HomeMy WebLinkAboutHEATING 08-0062
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
s-(r -&
ADDRESS
~1Y- fJl-a.s'~j- C.f
OWNER
CONTR.
PHONE NO.
PERMIT NO.
&~CL
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
,;a=-RNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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~RK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT ~?r~ff FOR REINSPECTION BEFORE COVERING
Inspector: ! II f ' Owner/Contr:
/
,CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
u
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~i~:n ~~~~y I PERMIT NO. () g 60GZ-[
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
4 \ q b"-P\ff),C:::):Lf1T--:';\ ~b,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) ,,*=-b Go yCO~
-- (Address) L\\C\~P\eC) ~ rr ~I:- SL
(Phone) QS3 -L\tb-lo\ S-~
APPLICANT "'-\ .. c . . AI" _ I LL. f\ (,-. 4 ^'_ . --J /YY"',
(Name~\.0 \.. Y J\ll-e.J-<;::) '-...--n t-\-r~:..-:1U/..il rTt:5 (Phone)'-i ~- .)\ . '\...J-1~-I
(Address)(oC\C;C') It:j. ,-4lDlb.. ';.:-:+- cW' Cj,J) (\p\:\~ lXlll-f-l.,\ .:;s, ~
(Address) V \ r (City) 0 (Zip Code)
(Phone) Q ~~-4~\- ja=lq
DATE Od-\~
(Contact Person) J \ \ , Y
APPLICANT SIGNATURE(/t... c~ d ~ b~
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION [titR.EPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL It-Lli...l cl, .. l.J& P-')LC:J.... () FUEL JOiL..t r (\.I
FLUE SIZE RETURN OPENINGS INPUT lj') CD"'\ OUTPUT, C-(V--l, aX ~
,
TYPE OF SYSTEM HEATING OR POWER PLANT
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.
DWarm Air Plants 0 Steam
DGravity 0 Hot Water
~' echanical 0 Radiation
ir Conditioning 0 Special Devices
Vent. System 0 Other Devices
NL.J -R . cl I I i
';'~;L~~;~CE MAKE AND MODEL UU - u..o N L 0 ~'""f
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $ ~ ~-c'f,":(,'
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~,S()
,,?O .5?) (JV
---~ --- ~~
(Office Use Only)
BuiIdin!! Official
Date
Paid 4a (/2J
Dat? -Z 2- cy
:ltNO 55777
U
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372