HomeMy WebLinkAboutHEATING 07-1185
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~/.f3 )
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
DATE TIME
)--q-tl!Y
(1j~t/l1 51
CONTR.
PERMIT NO.
7-//K)
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
#,WORK SATISFACTORY, PROCEED
;b CORRECT ACTION AND P~D
o CORRECT WORK. C~ REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
/ '
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
,z.~1.01
; ~::n ~:~ I PERMIT NO. -1_ lib. 5
3 YellO\\ Applicant I - D
(Please type or print and siJ:n at bottom)
ADDRESS
~ L-f"3 3 BITl-.s~tv\ 5, S k.J
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
\+A R- L ~&( SA-SS ~
~ I.{ '3 3 ~Ih-S~ <?r
S"'w
(Phone)
Pe t. 0 ~ L/t-~i.-
Cf.)'';)- - '(l-fo -I ;7-'3
,.t{ A.) S $"""3 ? r-
(Address)
APPLICANT
(Name) OPr,M.u.M. M..U'ff-1hJ 'CAH- ~f,J<S~ S (Phone) fpSt- ~tr9. g-'30?-
(Address) ~3o ~N~Ult-L-E.. f2..o Lt'/77--f- ~A-Qk S.s-117
(Address) (City) (Zip Code)
(Contact Person) ~1rhV N/ti2-"'Z-lITl.-L-1 (Phone) vS-J-I.{;r'1.d'-3c'd-
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION I2i REPLACEMENT D AL TERA nONS
FURNACE MAKE AND MODEL R tt~fM RG-Fr.::. (') q f. ~ C-.fvI. S FUEL;';A- S
FLUE SIZE "3 I' Pv' C- RETURN OPENINGS INPUT q f.) I () 1';)0 OUTPUT 5(" 000
TYPE OF SYSTEM
~Wann Air Plants
OGravity
o Mechanical
~Air Conditioning
OVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential. Heating & AIC (New Construction)
Residential. Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
39-SIZ
.50
Llf). (J()
(Office Use Only)
BuiJdinl! Official
Date
I Paid 4--0, oV
Date/Z, '2- 7.07
, Recei{;. 5907
BY)< I
J
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372