HomeMy WebLinkAboutHEATING 07-1142
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS L\,~\ (;)(\J<.tu-- 'Tr-
I
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: ~ \ \A~
,n 0.
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'--' -v -.j- _ '-
DATE TIME
(2..kz( 01
, .
7 - ( 1l.J?-
o EXIGRAD/FILLlNG
o COMPLAINT
~IREPLACE RI
o FIREPLACE FINAL
p( GASLlNE AIR TST
o
.-../WORK SATISFACTORY, PROCEED
~ORREC~ND PROCEED
o CORREdr w 6~. bAlL FOR REINSPECTION BEFORE COVERING
Inspector: ,-Y I / Owner/Contr:
CALL~7~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETYl
CITY OF PRIOR LAKE
REA TING/AIR CONDITIONING/FIREPLACE PERMiT
Date Rec'd
~. ~~e~n ~!~ I PERMIT NO.O 7 ..., 14'"
3. YeJlow Applicant '-
(Please type or print and si~n at bottom)
ADDRESS
4l2-/ QJA-a/VL/t'rlC
;Je
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK ADDITION
PID
OWNER
(Name)
.,1111)21 h:YL-1
(Phone) ~)) - Zlc).JJ )~
(Address)
LIlli c}ull~t:YL JUIL ;J~
APPUCAr Fireside Hearth & Home
(Name)_ 20802 Kensington Blvd _ (Phone).
Attn Danlelle Ostgard 952 9856675
(Address) License # 20512060
Lakeville, Mn 55044 (City)
(Contact Person) () !l&/J 0\ (Phone) 1 1
APPLICANT SIGNATURE "-J_A.JZJI/I/~' DATE I t!1o!J7
II APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
(Zip Code)
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
REA TING OR POWER PLANT
OUTPUT
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
o Stean1
o Hot Water
ORad' .
a Devices
ther Devices FT.
. ~.IN~ /
o . FEES~~~ .--'~"". ~
1 Yo of Job cost eSl lIual, uao [11 "l',d.:e
$39.50 minimum
$99.50
$64.50
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PLEASE NOTE:
Air Conditioner Units
nnot Encroach into
Req ired Side Yard
Setb cks
FIREPLACE MAKE AND MODEL
')
Industrial, Commercial & Multi-Family
$39.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
~
Building Permit #
$ ~~'l )P
$
$ '-tv.~:::-
.50
; ~ Your Building Perm't When/APproved Paid 4<D,.-
-- ...' t I ~ /01 Date I
_.) I Date l . \\ 3D ( 0 1
~ 7" notice for all inspections (952) 447-9850, fax (952) 447-4245
I Receipt No. $5o~~
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