HomeMy WebLinkAboutBuilding Permit 99-0577
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OJ'S HEATING & AIR CONDITIONING, INC.
HOUSE HEATING TEST RECORD
.permi t No.
.,.' ; f ~/ ! . i"._ .. } I
Owner (j n .i\.;;::;..r, . ,~)^ I r 't::.'i J .......c..:;..Jrf i ,
Addressi70 h{. ~~ ~.coO ,,'I m.~..... ..ok,) I. .-
Installed ByD'j: -. ,
GAS DESIGNED UNIT
Make
.
I~ ,~,^ ,~ ~,' .r,
\.'
,
Model'~ . ~; (~l...\''(~(... "'70
serial:91'O 7;) ~(fi, 4r:::.
Rated Input. i Q Co. '~.<
TEST
pilot Timina ":::., ~ e.,..'
Pressure '3.. '5 V''; ,;..
Input CFH '7 <:; . .' '.
stack Temp "'\ S <;::. "
Limi t setting_....1 ( ""j
Percent CO.
, -1
Percent o.
...,. ....J,
t:,~ 'I
j ,
Percent co
() , (,."~.~~
Heat Anticipator Setting
, q:
te Tested_ I;' ) C~7 C{
'........,
of Tester ) i "'i
-'
OREEN . FILE
YELLOW . A.PPLICA.NT
GOLD. en"
CITY OF PRIOR LAKE NO. QCj-.577
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the .city.
APPLICANT: Flu/It... (;;&j1J& IN c. PHONE :M2::...'~P/{J-15:V-
ADDRESS:_PI1 'H'J'X. ID PR/oJf!. J.,gJ<E /lJ/!/ DATE: ~9/9'9
SIGNATURE: ~J;r: /1fL}.I'dA~ BLDG. PERM;T # Cf1-577
SITE ADDRE~S: / 1o~ 10 J1H6A5l1tJt I1J E/1.tJoiU L./JP{:tD# 25 - 32.8 - OZ-I-O
FILL IN THE BLANKS
1. Estimated length of water service
~6
feet.
2. Size of water service
J
inch(es) .
4 .
Type of sewer pipe.
ABS
from structure ()
PVC V Cast Iron
&5 feet.
feet.
3 .
Location of any couplings
5.
Estimated length of sewer line
6. Clean out (if required), located at
structure.
-
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This applica~..I##J47 your permit when approved.
BY ~tJHD' _ DATE: ?'/~h9
=========~======================================================
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 PA~- -ill' 'l'l\:"~:l"~\\
l'I":"~, G r '-,
REC'D BY \ \\\.O\~
RECEIPT #
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 553721 Ph. (612) 447-42301 FAX (612) 447-4245
An Equal Opportunity Employer
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y ~~ -;'~~
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~
,'~', ....);L~~.i~iIr....~,;..:..::.>d..--~,.....;
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
II/It.. qc; q '. ~
ADDRESS \ 10 ~(~ p~ !vvr~ --Lit. \
SCHEDULED
OWNER
PHONE NO.
CONTR.
PERMIT NO. qq - ~7
D FOOTING
D FOUNDATION
D FRAMING
D JNSULA)lpN
]JE FINAL t;Ai
D SITE INSPECTION
D PLUMBING RI
D MECH RI
D WATER HOOKUP
D SEWER HOOKUP
;l!!!('PLUMBING FINAl .t:)
~MECH FINAL)t- 7t!:J:I
~ E~ CldVO~f
D EX/GRAD/FILLING
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLINE AIR TST
D
COMfJlENTS: f "P~i\;)IN.:>
~' il.E Uf;0. Fi Mt-'
~. <;Ot> ~ \j 2.-~
..*'4J/ ~ Lit- &/!s6~.
>f ~ g~\L ~ ~ft4JA..- w~
- l1'\,f) ~?~ o(C S'~.5
.(J Pt.-t.'lC; If..,~ c>:/(......L C,fc;Z-u: ,--.;
~"/~~~... . _ J ~.a.~8:?'~ /2,A-r{.,. /S.. .kGCiL1
AY- _ JCr S.,-A-'JeAV/1-4
. / '.. '~/
~s~ v'
D WORKSATISFACT RY, PROCEED
~CORRECfA I~ ND PROCEED
D CORRECT /~'.5 '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
INSNOTl
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
I~CJro(P
DATE TIME
SCHEDULED ~ /:30
PH6/1S/lN/ rt6170.
CONTR.
PERMIT NO.
99 - 577
o PLUMBING RI
/\ 0 MECHANICAL
P\ )g WATER HOOKUP
A ''jj!''SEWER HOOKUP
I'O"""sEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS: 1 r, . .
/,0\ ~o
.l L( l' \~ 1 k..,
- No (JU ~
~ .J-
en- fA. Ii., ~
~ '() If {..;
~-;Jv~
^^~
I
~ D< -tu
~)'"
Inspector:
Owner/Contr:
CALL 4474230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQ~MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'T
ic I :J.. - 4-'f 'S - 'Z."'L. c.{- ct-
7. TYPE OF WORK Fireplace LI Septic LI Deck LI Re-roofing LI Porch LI
New constructionl(. Alterations LI Addition LI Finish Attic LI Re-siding LI Finish Basement LI 16. PROJECT COSTNALUE
Chimney LI Misc. q b Q ~..,
\
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS t 10. CULVERT SIZE 17. COMPLETION DATE
Sq.Ft. "S?"t-~ Width 36' Depthg'C;: Yes ~ 4.WG:UST
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 menti ned pro 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 offic' revo t ,permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perf; nJ~: jqections.
X _ ~DOOI5.zJ-'- ~
Signature License No. Oat
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
MAY t 9 9ll TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. DATE
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
J i (J b (n ./'~ ANI /wf ~ 40 o-vO (AC!J.L.- ~. W "
3. LEGAL DESCRIPTION
S-/tq /qq
J!.(
BLOCK ~
PID 25"3Zf!;- ~z..I-o
LOT II')
ADDITION .I'~4 ,\;AN'f
4. OWNER (Name)
~~
5. ARCHITECT (Name)
A ttc.H l~c.r &.14 L C\.r.J t6Cl
6. BUILDER (Name)
/..A..P A O<!J ~
(Address)
(Tel. No.)
J
(Address)
l.(.." ~ ~ o~,l S IL'V'
(Address)
(Tel. No.)
"7S'S - "lIS'- 3" Co
(Tel. No.)
Wi LLL A""'~
D..c? Vtt..-LO '" "'-tQ l>t:'r, L . ,-, c..
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
I ~t'],OC)o. ()(')
USE OF BUILDING
Sr ,.:r
"'"
TYPE OF CONSTRUCTION: I II III IV(~.J
Occupancy Group A B E F 1:l I M'1R" S U
Division 1 2 G/ 4 ') '1 c:;-
Permit Fee ................................... $ Cf:J. ^
WJ.~2
rz~.~
1. White
2. Pink
3. Yellow
File
City
Applicant
J1;1fIN' ~/u;. #qet!-.57'
qq-577
Permit No.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) , (Width) I (Depth)
:2. cL ~<" 7tL
12. NO. OF STORIES
I
13. TYPE OF CONSTRUCTION
I=""-A M ~ Q
14, FLOOR AREA :;rORTIONMENT USE
J ~ '/.. 7-.
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS~ N.:l l-4. t=A.M" "','
J\ T1'A (tf.t~.ll
,.., ~ ~ .L
SEATS
MATERIAL FILED WITH APPLICATION
SOIL TESTS
LI ENERGY DATA
LI
PILING LOGS LI PERCOLATION TESTS LI
PLANS & SPECS LI
SURVEY 0
SETS
COPIES
PLOT PLAN
LI
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
~'YJ. <::xL
I ()~.~6
Collective Street Fee ....................... $
Sewer Tap ................................... $
~/ II $
Pressure Reducer ... .~.~................ $
I 00 .oD Meter Hom ........~r'.t................... $
i 00 ~O c) Water Meter .....9~....................... $ / 2 ~. C2L2
"?r-. .<sD Sewer & Water Connection Fee ........... $~ t'J I'J <::2.Q
Sewer & Water Permit ...................... $"'" W T F $ ~ CO
'10 .Of) ater ower ee ........................... .
Gas Fireplace Permit ....................... $ Water Tap ................................... $
This Application Becomes Your Building Permit When Approved. Builder's Deposit ............................ $1: ~ tJ!? . DO
By Date Other ......................................... $ .
Certificate of Occupancy Total Due .............................. $ 7L./q/5. -//
paidl4dS. ) I Receipt No. 2S)lJ1'V) .
Issued ,J t...r'!
Date to -J llDf By ~ 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 reqUe~~.-T~S document when
sig e City R r constnutes a temporary Certificate fl! .Zoning compliance ~d allow~ c~truction to commence. Before...ocrupancy, i Ce~icate of Occupancy must be issued.
,~...:L....l4?i ~ ~~
City lanner - Oate - Sp;,cial Conditions W any
Plan Check Fee ............................. $
State Surcharge ............................. !to
Penalty ....................................... $
Plumbing Permit Fee ....................... ~
Mechanical Permit Fee ..................... $
24 hour notice for all inspections 447-9850
.
45". CJr?
CITY OF PRIOR LAKE Me
16200 Elgie Creek Av. S.E. Permil No. qq - 577
P,lor Llk., MN 55372
HEATING APPLICATION I PERMIT
PlO. Z5-3Z.B- 02/-0
~e-"t~-t '(Yl/Ar\o'--'o.J ~, t2-/
PD~o TYPE OF SYSTEM
Warm AI. Plant&
G,avily
Mechanical
Nr CondlUoning
Vent. Syslem
HEATJHG OR POWER PLANT
Steam
Hot Wat..
Radlalion
Special Oevioos
If)
m
\D
N
?"-
m
'It
N
....
\D
Flue Size
d
~ Supply Openings I ()
z
~ ReMn Openings -'5
Input 69,<.X:Coutput55, 2..OCJ
Ed.. .
Clm..
M~' 5~7..0.\
Other Devlces
Alleranons
TYPE OF WORK
New Construclion
x
~ Repair
-
I-
a:
w
I
(J)
"
Q
Replacement
E&t. Comp. Dale
0/ 9- 57-;
Est. Cost S _ . Building Permit ,
HEATING PERM\T FEE' ~ ~
STATE SURCHARGE $ .50
TOTAL PERMIT FEES $ / 00 ~
E
o
0::
LL
~~l'~\o'tJ~ "A\\
\. ,\\\..O\NG pE.P-\'11
Receipt' . \ ~v
TYPE OF STRUCTURE
1.0......
J. Val_ .
017
C_WtII
Single Family
Commercial
Two.FamUy
Industrial
)(
Mull~Family
Olher
pubnc
Fee Schedule
Induatrial. Commercial & Mulli-Family
Resldenllal, Healing & AC
Residenlta/, Heating Only
R esidenlial, Gas fireplace
Residenlial, Add"iions & Alleralions
Residenlial, AC Only
1.'" or job cost ($39.50 minimum)
$99.50
$64.50
$39.50
S39.50
$39.50
Remember 10 add the Slale Surcharge on lhe bottom of this application.
The price 01 your healing permit includes one rough.in and one linel inspection.
Addilional inspeclions wiU be billed ., $35.00 .ach.
House Healing T .sl Record musl be submitted wilh ~II ~il~~ "P!~' I"W hI', ,r beton! build.
ing cerlilk:ale ()f occupancy will be issued.
HEAT r.,lI.l r.lll.ATlnN,c; nJ=(lIIn:~Fn with number or cuppy and relurn openings Hsted per
room with CFM's per opening. New slructures or additions send Aoor plan with supply
and retlllJllocallons 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 MlIST BE INSPECTED (ROllGH-IN AND FINAL). CALL CITY HALL
447-4230
I hereby apply lor a mechanical systems permit and I acknowledge that thl
Informalion above Is complele and accurate; Ihat tl\e wo,k will be In conformance
with lhe ordinances and codes 01 the ell)' and with Ihe .lale building/mechanical
codes: that this fo,m does not become a permit unlil signed by the BUilDING
OFFI~IAL; thaI the work wlll be in accordance with the approved plan 111 th,
K'.... 01 all work which requlre, review and approval of plans.
\~~'~.J~ 92)9C}
b-/. ^J AJPIi"'}l Sill~"~...,:!-/-...... r.....J..... ' " . Oil'"
fY1:('~ } j1~J"':',,<,'f,., q /3/qq
.- Building Off'IC8I's SI~f8 ' ...~ Dale
CITY OF PRIOR LAKE Me
16200 Eagl. Creek Av. S.E. Permit No.
Prior Llk., MN 55372
9CJ-577
Conn. load.
o Fuel Nb\.-\-
z
w
z
o
I
CL
Flue Siu
Supply Openings
Retl1rn Openings
Input.
Edr. .
elm..
Output,
TYPE OF WOAK
AI\erallons
Replacemenl
c:J
Z
....
I-
eI:
W
I
(f)
"
Cl
Repalr. Est Comp. Oms r
Est. Cosl S . Building Perm' ,
HEATING PERMIT FEE $ . '7f1 o..t::::J
STATE SURCHARGE . .50
TOTAL PERMIT FEES $ 1-/0 I::JC7
E
o
Ct:
lL.
TYPE OF SYSTEM
Warm Air P lanls
Gravily
Mechanical
Air Conditbning
Vent. System.
HEATlNG OR POWER PLANT
Steam
Hot Waler
A adia1ion
Special Deyices
Other Devie.s
New ConslrucUon
x
Qt:l-S77
. PJ>..\O \N\'TH
Aecelp6\l\LO\NG pE.RM\'
.TYPE OF STRUCTURE
1. 0-. . Cll,
3. Yd_ . C-.c...
Single Family
Commercial
. Two-Family
Industd.l
If)
CL
E
85 '-=.-/ HEAnNG APPLICATION J PERMIT
N
~ Dale Cf - :l. - Cf<1 PIO. 2. 5 - 32 'B - 0 Z. I - ()
~ Sile Address 1'10 r;.,Co VnP~ ~-\: '(Y}nv\o'--' Lv.. If!../
(J)
.-i
N lol /0 Block Z Addition PH€A$,e//IIr l'1el'1oow
: Owner', NameLJ I II i wY'\ \~ DeUe... \ 0 D fY'.tr' ~. '1 L C.
1IJ ' '
(f) Address.l.t) ~~ ~l.\VCAC\lA~ .~o \'t... S \)('\JL
Healing Contrador D:S I oC) ~ +; ~CJ....( C\ L.
Address c(j:)fD ~'1l.)X ~V(..: ~\b{)Au'\ \\P. (Y),,) ~~~ \
~ T lllephont" J.lq 1- .?~'=> \
~ Furnace Make & Model }-\~-t-N -G~o
~ ModelSizll ~L /60 -rR-N
N .
.-i
IJ)
Fee Schedule
Industrial, Commercial & Multi-famUy
Residenlial. H eatlog &. AC
Residenti aI, HeaUflg Only
Residential, Gas Fireplace
Resldenlia', Additions 8. ARe rations
Residential. AC Only
)(
MulU.Famlly
Public. Olhe,
t % of job cosl ($:J9.50 minimum)
$99.50
~
~
$39.50
Remember to add 1he Stale Surcharge on Ihe bo"om of lhis application.
The price 01 your healing permil includes one rough-in and one lin.llnspeclion.
Addilional inspeclions will be billed at $35.00 each.
House Heating Tesl Record musl be submltled with "11 ,1~!rll"'''' ..,(.1,....,1/ ~"'!""'I"I~ before build-
ing cerlificate 01 cx:cupancy wi. be Issued.
HEAT CALCULATIONS Bff'lllnFrl wllh number of supply .nd return openings llsled per
room with CFM's per opening. New alructur.s or addilions lend floor plan wlh supply
ano return localions 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 hoUfs are 6 a.m. . 4;30 p.m.
ALL WORK MUST BE INSPECTeD (ROUGH.1N AND FINAL). CALL CITY HALL
447-4230
. hereby apply fOf 8 mechanical systems permn and I acknowledgelhat the
inlormalltln above is comptete and accurate; that the work will be In conformance
wiltlln. ordinances and codes of the clly and wUh 1he alale bullding/mechanlc.l
codes; lhal this lorm does not become a permU until sIgned by the BUILDING
OFFICIAL; that Ihe work wIll be In accordance with the approved plan In the
~~eq:::ew~...::rov~.f:;i 2 J 9C1
v: JPpliEfJ'l'p Sj7Plt~r~ ... ,t. "'" . pate
,/~ I'~~ qj3/qq
BulJdlnlrOtflcal', Slvnalure Oate
......'__..~v.......~...... _._.~ .'......~ -.""-.-.....-..--. .........~._._.....,.- ~ -_._.-,._....~. - -
PRIOR LAKE
INSPECTION RECORD
SITEADDRESS ILntQ(. ?~<;CA..,,* ~,)~
. ,,~ .. .. ... .
NATURE OF WORK ~ ~CTl~ ~)- .
USE OF BUILDING :) f=).{-
PERMIT NO. 0: _ "'77 . DATE ISSUED :J-- 2L( - "t >
CONTRACTOR (.J i~\ ~7 ,hq..-. ~.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
I ~ INSPE""'"
,
FOUNDATION (Prior to Backfill) r r
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
. SEWER I WATER I SEPTIC ~"7/' V9 ~ -1:
FRAMING .1- \ f)
INSULATION L-.~. tiJP ,,/Rfrt ~,.j74~
ELECTRICAL
PLUMBING g;22 9./;~ /1 f
HEATING (if required)
FIREPLACE R:\. v:4c-- . fq-. 1- ~3 -49
GAS LINE AIR TEST BF 1 (n ~r
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I WALLBOARD L I
FINALS
;(ft- ;~!rj
\I t
~ ;:,i:t: .
OCCUpy UNTIL ABOVE HAS' BEEN SIGNED
NOTICE
DATE
FOOTING~ ~6"~~~lJ;("'~
I 7-;;' --1,
/o_J....A.1.
j
GRADING (Prior to SOddi"f; ,
BUILDING 7 - c.-c/. ~ 17 II tJ?
ELECTRICAL / ,
PLUMBING
HEATING
DO NOT
\
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
enD 61 I IN~PECTIONS (612) 447-9850
I