HomeMy WebLinkAboutBuilding 02-0138 (2)
CITY OF PRIOR LAKE
REA TINGI AIR CONDITIONINGlFlREPLACE PERMIT
I. Pint .11e
1. ar- ell]'
l. V.I..... ApplicM&
(Please type or print aDd aian It boUOm)
I ADDRESS
/o/tt7D C:::. s~ 1-41 1d\~
U,/Go.'1
At '-'.
LEGAL DESCRIPTION (omce use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
(Address)
6.IJ' ~X
(phone)
)-I~'~f
APPLICANT L.J_ ~
(Name) /~..., I' '^)
(Address)
r l-.-~
I
(Phone)
~,. .......
(City)
C:.I 7.. ..
3-
(Contact Person)
(Phone)
DATE
APPLICANT PLEASE COMPLETE BELOW
W CONSTRUCTION
FURNACE MAKE AND MODEL ~ c...., ..;.
FLUE SIZE pi" <.. RETURN OPENINGS
,
TYPE OF SYSTEM
~arm Air Plants
OGravity
o Mechanical
8~ir Conditioning
S'Vent. System
o REPLACEMENT 0 AL TERA nONS
~.so ~ J' C) go FUEL
'1 INPUT'?D I....... OUTPUT
,
HEATING OR POWER PLANT
o Sleam
o Hot Water
o Radiation
o Special DevicC$
o Other Devices
FIREPLACE ~1AKE AND MODEL
Industrial. Commercial &. Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99,50 Residential, Additions &; Alterations
$64.50 Residential, AC Only
Residential. Heating &. NC (New Construction)
Residential. Heating Only (New Construction)
Estimated Cost S Building Pennit #
4'.2.?".
$39,50
HEATING PERMIT FEE $
STATE SURCHARGE $ ,so
TOTAL PERMIT FEE S
ff1~l
~p~i1'
.~.
(Orner Use Only)
This Application Be~omes Your Buildine Permit When Approved
Buildinl Official
DaCe
14 hour notice for alllnspectiona (951) 4<47-9850, fax (951) 447-4245
2:0-d
2: 89:z:82:17:Z:9,L
..
aMi ~NIlaa8 ~ ~NIi~3H W~ 0t=tt 2:0-8t-~~W
PRIOR LAKE DEPARTMENT OF
, BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS ItN f)fL Ca~~&&b. ~/
NATURE OF WORK __~ ___
USE OF BUILDING 5 FD
PERMIT NO. _~ ~ DATE ISSUED ;;( -1- e 2
CONTRACTOR () c; PHONE (;,12 - 5tr-~f)
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
FOUNDATION (Prior to Backfill) ~ ~~ t ...C>~ ~, a.'
PLACE NO CONCRETE UNTIL ABOVE HAS BEE
ROUGH - INS
~
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
ff'
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
This card must be posted near an electrical serxice 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.
c)~
()
~ C)~
EEN SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850