HomeMy WebLinkAboutBuilding Permit 99-0576
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OJ'S HEATING & AIR CONDITIONING, INC.
HOUSE !!E;A~:tJG TEST REl"'nnn
Permit No.
Owner "}~, '".. \ . rl1p....J(, r h <:. /)"1.. '3 -5' ..~:,~'..
i .
-- .... ~ ,::) ...~) ...' ' .~ , . -\
Address J /l.:..lc.. d~ { ~ /;l........ ")c.: h trke;".{.c.:-.:
""--" ' "-
Installed Bv/,j.....J
1
.".f
GAS DESIGNED UNIT
Make I~ V"'V\ t:;' 'I" q_
" " -, I'f'l\.t . ..,
Model If;'\, (' V Q. 1 :) f'U " -I \,,)
L
serial
.:'.~I
,
f1 '-I L ''; L" S
Rated Input J <..: . .., . ')
TEST
./
pilot Timino .....
.t,..,~:~...; t
Limi t settina '0 <::. ;:
I>
Percent CO. c.;
g Ctl
Percent 0 /0
.
Percent CO 0 / C ',',
Pressure .~.. S L'V C
Input CFH 7 <~ ,( '..<
I;:
~
Stack Temo 'S
Heat Anticipator settina
Date Tested I J ' j ",;'., <; <j
~-~,
\
Name of Tester /.: "
;l
-1
,.,,:,""......J[,;~ ~.~ '"-,,,,'..:..ot """,,; .,,';
w:..~~L';-l':.-.>JO~' :.'~',,",~,"', ' '.', ,,,Jrl.L::..' il"k;~ ,~....." ."" : ,,1;=; ;,~~;..~....r~~~+.1,~~ii:.:t..... .-.-!..,.;.,."" ,iI.! J.;}~ -,:....:,:.i:!';.,'~....;;...- .J.~:~:',' ....;i:.:.J....... -... a, .. ,,~' ,M-o;,' oil/ilW
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
/-?()&:'2-
SCH~DULED /~~;(~
7flE?9S/9A/~1
3 ~l!Q
A1
.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99-570
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL ' ~ PLUMBING FINAL
o SITE INSPECTION /).?,MECH FINAL
/:)COMMENTS:
(Ij ~~ (,/0 ~ ~ ,~M~
~~~N
!1t'O IlL ~ ~r:1
o EX/GRAD/FilliNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~L."'--S i'6-r
A,rr ~
....
\
/
o ~ A FACTORY ).,OCEED
t:::t A ON AN~ ~~OCEED
o CORRE WORK, ~7' SPECTION BEFORE COVERING
Inspector: /' I Owner/Contr:
CALL rSO FOR E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RJ ".:QUIREME :s' ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI
/'1()(P z
DATE TIME
SCHEDULED #1 /:3n
PIIf5'?/S/l1VT /'1~ W
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
CONTR.
PERMIT NO.
Q9-57(c;
AD PLUMBING RI
o MECHANICAL
~ATER HOOKUP
EWER HOOKUP
Pr 0 SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHOREANETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
C~,ENTS:L~ I
\ t, I)r- LL
f1 V(~
(~~
. !l.'vL--
~
4t.J 't-V'-
4tlJ
C5k--
~
olA---'/
\AwJ~ ~t
r / JA
d1;~
b~
Inspector:
Owner/Contr:
CALL 447... :::~,l THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQL\JNTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
T'~"
DATE TIME
-<lOR LAKE
~ nON NOTICE
SCHEDULED
J%/g /9f'
, I
,
ADDRESS nJX,2. f 17()~'
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
"rfI FINAL
/0' SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
f;..l~~ rfEA/J&1U L14NG:....
CONTR. ,Al,....., 'aIS.II1S J)~~EJr
PERMIT NO. '9- 57hj5'7?
)( EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
PHONE NO.
COMMENTS:
..f.,J-r.Ilf:. '1'.4/U) I"'" .sSl)AEb -4. I .ANfj~AlJfJ\
au~~E'S
&e
QJ<
XWORK 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 & SAFETYl
INSNOTI
'-.'--'.-..'..,..-..
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED f;)~!ij ,2.' (7)
;Z~e/lS/J7l/T /Z?c77VOvc!
ADDRESS
/'i(Jrc 2
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
COMMENTS:
( ~ ~\I\.t.O
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
r~ ~\lVtAA~~.
---------
~
/-r~
( -
"'---
'6<;'M,t\
~
c.,J.+o
----
99- S7(P
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
f~~
~
~
7- [-2= ')
-.
Oy-~ed.
F.P_
~ T~
,
u.4R
ORY, PR~D
RRECT A 10 AND P~~~JD
K FOR RE ~ION BEFORE COVERING
Inspector: / Owner/Contr:
CALL J7-9850 FOR THE'EXT INSPECTION 24 HOURS IN ADVANCE.
CODE R
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ta/J/iJ- 3: 0 0
ADDRESS
1'10~2- PtlO1fmvT nero~lA.l
OWNER
CONTR.
PHONE NO.
PERMIT NO.
t?t;"'5/(,
o FOOTING
o FOUNDATION 6.
)5 FRAMING n
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ~ -- ~
\. PJ;r.l_('T-~_.~ 1/\ t-:<:tod W~
g. R,~ ..a-.L\~~ %W Tot.,
:wr1-7hJCclJ~ ~ 'J'-'~_1l) ,() -+:- f) t~lf~A. <;-b t.l<.Q..O( p( ~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
()C
+n ~~V Lt\ k'
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CO~RT 0 K, CALL FOR REINSPECTION BEFORE COVERING
Inspec ro . Owner/Contr:
C~ 4'J7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
/7o~ 2-
ADDRESS /7 0 ~ C::>
OWNER
DATE TIME
SCHEDULED /ok/t9 / /.3-i)
?/leJ"/S/7A.fT /'1E7toO W
'PHOIS /TNT 1'10-100 L-J
CONTR.
PHONE NO.
PERMIT NO.
9'9 - 57'"
~ - -577
o FOOTING 0 PLUMBING RI
o FOUNDA TION ~ 0 MECH RI
;g( FRAMING l 0 WATER HOOKUP
)( INSULATION I" 0 SEWER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: 4- ~ .
(J ~ ~f h~ fi;t ~~ ~~y?, b.ru
(j; ~~'he4'i'rC- 0- f3~~&,
('!;) Yo tv)' ~: ~ v-1 Oll~ ~~V~ [ _ .
~) hrl.- \) lev..J.iJ-. ~ ~
(~l.v Su.u IU~V ~ ~f- ~Jl &-
;1\ /' /'
I //
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
Owner/Contr:
CJ LL 447-985l FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTI
CO 'E R'EQUIR1M'ENTS AR'E FOR YOUR P'ERSONAL HEALTH & SAF'ETY!
/
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)i(fINAL A
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED ~
(r00-Z- P;'"fG'=\-~4~~...-..J
CONTR.
PERMIT NO.
ro/-57~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
C!- '- c? 5& h c..G
~ ~~;...
IJ1 A-{(_ C!.. 0 .
~RK SATISFACTORY, PROCEED
o CORRECT ACTIO~'A ~D PROCEED
o CORRECT ~K' ILL FOR REINSPECTlON BEFORE COVERING
Inspector: {< - ,t1 Owner/Contr:
.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
QAIf RFr;FDlEQ.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
MAY t 9 1999
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
)7o~ ""' PUelJ(]!J.t.../( 1--Il;:At)ou.:>
3. LEGAL DESCRIPTION
LOT q BLOCK ~
ADDITIO~rt'/J...I<A.~ AwV'"' ~A 0 ~..o
1. DATE
5/tq /qq
LANJL 1 ~.W. /I!./
PID 25- 3ze; .- O?.CJ - 0
(Name)
(Address)
(Tel. No.)
4. OWNER
Sj;1.. ~ e..
5. ARCHITECT (Name)
A;u::-if. l or <If2 c.r "A-I_
6. BUILDER (Name)
(Tel. No.)
75~~71.s-~
q-3?-~~OZ-
WILt., ""Ii S O..f.'^€...L.OI" ~N"0 L. L., c.. b/"l.. - q..'\3-~~4- q..
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re,roofing 0 Porch 0
New constructio~ Alterations 0 Addition 0 Finish Attic 0 Re'siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft. -;'9 "'Z. 4-
(Address)
0-'?S fCSN Lti..scn.r~ II"(
(Address) , " ,^-^o...rV-'-
9. PROPERTY DIMENSIONS
, ,
Width ~ to Depth g 4-
1 O. CULVERT SIZE
(fID
Yes
File
City
Applicant
I'?AIAI Ru5':#=
Permit No. qq-57b
1. White
2, Pink
3. Yellow
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) , (Width) (Depth!,
~ cL '3,5 "7 c.L
12. NO. OF STORIES
I
13. TYPE OF CONSTRUCTION
F=n.. A- I\.f -e 0
14. FLOOR AREA AP~RTIONMENT USE
l~t.l.-:z.
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS ~ 1\11;; L.Q.. I=14M. J9r~~
SEATS /..J..2~_
16. PROJECT COSTNALUE
qD ~OO..
,/.
17. COMPLETION DATE
4LCu.rr
I hereby certify that I have fumished 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 abOVe m tioned ~rope d 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
buildin 0 n revo ermi~for just cause, Furthermore. I hereby agree that the city official or a designee may e. n. ter upon the property to perform need~ inspections.
X ~ ~....... r') no n I ~"'iS ~ -<'llq f q q
Signature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN l 2.6 I C!) t.;..;A--" , (!) 0
PERMIT VALUATION _~.~, :-:~
USE OF BUILDING
.sPA
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
Permit Fee ................................... $
I~.L'
{J" 1.72-
(P<i .00
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
~j. I, $
Pressure Reducer .......~................. $
City:
Plan Check Fee ............................. $
State Surcharge ...........................,. $
Penalty ....................................... $
100. CD
(O() .00
. '"},- m
Sewer & Water Permit ...................... $ ",-L.. . S
......,-
G$~~' ...... ............... $ '10 .00
This I ecom Your Building Permit ~~epro~<(l
By _ V Date :J-L?~77
Certificate of Occupancy
eso.QO
t () ~-o. C'!:) t2
4<;;. 011
Meter Hom ................................... $
Water Meter .....5J&,....................... $ L :;2..5. 0 ~
Sewer & Water Connection Fee ........... $-J.:2-DO ~e Cl
Water Tower Fee ........................... $ '((')(") .00
Water Tap ................................... $
Builder's Deposit ............................ $ 'I L,.....On ,OQ
Other ......................................... $- . '. 7
Total Due .............................. $ 7C;(1L.J. t...j
Paid ,c:::rJ-I. Ul Receipt No. ;:::) S
Date Vyl .q q By (
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Issued
This is to certify that the raquest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as raque ed. This document when
signed the City I ner const~utes a temporary Certificate of ~^omPliance and allows const ion to comme~e. Be~ oc~p,ncy. a Cfe~i'te ~~cupancy must be issued.
~-2? ~"4 ~(I.w..<Y~
rty lanner Date Special Conditions if any
24 hour notice for all inspections 447,9850
~ ~ CITY OF PRIOR LAKE Me
...IIIIIIII~ " ~ 16200 Elgie Creek Av. S,E. Permil No. 99'-57(1:;
.. Prior Lak., MN 5537l
~ HEATING APPLICATION I PERMIT
Iii Date 9 - [). .... 901,
~ '
~ Slle Addr.'~ \ '1 O(nP...
en '
~ lol q Block Z Addillon PNliASA-/l/r /ff€"'IooW.s
~ '
Ii. Owner's Name.LJ I Iii WT\ 'C; De.ue..\o 0 MfJ' \-, '1 LC
ill ' '
If) Address -'J)~~ ~a.Vo..C-;f^",,<hO't',~ QC'l\,)L
Healing Contractor \) -:s f '") ~ +; (\0\ -t ~ I C.
Address (j:)fj:) ~~L>X ~vc, \.\\~r\J, \~_ Mt\\ ~S~D\
.
IS{ Telephone " J../q 1- :).ro~ \
I.D '
~ Furnace Make 8. Model ~tvV-~ C):) k
~ Model Silt '10.000
N '.
Ul Conn. Load . ~ 6~ LJ
o Fuel No.k-. .Flue Size J-j.."
~ Supply Openings -L t::;
z
~ Return Openings '1
Inpul ~Cf # CCOoulput h.h, QCx:),
. . .
PID.. 2S - 32.8- 020 - 0
~e~~-\- ft/"o.r1oW 1~
Edr.
elm..
TYPE OF WORk
Aller allan"
Replacement
Est Comp. Date
~ Repair
z
.....
~
<I
UJ
I
If)
...,
Q
Building Permft.
qe>; ~
.50
J 00 E!:;
Est. Cosl $
HEATING PERMIT FEE S
STATE SURCHARGE $
E
o
0::
LL
TOTAL PERMIT FEES $
TYPE OF SYSTEM
Warm Air Plents
GraYily
Mechanlcel
Air Condillonlng
Venl. Syslem
HEA nNG OR POWER PLANT
Steam
Hot Wale.
Radiation .
Special Devices
Other Devices
New Conslrucllon
x
qq-670
p~\O \N\1'\-\
R......JlU\\.O\t.\G pE.P-"^\"\"
TYPE OF STRUCTURE
1. 0_ . Ct.,
J. Yell_ . c.nJnl:""
Single Family
Commercial
, Two-Family
Indue"ia1
)(
Mulli-Famlly
Olh&T
Public
lei
Fee Schedule
Industrial, Commercial & Mulli-Family
Residentia~ Healing & AC
Residential Heatlng Only
Residential, Gas Fireplace
Residenllal, Additions I. AIler81ions
Resldenlial, f.A, Only
?-r, n'.:aloeSI ($39.50 minimum)
'- $99.~
184.50
$39.50
$39.50
$39.50
I
Remember 10 add lhe Slate Surcharge on the botlom oIlhis application.
The price 01 your heating permit includes one rough. in 8f1d one final inspection.
Addilionat Inspections will be bftled al $35.00 each.
House Healing Test Record musl be submllted wilh ";ppn~19lI1" r'p.f",l' "I" "~~II' belate build-
ing cerlilicele of occupancy wnl be issued.
HEAT CAlCUlATIONS RFOlllR,Ffl w1lh number of supply and return open;,.gs Ilsled per
room with CFM's per opening, New struclures or additions send loor plan with supply
end relurn locations shown. HEAT LOSS CALCULATIONS. PAYMENT AND
APPLICATIONS MAV BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372,
Cily Hall business hours lIe 8 8.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HAlL
447-4230
I hereby apply for a mechanicaf systems permit and I acknowledge that the
in'ormation above Is compiele and accurate; thatlhe wort( will be In conformance
wilh the ordinances and codes of Ih. cIty and with the .,.te bulldlngfmechenicat
codes; that this rorm does not become. permit until sIgned by lh. BUilDING
OFFICIAL; that the work will be In accordance wllh Ihe approved plan In th.
tS:~"~::::'IO'P'~'_2 ~ qq
P'f:"~~J7d1.. 9/37<19'
L.~ng ~1'e'Slg~'f-.~ Date
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. Permit No.
Prior lake, MN 55372 '
99-570
1'1
a.
E
~ '-....:=-/ HEATING APPUCATION I PERMIT
N
in Dale 9 - 2. .... 9q PIO, 2.5-328- 020- 0
~ '
m Sil. Address \ '1 0 V>~ Yh<?~SCN"\. -tM p~ v.) 1", t</
~ lot q Block ~ Addllion J>#t9!S",Nr /"I,91LJof/lS
: own.r'sNam.W.I/iG\",\4)' De.Ut-\O()Mtr"t-, 'ILC
(lJ {' ,
U) Addr8s.15 ~~ ~D.Vo..c-l,^f'\ <ho("~ \)(",vL.
Healing Contractor D -=s. ' "5 ~ ~ (\o....f ~ I C.
Address &::>f:D kh~L>X \\V(.., I \\\beAu'. \\t,_ (Y)~, 55'~o \
Telephone' ~/ql- :;2.roro \
Furnace Mak. & Model ~. N. GI o-1..lYPE OF SYSTEM
L: L '"15 -1"1R l\.' Warm Air Plants
ModelSizl ,-J I D J' '''. GravIty
r _____.r-.. in M.chanlcal
Conn. load ~ 't'-... Air Co d'It' .
. n 1000ng
fuel ~-\- Flue Size Vent. System.
If)
IJ)
\D
N
I"-
IJ)
V
N
.-i
\D
o
z
w
z
o
I
a.
Supply Opening' _
HEATING OR POWER PLANT
Steam
Hot Wat"
Radiation
Special D.vlces
Return Openings
Input _
Edr._
elm.
OUlpul
Olher Devices
TYPE Of WORK
Allel alions
New Construf:lion
x
R.ptac.menl
. Est Comp. Date
BuildIng Perml'
CJ
Z
.....
I-
a:
w
I
U)
...,
o
Repair
Est. Cost $
CJ9-57Cp
HEATING PERMlT FEE S
STATE SURCHARGE S
TOTAL PERMIT FEES $
.50
~~\O \f'J\1'\'\ \\
Aoce\ll ~,e\lI\.OING pEi\t-J\
E
o
e:::
lJ..
IYPE OF STRUCTURE
J. j'..u' J"1lc.
1. Gnn - City
J, Vel"", . Oll!llaclla1
Single Family
Commercial
Two-Famly
Industrial
.'X
Multi-Family
Olher
, PubJic
F e8 Schedule
Indus! rial, Commercial & Multi-Family
R9sidenlial, l1eatlng & AC
Residential. Healing Only
Residential, Gas Fireplace
Residential, Addllions & Alleratlons
Residenliol. AC Only
1% of job cost ($39.50 minimum)
$99.50
~
$39.50
$39.50
Remember to add Ihe SIale Surcharge on Ihe bottom of this application.
The price of your heating permil includes OI1e rough.ln and olle Iinallnspectlon.
Additional inspections will be blllad at $35,00 eadl.
Hovse Healing Test Record musl be submlllecf with lwikIiwl HDDl1 m.unIw belor. build-
ing certlfieate of occupancy will be issued.
I:I.EAt ~ m:aUIREO wilh number .or supply and return openings Ifsled per
room wilh CFM'. per opening, New sl,ucfures or addiliollB send 1I00r plan with suppl,
eml,.turn laeaUons shown. HEAT LOSS CALCULATIONS. PAYMENT AND
APPLICATIONS MAY BOe MAILEO TO THE C1TY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE.S.E. PRIOR LAKE. MN 55372.
eily Hall business houl'1 8rt 8 a.m. . <4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUG.....IN AND FINAL). CALL CiTY HALL
447-4230
I hereby apply lor B mechanlcalsystema permit and I acknowledge ,,,..I the
inf9lmalion above is complete and accurale; thai the work will be In conformance
wilh lhe ordinances and codes oltha city and with lhe etat. bundtnglmecllBnical
codes; that this form does not become. permit unlll slgn.d by Ihe OUILDlNG
OFFICIAL; Ihal the wOlk will be In acco,danc8 with the approved plan In the
~ ~.q~ and .p~.v~.f Pl~._ 2 _ Cf4
. Applicant'. 'Slgrnilure > ~ Oat. I
/Ii; " ....)'. , I /qa
'd ~'\{o'Z. q 3/' I
... _~ Bu.dlng Ollical'l Si~ T~ Dale
GREEN . FILE
YELLOW ' APPLICANT
GOLD . CIT.,
CITY OF PRIOR LAKE NO. qq... 57~
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City.
APPLI CANT: Fi AI f}-~ (;k' fl-IJ E. :JJ1J G
ADDRESS :?O :Bt2f JD fRIDk!- MkE. /fJ;tJ
SIGNATURE: '::?/:~./j?J~/'JJr_uJ~~
4..0'- ,. -
SITE ADDRESS:/71J/,f} IH~/Js/J-AJr JtJc-Ii'oLJW PID#.25-328" O~O-C
J.../j1V e
FILL IN THE BLANKS
PHONE:b/t1...~.L/P'" /5':<'/
DATE: ~ 7/'f' / r9
- / /
BLDG. PERMIT # qq-576
1. Estimated length of water service
Xb
feet.
2. Size of water service
I
inch(es) .
4 .
Type of sewer pipe.
ABS
from structure
pvc ./" Cast Iron
65
o
feet.
3 .
Location of any couplings
5.
Estimated length of sewer line
feet.
6. Clean out (if required), located at
structure.
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This
your permit when approved.
DATE: 7/q /<19
BY
,
----------~-------------------------------------------------------
------------------------------------------------------------------
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.
DATE PAID
AMOUNT PAr -:f .~t~RM\\
REC' 0 BY \ BU\\..O~
RECEIPT #
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
qq - 57(p
qq - 577
White - Building
Canary - Engineering
Pink - Planning
Tht' Crntrr of Iht Lakr Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT W/~f..,.1 Ar15 DE- VEt."O Pt16tv I
APPLICATION RECEIVED 5/1 q./ q '1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
170~L RNO 170 ~t:, PIle-/75A-N / nEAOOW
Accepted
Accepted With Corrections X
Denied I~
Reviewed By: ()f ~ i;::.
Date:
5-2 (!-79'
Comments:
\, e~r~f)Q OL~~J. ~~
"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
The- Ce-nle-r or Ihe- L.ke- Counlry
.BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED,
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~
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I ,,/
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Accepted
v--
Accepted With Corrections
Denied
Reviewed By: 9.1.4. ~~JAA Date: ,) - 20 .Lj C;
Comments:
I1,cJ~ b-l1v'\1" f)J~INJNVf. ~hJ.t l~
P.lA.J'X"r9Ct/ ~ cJIfl..v IA~ Y~(pv~~ I~~...
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4/S6lO '1 u:~ (~Ik.- ~
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."
"",.'.' ..,..
The e.nl., or .11. LU. COUnl1'}
qc; - 57~:
qq- 577
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
_ NAME OF APPLICANT tV / L L I 1-1/'vj S- 0 c.. l/ E L 0 ;.J HI:::/ r:i I
APPLICATION RECEIVED 5/1 q./ C; 1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7{)hL. /1/VO /70~& PflEr75111'// /It:rtOO~'v
Accepted
./
Accepted With Corrections
Denied
Reviewed By: J,JALTIO.A. ~f/1f.ANA.J
Date:
I I
(,/7/'19
. I
Comments: r?;)_~('
M\lST
Be:
Cd tJlJ~"'CD 7'""0 ANI') IlLoN& ,Dt(I/IJJIIG.E.
I
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jJTu_r TV tAsE....E.tJ'B As I"1vlJ4 14S fltllC-TICifL,
DA,ofitt.E.D eDAJClf..E.TE '-.J..J!J.t..K
tJ~ j;.t (. /J 1J1t'r~
~ f<E.PL"'~"" 1""t-If: SLIt ...OEll. PIt\O~ 70 fiJ-J1\L.
SEE I N ~ tJ t( tI1 ATI""" ON t<U &ItS e:. ~. ~~ 1..11 Alif:
LoT" 1..lI\JE WILl.. AJ EF l\ "-0 Be: t:' 1t.4,pEJ) so ~AT
('~b ?<lSl'Tl~ Dft /'lIoN 4\{. E.. A iUit ... 1="A.Oto'l 8011-1 f3 .JI~J)/,.J 6>.
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TH EJt.c:. I S
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3. E~csuw ~rR"l.. ~SlJit.f"5
t/. fJ.ac 11)~ J (lot) ..utA. 0'- RI'fN
"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."
J
>_,~.._...;.:,;..:.---:-,...:l~ ~~. ..._.,_~_..... <--,-..,_. _~ ,_~... "'~''''.- ~ ~..,- ..4__ .
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS Ilo~L Q~ ~ ~
NATURE OF WORK rJ~ ~u~ .
USE OF BUILDING SF'ft-
PERMIT NO. ~l.... _ 5"'')( ~ DATE ISSUED c:}-2-t.( -11
CONTRACTOR LJ\'\\~~, -~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
I FOOTING(~ e~~r'e:4~' 1.~.,q'1
~ f\ INSPECTOR
~ljf
I FOUNDATION (Prior to Backfill) ~. ) 7/1,/0/ ') I
PLACE NO CONCRETE UN'TIL ABOVE HAS BEE,N ~'IG~ED
L.L - f-fJ. RO UGH - INS (21/ {(!rz(fY'
SEWER I WATER I SEPTIC W 7~z../1'7 1)7~ '
FRAMING (/ (.)U, - ~{rJ k!JIUj,/"1 l6-1
INSULATION L-& VY 11/311'7 >c1J I~th I,. 1
ELECTRICAL v I/',
PLUMBING .~ rM'I;/$"/f'l
HEATING (if required) /tV Vb,-.
FIREPLACE /o.;r[. ~ p-. ~ ( -Jtt., ~l ~ ~ 1"'-#-3- <7 J
GAS LINE AIR TEST t-.~I ~~. 'Y-J9~9
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I !
FINALS
I
DATE
I ~-z,c;'P
9--:J~ -1~
~'~'" - - ..:.riRB-
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
w.lr./
/2-/-J
i. ,
{'t- . 3/t:?9
/'Z- '(&/,,;
(;/J /1!J8I/qg
I lil; 1;/1 g/'f~
UNTIL iBOVE HAS
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 (612) 447-9850
I
BEEN SIGNED