.t. AC Only
1% 0' Jab coat (138.60 ninnun)
198.&0
184.&0
$38.60
$3IUO
..50
Remember to add the S1ale Sun:harge on lhe botlom of Ihla appllclUon.
The price of yaw he.Ung permlllncludea ane rough.1n and one tNIln1pecltlon.
Additional Il1IpeCuons will be "'Ned at $35.00 I8Ch.
House Heltinv Tell RKard mUll be .ubmltlld w1lh luiIIIDsIlIDDII DIIIDl tJeforIlIuId-
Ing cerUnea.. of occupancy wig be ll1ued.
""1=~1' roM r" 'I j\T1~1.Q; ~F'" ~I~C" wllh number a' supply and rebIm DJJ8n1ngt""" per
room wilh CFtS. per cPlnInt. New alfUc1urel or aMoRl IInd floor ...... wIh I"""
Ind ,aturn locations shown, HEAT LOSS CAlCUlAOONS. PAYMENT AND
APPliCATIONS MAV BE MAILED TO THE CITY OF PRIOR LAKE, 18200 EAGLE
CREEK AVE. S.E. PRIOR LAKe, MN 55372.
City Hair busln... hours 8'1t 8 ..m. . 4:30 p.rn.
ALL WORK MUST BE &NSPECTED (ROUGH-IN AND F1NAL) . CALL CITY MALL
447-4UO
I hereby apply 'or a mechanlca' Iyelem. permll .nd I acknowledge that the
Information above I, complete and accurate; t"" the work .be 1ft OOIIfofmance
wllh lhe ordln.ncea and cod.. of lhe elly and wfllt Ih. "ate buldlnglmteh.'"
code.; that lhlllorm doe. not become a permit untll Ilgnld by 'hi BUILDING
OFFI~IAl; Ihet the work will be In accordance with 'he approved plan In ....
~~~h';;;;::;_.I.IP~~ ~J-~
~~ ~ 6/Z~/9r'
Bulking Ob,. &ignalunt a.M.
CITY OF PRIOR LAKE Me
18100 ElgIe Creek Av. S.E. Pe,mit No. qq... 307
PrIor La.... MH 55372
HEATING APPLlCAnON , PERMJT
~Oal. ? - 2/- qt1 PIO,~5-.347-()Oe-O
~SlleAddr." l, I p)~ \7h(c^~- r1pe:./\n~ -< W ~12.1
..-l .
F;j lot ~ Block c I . Addllion. pH8ASAAI/ l1eAO()W 2^'O AnON.
~OWnl(.N.ml.lJl )liGVT\'c) DeUL\OO(y\t!"\\-. 'ILC.
E ' .
Addr... 11) ~~ ~Clvo...c-it^" ~Q("f ~ \)r\vL
HeIlTng~ntrac1Or\):\/~ u,~~(\C-.A...f ~ C-
Add.... ~(::D ~ClO)(. ~vt.... ~\~r\ v\ ,~ , Mt\\ 5~~'
~ T'I~' .J../qt- ~~ \ · -
N '
r- Furnace Make" Model ~A e:o ~ TYPE OF SYSTEM
(J'I
-.;t r or, c..'" J~ .... ) it:: 000 WIIm Air Plln"
~ Model SilI':O'- v-r..; , -r ..11 GnM1y ,
I.D "2 CO 4 I Ot Mtchanicll
Conn. Lou. ) 'J i I Air Condllloning
o Fuel 6\1f Flue S.1I .L{ VIfI1. S,.lm
z
~ Supply OpInings q HEAll~G OR POWEfl PLANT
o '1. \ f.) ~llam
1[ Return Openings } {'R..J"lCl=\ ..A.2 \f:,~ Hal Waler
} II CXD "')/' 0 CO Radiation,
Inpul.-,fo, O~pul ~: 0 , Spedal Davie.. .
Edr.
elm.,
.
Olher Devices
TYPE OF WORK
x
Aller allon. ,
Rlpllceniln1
_ Eal. Comp. Dal. .
New Consl.uction
~
Z Repair,
......
f-
er
w
I
(f)
I-:>
o
Bulldlng Plrmlt"
99,~ '
.50
100 ~
q9- .307
Est. Cost S
HEAllNG PERMIT fEE.
STAll: SURCHARGE $
is TOTAL'PERMIT FEES .
ct:
LL
PAID WITH
, BUILDING PERMIT
RecefJt , ,
TYPE OF STRUCTURE
1.4'iIIII . flIa
1..0- . 0lJ
1. y..... . 0IIIIndaf
Single Family
Commercial
Two-FBmny
Induetrial
-x
MuIU.f8mIV
Olhll
Public
Fl. Schedule
Industrial, Commercial & Mufti-Family
RlSidenOar. HeaOn; &. AC
Residential Healing onty
Resldential, Gas Rreplae>>
R8Ildentl.I, Additions & Allera~ons
. ResldenUIl, N; Only
t % of Job CDI\ (taIUO ninlmum)
$99.50
164.sG
$39.&0
I3IUO
139.50
Remembftf to add the Stale Sutch_rge on the bottom of thl, IppUcaUon.
Tne price 01 your tlealing permU IndOOu one rou~h-In Ind one finallnlpec:lIon.
Additional Inspections wftl be billed III $35.00 ellCh.
House Heating Test Record mUlt be l\.lbmftled wilh bYIId1DaRlDlil DWdIIl bIfofI bul'"
Ing cerliJiclte of occupancv win be lssued, '
~F4T roM rol" ATln~,q ~r:(,\I I."r:" wIll number of supply and ..,"" eptnlnglllltedper
room wi1h CFM~ per opening. New ,',uew.. or IddltloN Hnd floor plan witt .uppe,
Ind felurn IocaUan. .hown. HEAT lOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAIL~O TO THE CITY OF PRIOR LAf<E. 1&200 EAGLE
CREEK AVE. S.E. PRIOR LAKE. MN 56372-
City Hall buline., houri .,e B I.m. . 4:30 p.m. . -
AU WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL el1'Y HALL
447-4230
I hereby apply for a mechanical 'Valem. parm" Ind I Icknowladga thlt the
information abovI L9 compl.I' end accurale; thll lhe work wIll be In conlonnlne.
with Ihe ordlnanc'lI end cod.. of lhl 1:lty Ind with the I1ala bulldlnglmechlnlcel
codes; Ihallh" lo.m does not become. perm" until .1Un" by "" BUILDINO
OFFICIAL: Ihl' lhe work wJlI be In accordllnce with th. approved plan In 111.
\~ ~-;:r::~.,r~ow~r.'.1 0/ p;;~ ~/_q~
~~~~"' DIIo.
. . Building 0flic81'~ 5,/ :z. ~ t:jq
6- 8-99; 9:00AM;ELANDER MECHANICAL
;612 445 7487
# 3/ 3
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: 6' /c:; on~"/ 4(/? dr a",. , C PI- L
Address: sf / ?/4-~dI-:J4 b-/v<::""
Signature: & ~
Legal Description: Lot E; Block / Sub PIIM S M6~{)OW ;z. Nt:>
Site Address: / 7/B";;- ,r?A~5'~"c -/ ./Kffl~d,W t.A A e.... A..-/
Buitding Permit' qq... :!Jo 1 PID # 25-34-1- OC8-0
NOTE: ' This permit will not be processed without complete' information.
1. IIIIe Pile
2.. Gold 0'7
1. YdIawI ~
PPNo. 99-307
I
Phone: L/V 5:'=-1' ~ f":J-
.5 ~ Ak.-o/,k k- ,A/?'",,)
T" c..... or ... &.ak. c...."
FIXTURE UNITS
/
I
I
<.2-:-
Type of Fixture
Bath Tub with or without shower
Quantity
Type of Fixture
Quantity
RougtJ...ins
Dishwasher
/'
Water Heater
I
/
Floor Drain
lavatory (bathroom sink)
Laundry Trav (1 or 2 c:ornpa~:ment sink)
Shower Stall ,
.\
/....,.
. .
Water SOftner
Stand ~Ipe; (washing machine)
!i, .. "'.9.e Ej~ot:..', ,
B8cIdIow Assembiy (RPZ. Ooubie Check, PVB)
Backflow Assembly Test
Lawn Sprinkler '
Other
2-
Sinks
Bar Sink
Water Closet (toilet)
FEE SCHEDULE
Industrial, Commen;:ial & Multi-Family
(10.4 of job cost. $39.50 minimum)
Residential, New One & Two Family
Re$idential, Additions & Alterations
State Surcharge
$99.50
$39.50
~" ~O :~tA\1" ,
\ eU\\J2\N
$ '9 9 s::::.
$
S .50
GRAND TOTAL
s /tJb ~Ji!..
This permi( is granted upon thc Cll.prcss condition tha( said
conuaclor, shall comply in all rcspc:cts with me ordinances
of [he Stale Plumbing c UK! the ~d~ thereof.
. fp/e/w DAn:
ATmST
Call for n..l"'....tions 24 hours in advancc.
16200 Eagle Creek Av. S.E. Prior Lake, MN 553721 Ph (612) 447-9850 I FAX (612) 447-4245
An Equal OpponunilY Employer
-'~ -.. .... . .~,-- <o.'....__..:.~ -'r" -. .. ,,-_.,,-~._- -_..,--...~ ~,,-".." .....
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS --Dl.BE:; lp"'~ ~') cR~_
NATURE OF WORK Ne uJ lb-tS,h'OC.1tOv\.
USE OF BUILDING q '1- ~()7
PERMIT NO. ~'1-~'l DATE ISSUED l/-/5-1CC
CONTRACTOR
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
FOOTING I -:I.u.. ls-~.-Pt"'I
FOUNDATION (Prior to Backfill) (J.)J .!f~ I
PLACE NO CONCRETE UtJ:(IL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC en si.;l4
FRAMING 1\ {/(/f) S/I 0/'9'9
INSULATION ~~} [) ~\
ELECTRICAL \Y
PLUMBING 0 G, (2v ("f!;(t; q . ~.1/ e)s-/'19
HEATING (if requir~ (;j) ~J)/~ t
FIREPLACE IJ VI? fl.:;!;" '
GAS LINE AIR TEST fttJ "8/9'1
COVER NO WORKto'NTIL ABOVE HAS BEEN SIGNED
,~ I I
FINALS
}JJ ' ~.
q"'3"'1~
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
q.... :1';/' 97
..
& '0- \, "Cf'i
. , 'Co/if'n
OCCUpy UNTIL A VE HAS BEEN SIGNED
NOTICE
f#
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
I