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HomeMy WebLinkAboutBuilding Permit 14. 0669 r• r.:, v,ny.,e.j ...,t.yv 'a`'!tb"� v. .. y. tqY-'.`""� i w. `wKs,v .+ .'. <,ng,,, ._.. :_. � s. .. ;.<.,w�.., iP'�i'r..., o ..:,.... ,.�.. .�,7,.,,..av ,.v+ `::u".' 'J' ,c:. '-w ,•u'`pew.+t ,' C rrttft zfr of ®x u znry CITY OF PRIOR LAKE !tparfnunf of gauitMMxtj cIn %pi r to jK _ Final Permitted ❑ Conditional C.O. Expires K This Certificate issued pursuant to the requirements of Section 110 of the E Residential/❑International 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 . SI NGLE FAM I LY Bldg.Permit No. 114-0669 Occupancy Type Type'Construction Zoning District R3 K Legal Description L75, B4, WENSMANNS FOURTH ADDN ', Owner of Building Site Address 2596 WATERFALL WAY NW Contractor's Name&Address CENTRA HOMES ROBERT 'D, HUTCFtI NS _ Building Official Fe) City Planner Date: N 01/c'A`X110-- I 7J ' C O a Date: • POST IN CONSPICUOUS PLACE Z 2 N P 7.1 cc u. V Ly F V W < Z Lx, gagaaa �--... ..'N Cr.. 0TWWN a 'n ot0 � EC0 ZE. LI �\) V Er.EC CC Z o W 0000C10 > a O I W W O > > < �-- Z O F. 4 J Z w O V V tuitg _0 0 UJ = Sza 44 `t- w ; w 0 aC u. a z W 0 a x x W Z 2 V W W ? x O mc 1 W W I a23vnaa..2 v v Z ❑ ❑ o❑ o❑ o°c °° 0 '� a a u- 11,‘ 0J w S a t''. YV `� Z G 040 pt 0 ZO Y '2. 0- o g ~ Z Z ,, N � li 0Z O O W F- < V :7 a� co CL Z O ZOZ ~ Z W Y re Z < C LLH N -- W F- Z44� <W 3 V V O V V W W 00 :30 NZt 2 N 5Z < O a ❑ ❑ ❑❑'R0 0 J Ili Z �y OS U. W o 6 cWi W §555 = > k. 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Pink City 3.Yellow Applicant (Please type or print and sign at bottom) ZONING(office use) ADDRESS 2596 Waterfall Way NW Prior Lake, MN 55372 �- LEGAL DESCRIPTION(office use only) LOT 25 BLOCK 4 ADDITION Wensmann' s 4th PID 254181010 OWNER (Phone) 763-772-1000 (Name) Centra Homes (Address) 11460 Robinson Dr NW Minneapolis, MN 55433 BUILDER 763-772-1000 Centra Homes (Phone) (Company Name) (Contact Solomonson Contact Name) (Phone) 612-242-5046 (Address) 11460 Robinson Dr NW Minneapolis, MN 55433 TYPE OF WORK ®New Construction ['Deck ❑Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish 0 Fireplace DAddition DAlteration ['Utility Connection CODE: :R.C. ❑I.B.C. 0 Misc: Type of Construction: I II III IV V A B PROJECT COST/VALUE $ 135,846 Occupancy Group: ABE F HI MRSU (excluding land) Division: 1 2 3 4 5 I hereby certify that I have film he.information on th' 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-mentioned pro.- % a.. th/all constru 'on i conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revo.- .e , it fo, st cause. F ,. e ;.re,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. 2/‘ /y X Signa re Contractor's License No. Date , . Permit Valuation (7(p/ QGaa Park Support Fee # $ .. Permit Fee $ 1 Z 6j6i .50 SAC # $ 2--4 5,— Plan Check Fee $ 1,5 Water Meter Sizes"; 1"; $ Age. State Surcharge $ Pressure Reducer t USI- Penalty $ Sewer/Water Connection Fee # $ t 500 Plumbing Permit Fee $ t 5-A-• Water Tower Fee # $ t o 00, Mechanical Permit Fee $ t54.50 Builder's Deposit $ Z-�=>a — Sewer&Water Permit Fee $ 5 •50 Other ' l 12..x✓ $ 1 c>,4" St TOTAL DUE 1 (`� $ �, it Gas Fireplace Permit Fee $ rj 4 -C7-0 This Ap cat! Be omes Your Building Permit Approved Paid /64 �� I R ei t No. `/ tor I Date , /j---,1,--( , A .iris=�►_• 4 Buildin. Official Id ate , This is to certify that the request in the above application and accompanying•.cu nts is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signed by e Ci Pla r constitutes a temporary Certificate of Zoni :co '.liance and allows construction to commence. Before occupancy,a Certificate of CIccupancy must be issued. r Al `_ `J�• Date Special Conditions,if any P arming Director 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 F., p °'fia Builders Deposit ,, sO. City of Prior Lake A$2,500.00 Builders Deposit is included in the Building Permit fee. The Builders Deposit is issued as security to insure compliance for a Final Occupancy Permit. (It is not an escrow account.) All exterior items including but not limited to grading, sodding, landscaping,tree planting, driveways, siding and painting shall be completed 180 days after the date the building permit is issued. If the work is not complete within the 180 day time period, the City shall notify the applicant of the violation and the applicant shall have 10 days to comply or the $2,500.00 builders deposit will be forfeited and the applicant will be billed for clean up or corrective work to rectify the situation. A $500.00 Tree Deposit may also be required and will be refunded if specified trees are preserved for a period of one year. By signing this I, the undersigned contractor, acknowledge that I am aware of the erosion control requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors handout. DATE: 6-12-2014 SITE ADDRESS: 2596, 5898, 2600, 2602 waterfall Way PERMIT/�f. 66 REFUND TO BE MAILED TO: Centra Homes 11460 Robinson Dr NW Minneapolis, MN 55433 AUTHORIZATION TO RELEASE PLEASE REMEMBER dg2(S0O-W Lynda S. len,Building Services Amount /S--.(5 Acct.801.20204 1. KEEP STREETS CLEAN DURING CONSTRUCTION Date 2. KEEP EROSION CONTROL IN PLACE 3. TEMPORARY OCCUPANCY PERMIT MUS OT EXPIRE OR $500.00 WILL BE FORFEITED SIGNATURE: Al 77: --- _ 51312 Kleini3aPPXmar Centra Homes,LLC .888.5834848 11460 Robinson Drive NW www.kleinbank.com Minneapolis,MN 55433 75-1565-919 2 PAY ******43,165 DOLLARS AND 52 CENTS DATE AMOUNT TO THE ORDER OF 07/14/2014 *****43,165.52 City of.Prior Lake 4646 Dakota Street SE. r Prior Lake, MN=55372-1 14 I rn/' 1d r•❑:sKnruRE ii'05L3L211' 1:09L9L5654u: 000325663L11' C:\Users\CentraSara\Downloads\BUILDERS DEPOSIT FORM.DOC Residential Building Permit Checklist New Constr ction for Single or Two-family Dwellings in R-1 or R-2 Districts Reviewed by: .,,' Date: 1 16 ii 4_ • Building Permit# PID: Zoning: Address: 2 J ZS,Ab Z ccts 2( , 2-Go 2. CA)A-Tt FA I—L LAJ A Legal: L B ' Subdivision: Existing Structure? YES/al Existing Nonconforming Structure? YES/NO CONFORMS TO ZONING NO ORDINANCE . Yard Setbacks: NAI FAILS/COMPF .1 Standard I Proposed. • Front Yard(can be 20'if avg.vs/in 150') ' .25' z.2`FND_c utzi z5.3 • Side Yards 10'/ N 25'if abutting a street 2-‘ + I-II c-Nfl - f t • Sidewall exceeding 60'requires additional side 2" 10'setback 4- setback setback for every 1'over 60'in length. Not required 271'over 60' if building wall is 10'-0"or greater of being parallel to •• a side lot line. , • Rear Yard 25' To P L . 21.(.1 Loy xi a • Patio Door: provide for minimum 10'deck or sign 10'side/ statement indicating no deck will be built in the future 25'rear _ • From 100 year flood elevation of wetland/NURP 30' pond. • Refer in-ground pools to the Planning Department • From OHW(Prior or Spring Lake) 75'or setback average of adjacent structures,but no _ less than 50' I Floor Area Ratio: NA/FAILS/C•,„ti's IES I .30 Maximum I ` P u p Yard Encroachments: ' FAILS/COMPLIES ( Standard I Proposed Eaves and Gutters no a than 2 feet in width and no closer than 5 feet to a lot line(Easements). - A/C and other equipment cannot encroach on interior side yards. Tree Preservation: NA/FAILS/COMPLIES 1 Standard 1 Proposed • Total caliper inches • Permit 35%Removal • Caliper Inches Removed • Caliper Inches Preserved • Replacement 1/2:1 L:\TEMPLATE\BLDGLIST.DOC 716-0 4, 1 White -Building Canary -Engineering ' soy'' Pink -Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED 6 . l The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: z5gq -- z.CO Z_ W/ wrety Accepted Accepted With Corrections Denied Reviewed By: /e) Date: 7 /crtei Comments: "The issuance or granting of a permit or approval of plans, ecifications and computations shall not be construed to be a permit for, or an approval o any violation of any of the provisions of this code or of any other ordinance of the jurisdi tion. Permits presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid." pl P$10�' White -Building Canary -Engineering "slivNs do* Pink -Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST 0;6707)e19 71-0/1165 NAME OF APPLICANT APPLICATION RECEIVED 1 The Building, Engineering, and Planning Departments have reviewed the building permit: application for construction activity which is proposed at: gi& � . 2-00Q lam/7-6- /9W147/97 /l , Accepted Accepted With Corrections Denied j Reviewed By: f L4.. � Date: Y 7 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." 01 mqt tJ j �fiV16s0'��' �7i White -Building ry -Pinkngineering j , . -Planning • • t _._._ NAME OF APPLICANT �A ,i) APPLICATION R ��7�/fS' RECEIVED 6 , z The Building, Engineering, application for constructioand Planning 9 Departments have reviewed the building .fr'� � activity which is proposed zooms, at: permit Accepted_____.e.,_____ �`� Accepted With Corrections Denied Reviewed By: Comments: Date: 7 // it "The issuance or ,....414.1.•. �.�� . computations shall being of any of thea permit or approval provisions to be presuming not construedodu a permit for, or an plans, of, vii lat and to give authority this or of any other ordinance of the u of Permits ordinances of the jurisdiction� to violate � any. violation of shall not be cancel the Jurisdiction. valid." Provisions of this code or other ii--PRi o� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 2-4/6 / �� AND UTILITY CONNECTION PERMIT I 4/6 K4,NNEsci, I. white File PERMIT NO. 2. Pink City 3 Yellow Applicant (Please type or pri5 and sigiat bottom) ADDRESS 'I ) 9-) ZONING(office t. 1 5-96, Y ,d- 0(9� a 60-Z l 0a-(e.5-Ca ll f_) ,...2 ,Uc.,� '3 LEGAL DESCRIPTION(office use only) 1 2.5--/y icie m_silll�na (1i Add ) � ---ei/g-ioi- f `( /" 24* A ?') i5= E1) /0Z-Q � I 70 • LOT BLOCK ADDITION ) ,7 LI I ' Ir 7> IDZ5_ / �03 --1 -j4 671 7 1,4 „ „ // ti� j1 -- i)1 ? -,0I/-O 72- OWNER ^ JJ // �pp ,, I (Name) /1 p,Qr13 C r 11 4i1- —Lk Q). l cC (Phone) (Address) U • —ODER 5 fly ' r k, 0-/ • ii (Company Name) S 6,r„,4.7 ,J f- i r ' ria Tec- «,^ (Phone) (Contact Name) `f�c, ,, '5 7/ (Phone) 1-Z 5/—f cd�'O (Address) 57 --- M,Kcha 44 4rje C✓ • TYPE OF WORK pp New Construction ❑Deck [Porch ['Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace Addition [Alteration ['Utility Connection , � CODE: ❑ (— LR.C. I.B.C.❑I.B.C. Misc. I 5dat7 4-ie./[�Q Type of Construction: I II III IV V A B (( PROJECT COST/VALUE $ / I ?© Occupancy Group: ABE F HI MR SU Division: 1 2 3 4 5 (excluding land) 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 above-mentioned property and that all co,:'uction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revo is permit for just . e. Furthermore,I hereby agree that the city official ora designee may enter n the property to perform needed inspections. Or Signature Contractor's License No. Date Permit Valuation 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 $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE /?) I/' $ 4) T 's p.1i -o `ecomes Your Building Permit When Approved PaidTOL ' 'Air) ' / Date : d 0 1 :Ivding Official Da 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. Thi,document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupar cy must be issued. Planning Director Date 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 i fiiT- VRto CITY OF PRIOR LAKE JUL' ��6f4d ° i,e HEATING/AIR CONDITIONING/FIREPLACE PERMIT By i.Pink Fite PERMIT NO. V 1 gr 44A•t tso'tr 2.Green City ► / 1 (Please type or print and sign at bottom) 3.Yellow Applicant y ADDRESS ZONING(office use) 20 g 4) rottzto 6. LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER i > e 1 (Name) , i `irep3 �' ✓ '' (Phone) (Address) APPLICANT , -,, �-7. �., hone) 4t 7 1D1 ) (Address) t AHyl . 4 i . 4„6 -c- '' (Contact Person) t ilia ” 1.1{ 1 (Phone) "t ,, 11 1 APPLICANT SIGNATU iY44/77 E DATE ` APPLICANT PLEASE COMPLETE BELOW [INEW CONSTRUCTION, 0 REPLACEMENT ❑ALTERATIONS , FURNACE MAKE AND MODEL 000114w Geti 6 0 \A_FUEL _ FLUE SIZE RETURN OPENINGS INPUT t) 0OD OUTPUT _nil- ffill_ TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner DWarm Air Plants ❑Steam Units and Fireplaces Cannot Encroach ❑Gravity DHot Water into Required Side Yard Setbacks. ❑Mechanical CI Radiation Fireplaces with Box Additions or Ei it Conditioning ❑Special Devices Cantilevers to the Outside of Buildings g.Vent. System 0 Other Devices Require a Building Permit. FIREPLACE MAKE AND MODEL — 4 �/ 1-Commercial is 6 FEE SCHEDULE Industrial,Commercial&Multi Family 1%of job cost Residential,Gas Fireplace $49.50 $49.50 minimum Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations $49.50 Residential,Heating Only(New Construction) . $64,,0 Residential,AC Only $49.50 Cog. ,.IV, BuildrngY n nrt#1 ._ HEATING PERMIT FEE $ STATE SURCHARGE $ 5.00 TOTAL PERMIT FEE $ This Application Becomes YourBuilding PermitWhen Approved Paid Re�j�t�itdto �01' :c BuildingOfficial Date Date B lQi1��p 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 Q VRlo Date Ree'd Et,.,,,, , CITY OF PRIOR LAKE ' SEWER AND WATER PERMIT 7 g/. ( 7 i 6,& .. l�' - w/ 6 0 m«n Fat PERMIT NO. Se 2. Yellow ��[[ Co' / �J 3. Gold Applicant (Please ty.-or prl, <nd sign at atom) /7•lf'�/ /I 7„2- ADD �2- ZONING(once use) ADD , . lk 1(� 1 25'1S � 2j 2 C&O �/at"a� i it WDC 3 • LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER - l/V-\-17-G,- I 1 A ,GS (Phone) ---7(, '3- �7 5'12? (Name) �"l��t (Address) I I4(DO P 5 V ' b ive.— KM./ — (Address) (City) (Zip Code) APPLICANT f v„ ,J ( in C— (Phone) 1ST y- -5-1 0() (Name) t ]j� 5 �it.l� (Address) �' t\A-C---PDrl✓ — Jckret \ 552A-X-- _. (Address) (City) (Zip Code) (Contact Person) J-- Iii k 1-- (Phone) APPLICANT SIGNATURE '- --------------- DATE 7 .— APPLICANT PLEASE COMPLETE BELOW Size of water service 1 inches. • - Location of any couplings from structure U feet. Type of sewer pipe. ❑ABc ErPVC ❑ Cast Iron Estimated length of sewer line O feet. Clean out(if required)located at feet from structure. FEE SCHEDULE Residential sewer and water line connection $51.50 Industrial,Coral&Multi-family 1%of job cost with a$51.50 minimum Sewer connection only $25.50 Water connection only $25.50 . Estimated Cost $ Building Permit# SEWER AND WATER PERMIT FEE $ STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Building Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 WITH lH BUILDING PERMIT • - NEMIOWIT ,�a , o By Q?RI% CITY OF PRIOR LAKE PLUMBING PERMIT -. al Ju�' e�� �� ti 4147gEs t• t.Blue File PERMIT I WW2''-I z OW Cityt, PERMIT NO. I r � (Please type or print and sign at bottom) 3.Yellow Applicant ADDRESS ZONING(orrice use) 2.00119 tAl, COCKTol I 1 VV," Vi MA., LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) i o ,t (6 ('() (Phone) (Address) APPLICANT � (Name) rr ice— 'it J (Phone) 6. L��.t _ 101.,E M of (Address)L.,c 3 itJ �4 _1 i i i , g IA /(Address / (City) �j "� (Zip Code) (ContactPerson)1� .1/1`1 . ilia IYfr9/`C (Phone) te:2 ( 1 r M APPLICANT SIGNATURE( le-i. ft' /Jt 1,1(1,4I 114(CANTC / DATE ,_ �.1. APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture ' - Bath Tub with or without shower Rough-ins Dishwasher I Water Heater Floor Drain Water Softener {' Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector 3 Shower Stall Backflow Assembly i Sinks Backflow Assembly Test Bar Sink 2_ Lawn Sprinkler 3 Water Closet(Toilet) Other FEE"SURCeHARGE" nnesota Statutes§326B.148 ijob cost with$49.50 minimum Residential,New One&Two-Family $149.50 "SURCHARGE"has been extended Residential,Additions&Alterations $49.50 The minimum surcharge for a1 DO „fixed fee"permit is$5.00 S - Building Permit# STATE SURCHARGE $ XXX 5.00 TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No.4,A1 rl Date BP , Bulldina Official Date ` G P��� 24 hour notice for ail inspections(952)447-9850,fax(952)447-4245 �`AO 4646 Dakota Street S.L.,Prior Lake,Minnesota 55372 , CONTRACTORS MATERIAL &TEST CERTIFICATE FOR ABOVEGROUND PIPING PROCEDURE: Upon completion or work,inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall be left in service before contractor's personnel finally leave the job. !A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities,owners,and contractor. It is understood the owner's representative's signature in no way prejudices any claim for faulty material,poor workmanship,or failure to comply with approving authority's requirements or local ordinances. •PROPERTY NAME: Aepraa011 a} =the- Was DATE: PROPERTY ADDRESS: ).5' C r?„L,,-ark1I7 (�;cJ, / Prror !.akar, rri11 ACCEPTED BY APPROVING AUTHORITIES(NAMES) PLANS ADDRESS: INSTALLATION CONFORMS TO ACCEPTED PLANS • YES ❑ NO EQUIPMENT USED IS APPROVED • YES ❑ NO IF NO,EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION ( OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT II YES ❑ NO IF NO,EXPLAIN INSTRUCTIONS HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: 1.SYSTEM COMPONENTS INSTRUCTIONS • YES ❑ NO 2.CARE AND MAINTENANCE INSTRUCTIONS • YES El NO 3.NFPA 25 • YES ❑ NO LOCATION OF SYSTEM DESCRIPTION MODEL YEAR ORIFICE SIZE TEMPERATURE QUANTITY £Ztk4ti Penda l+ 43333 Ei-58 A013 %" /55 F tfiKVA vhrk Ci-SY .24ls " ii$SF r feirablt F St;rt Dry 4rJci#H c-30C 20#3 '/}" 1 551- 1 SPRINKLERS • PIPE&FITTINGS \\ ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST ALARM VALVE CONNECTION OR FLOW TYPE MAKE MODEL MINUTES . SECONDS\ INDICATOR q DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL TIME TO TRIP* WATER AIR TRIP POINT TIME WATER REACHED ALARM ERATED THROUGH TEST CONNECTION PRESSURE PRESSURE AIR PRESSURE TEST OUTLET` PROP LY MINUTES SECONDS PSI PSI PSI MINUTES SECONDS YES \ DRY PIPE WITHOUT OPERATING Q.O.D. TEST WITH Q.O.D. IF NO,EXPLAIN `MEASURED FROM THE TIME THE INSPECTOR'S TEST CONNECTION IS OPENED. OPERATION PNEUMATIC ELECTRI ❑ HYDRAULI I 4?Rio, CITY OF PRIOR LAKE Date Recd ° p. ., HEATING/AIR CONDITIONING/FIREPLACE PERMIT " 44NNEsciot.ria File PERi14IT NO. 4--,-Gyi , ' 2.Gl«„ MY 2.Yams,* ApNieani {Pleasetype or print and sign at bottom) _ ADDRESS. LZO ( u sc) . - Cr CO "akejrcal 0 @)6 .K Ai . LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID (N°1111: CX*ryA Y tr es • _ -— -— (Phone) -s )- 7-72. iczo (Address) 1 /o le- k9 i f su J )T V V U v APPLICANT HEARTH &HOME TECHNOLOGIh5 (Name) dba FIRESIDE HEARTH &HOME (Phone) 4)5) {03--2_6Lo1 Uc i10662656 , ' - (Address) 2700 FAIRVIEW AVENUE N Ta ( 6I tp33- 48 ROiiV4E, MN 55113 651.633.2561 _ • (Contact Person) _ (Phone) /-• I i: t vs 1" se)" 53 r2' • APPLICANT SIGNATURE *.a w itgoW+"-_51--'`"- DATE )/23/ /1 i ofc to fav or e-mai I ms1 1' Rtuille_ at,jlde+-bps , basic perm%4s, }r- APPLICANT PLEASE COMPLETE BELOW e learkh n ht, ,Lest-N El EW CONSTRUCTION D REPLACEMENT ❑ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINOS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner ❑Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach pG��r ty 0 Hot Water into Required Side Yard Setbacks. TrlC�feehanical ❑Radiation ❑Air Conditioning ❑Special Devices---------' evices_,___,__.-- _,--_,,__ Fireplaces with Box Additions or ❑Ven:.System ❑Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. :FIREPLACE MAKE AND MODEL 16"US N hvao rs . FEE SCHEDULE industrial,Commercial&Multi-Family 1%of job cost Residential,Gas Fireplace $49.50 - - $49.50 minimum Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations $49.50 Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50 • Estimated Cost$ Building Permit If_ The Minnesota Statutes+;32613.148 "StiRC:HARGR"has been changed for one HEATING PERMIT FEE $ veer effective STATE SURCHARGE $ .50 .tuly t,20 10,until June MI.2(11 t. TOTAL PERMIT THEE $ The minimum surcharge for a"fixed Ice"permit (Office Use Unly) is!if:,beginning.iuty 1.2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. __ Date B uulldlna Official pate -_ y 01143kfit i� 24 hour notice for alt inspections(952)447-9850,fax(952)447.4245 �1 4 ftt%,'' 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 } - PRIOR LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RE 0 °, 0 1 I me- i SITE ADDRESS 2 gt Co (,C} PALL. LJ, j.10 NATURE OF WORK -FAN6. pct j rN, LL. I Ni �. USE OF BUILDING FA/Vik, /1-`-TQC l'741-- 4 PERMIT NO. ! DATE ISSUED -7 (g i CONTRACTOR C '/ I• A ( i C---S PHONE aiz-Zz- -5046 INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES INSPECTOR D E FOOTING '(tJ C ?./37;//7;/ FOUNDATION (Prior To Backfill) el( cry a ,4 i/' -/ RADON RETARDER 'IA.,,, - -�-- -7`311 c( PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS SEWER/WATER/SEPTIC -/e,u,t 11 i,,d FRAMING �k.-.c.._ q 12. , i INSULATION tjt-C e6 Ji I ELECTRICAL PLUMBING PQ ?ftek HEATING � -.9.-- )- c FIREPLACE �J 9 �2�rik GAS LINE AIR TEST yK�., 06 >o /v RADON COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGN D HOUSEWRAP(9\L- 9\ u'l j- LATH FIRE 0 f PKESS i®64 FINALS et- /06-9t1 GRADING ( PRIOR TO SODDING) q u-A)- soa ) J • BUILDING ELECTRICAL PLUMBING P.44 JO ) s 111,51 HEATING DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED 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 rio service cabinet is available, card shall be placed near main entrance. FOR ALL INSPECTIONS (952) 447-9850