HomeMy WebLinkAboutHEATING 07-1167
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~(O ~5~
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
~ECH FINAL
COMMENTS:
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DATE TIME
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~GASLlNE AIR TST
o
'fI WORK SATISFACTORY. PROCEED
~ C025R - ACTION AND PROCEED
o CO EC~ORK. CALL FOR REINSPECTION BEFORE COVERING
Inspe ~: j h Owner/Contr:
'-- GU-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
V
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
(Please type or print and si2n at bottom)
ADDRESS
35-/ {)
Date Rec'd
/L,17. -0/
]. Pink
2. Grecn
3. Yellow
I PERMIT NO. (j-711 ~ 11
I
File
City
Applicant
~j A-~ S' iL' CJ c) d G- S't()
ZONING (office use)
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(N ame)
(Address)
APPLICANT
(Name)
(Address)
(Contact Person)
~{'-C.- I C)/}'].s I C ~7
S Y4-:rn e __
BURNSVILLE HEATING & Ale, INC
:]451 W. Bymsvillp. Parkway
Suite 120
- -,.:tI~ "MIl 5h':l':l7
(A!im~~IllI1t'r,"1VIT. ~~_.
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APPLICANT SIGNATURE
PID
(Phone) q S"c> l/ V 7 5S / CJ
(Phone) q~';J (f cJ '-I {)?)o ~--
(City)
(Zip Code)
(Phone)
DATE!,;) -Id -0 '7
APPLICANT PLEASE COMPLETE BELOW,
DNEW CONSTRUCTION 0 REPLACEMENT Q9. ALTERATIONS , r~W (7- '~~J
FURNACE MAKE AND MODEL/hr J-t,i/ j-e,\.) ~'7 1-1 L.,{ ,s,-'AJ ('-r- FUEL /I//;- j-- <:"',,/]l_f
!/
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
DGravity
~echanical
DAir Conditioning
OVen!. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
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.
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Industrial. Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
(Office Use Only)
Estimated Cost $
$39.50
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
This Application Becomes Your Building Permit When Approved
Buildin!! Official
Date
$
$
$
;3C;s-Z)
.50
L//J. 00
Paid 4'0. C' U
Date 7
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//
~PtNO. 5507 Z-
3Y
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372