HomeMy WebLinkAboutHEATING 07-0904
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
,.I'/. ().f
ADDRESS
/4/71 bt?J0661e ~/te...A
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
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
l.c;04-
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
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'J. WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK1CALL FOR REINSPECTION BEFORE COVERING
0/ I
Inspector: r-:f;---i Owner/Contr:
,
,CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
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CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONING/FIREPLACE PERMIT
CJ6~~~'V
Date Rec'd
~. ~~~n ~:~ I PERMIT NO. 07- oq 04--
3. Yellow Applicant r
(Please type or print and sign at bottom)
ADDRESS
}Llffl l~/h)(,L~l/ CR.
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ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(l/1 (lilt- -Tit<; 11"1e::1
,,-
(Phone) 9<; 2 . th ,,- - (}.::, )"
(Address) / LI/ 7 I
t3Al)6dZ C Q _ }), LJ
APPLlCA
(NarneL
(Address)
Fireside Hearth & Home
20802 Kensington Blvd
Attn Danlelle Ostgard 9529856675
License # 20~512060
Lakeville, Mn 55044
_ (Phone)
(City)
(Zip Code)
APPLICANT SIGNATURE
f\ (..9;: (Phone)
~/.' DATE 9 tY \i7
~ PLICANT PL-tASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
(Contact Person)
OWaml Air Plants
o Gravity
o Mechanical
OAir Conditioning
OVen!. System
o Steam
o Hot Water
o Radiation
o Spt:cial Devil;t:s
o Other Devices
1ft: AT- 1--1 / &lO {(){dOl"- V- f P /
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
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1"'~ \l~'
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
Building Permit #
$ ':M.~
$ -
$ 4~-
.50
(
Buildinl! Official
Date
I Paid 40, () ()
Date q 2-0,(;1
r;
;;pectpt o. .5 f(,~ Z-
By
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245