HomeMy WebLinkAboutBuilding Permit 03-0009
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS _' C;'). If3
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
CQMMENTS:
\, ~-
DATE TIME
Y-ll-01'
~.~_ Iff; 0.. t-
O '-'
CONTR.
SCHEDULED
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~LUMBING FINAL
;.e:r MECH FINAL
~'f ~tJ
,
'2. l'. oJ!J- ~ r-- \,U\..- t ()
01-06ett
o EXIGRAOIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
LN1-'78~
o WORK SATISFACTORY, PROCEED
"!lLCORRECT ACTION AND PROCEED
/ c """'mK CALL FOR REINSPECTION BEFORE COVERING
Inspeelor: . Owner/Conlr:
CALI.! 7. 50 R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE fleQ~MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
~J
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
,/..JO-Cl
ADDRESS /52 7 R Fe, /." Lvc.... N,.~ t. r
I
OWNER
W("'J~'''')
CONTR.
PHONE NO.
PERMIT NO. ..Q3-tx;09
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
)l EXIJa1G:OO:ILLlNG
o CO~NT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMI;NTS:
/III &L
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InSpector~ ~Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETYl
INSNOTI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
--
SCHEDULED (,: ~'~5
~ ~ :J~
ADDRESS I S~ 7;J
~ir-~ U./s C~
OWNER
CONlR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~I SULATION
FINAL
SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
)Il(GASLlNE AI~ TS~
o ~1L4""'"'lJ'_
COMMENTS:
\. (\~ \~ \~7)
7. Vr-oll" -0", "U--o-y',.......
\\.:::h.r.,
-
~Z~~
4. 50..! -!- U)~
t\~-
.....
b;trw 4..J)
.
'-'~P
T"'\r }". ~ - I
/'7 fJ
'~I
r- --. /II"....
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
I
~""l(')A.,~ ~/\
Inspeelor:
Owner/Conlr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'N$NOn
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ~\-D)
ADDRESS (~7$ fi i,.- t. )u.... / Ilk:; Cf
.J
OWNER CONlR.
PHONE NO. PERMIT NO. 05- ooJ
o FOOTING o PLUMBING RI o EXIGRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
1
~e J:- I 17 a.VJ /') ~
~ V
~~ {LI- rr~/f~
\( WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o COR~WORK' CALL FOR REINSPECTION BEFORE COVERING
Inspeel : Owner/Conlr:
CALL: ~50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'N$NOn
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
/.,1J...N)6 -oIL...
DATE TIME
SCHEDULED
~
/5 Z 78 h4/0~/tY 1115 c'..r
CONTR.
PERMIT NO.
{! ]-((507
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECHFIN~ 0
E/V61::/ F/ Iv~ 6..t:ft2?c:;.
(~uA~S1cP - OK..
CuiJ ti-- 'l"'"'R tf(,
"yWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InSpeelOr:t\~", A~\~. Owner/Contr:
CALL~ T~ NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
r/'fSNOT/
-.. . . fJ.-
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS I~ '19 F'AiR,&.\.lAV U
NATURE OF WORK . ~e w ecfo-)STa.144'~""
USE OF BUILDING -S F. I) ,
PERMIT NO. /}3 - oorJCl DATE ISSUED ~G"
CONTRACTOR \U~SAAa..)~/ ~M.ES .tJc. PHO~EJ..n. - 3C.Cl- ?'Z~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
.,.
I FOOTING I ;!J/5SPECTOR I / _ ~A~ 0:8
, FOUNDATION (Prior to Backfill) I ~ I \ I [ "3 r 63
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN'SIGNED
ROUGH - !NS
~, [/'3(6~
uJ C (./1/6 .- c;J~:;6 -t. '5'
/J./S ? - "? - IU>
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
.1~ttt~/L/(T~/t!ttLTt/~c7J ~ I
FINALS
ff2 () r?, /f) IU
(fA
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
GRADING (Prior to Sodding)
BUILDING ~:+o ~_I rtl
ELECTRICAL I
PLUMBING
HEATING
DO NOT OCCUpy
Ph ~ - f'1
t1Jjfl.,
aiK
z-2~.
-2'4
j
1.1'-5
(/ ,j .()~
V ./
"
ftJ
CI- /J
I
UNTIL ABOVE
NOTICE
HAS BEEN SIGNED
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
I ADDRESS
/5;1, 7e - =1111r,:(4 y J+e 1'1 h i-:S
Date Rec'd
t 1- ~I/OJ>
/ () ? ,..[)a.if
PERMITNO~ I"
I. White File
2 Pink City
J. Yellow Applicant
C 00 rr
LEGAL DESCRIPTION (office use only)
LOT lu BLOCK 4 ADDITION We 115P1/Hl 71
OWNER
(Name)
We..J16",~nn
1~'J5- /h.~z..fI
(Address)
BUILDER
(Name)
(Conlact Name)
(Address)
511Jt1e
T11 t~ k
TYPE OF WORK
DMisc.
)..lojt1 es
nrlLJe
1st
(Phone)
CJl."If1-II.fl1f\
1-I"'_II..J"'J4 ')'\..
1New Construction
DLower Level Finish
l "Fireplace
PROJECTCOST/VALUE (exchi&ngland) $
DAddition
OAlteration
v
(Phone)
(Phone) .
DDeck
DPorch
ORe. Roofing
ZONING (office use)
~J
PID:)5- E 1b" 03~-C
(;51/ "-'I LJoV
/
(;Iz-,Jt;;.q- 7(;, z.Cl
"
ORe-Siding
OUtility Connection
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;ter~V.Jtop~pections l4-sf1 /1- Z"-O~
(~ Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
\ Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
~~'7 tJ(JO,Od
$ Ii/'~q. 95,
$ 9 Z{,.[ z...
$ ,P 7. 5() ,
$
$
$
$
$
loa. DO
100, 00
35.:>a
~4 . " d
This Application Becomes Your Building Permit When Approved
~ ~ /cVS-~Z-
Building Official Date
I Park Support Fee
I SAC
I WaterMeter~I";
I Pressure Reducer
I City SAC and WAC
\ Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Paid 6. 5.5 ~ . / I
Date / - Z- - 0 l'
$
$
$
$
$
$
$
$
I ~ Y53S. /7
II -, cY
I Recejj,fNo. 4:..J'~ U
By I
o
#
#
#
#
~
eSo,tJo
/200, D d
Z5o, 0 0
"I5.d()
!d.tJO, 0 tJ
7(}D, f}o
/StJb.O()
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This documen
:~~~Pl~:;:tempo'~ce~fi;~bn~~ceWdill::~~~cru~w~mustb
Planning Director ate Special Conditions, if any
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Cleek Avenue Prior Lake. MN 55372
~t
White . Building
Canary . Engineering
Pink . Planning
Th(' ("('nln of llll' L.kt ('ounlry
J3UILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,
/ / - /
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.,.-' :..
,
/
/
--I
I
Accepted
/
Accepted With Corrections
Denied
Reviewed By:
Comments: R~
~
a.d.
1~
a. -rh dL.P
Date:
/ -,lri~ z...--
I
,
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~~
White - Building
Canary . Engineering
Pink . Planning
Thr (-rntrr of Ihr I.akr Caunll"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~t )fl/1l(MUO~ ~&111QA
,II - 4 -{)()..,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/)~71 ~~/JZ(A ~ c!-r
. - {J ~
Accepted
/'
Accepted With Corrections
Denied
Reviewed By:
~ t:/..u.i2/-J Date: /co/~2--
6J.. ilf ~k.P ~-~.
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
White - Building
Canary . Engineering
Pink . Planning
Th.. ('...1... ..flh..l..kt ('ountry
BUILDIIft PERMIT APpLIcATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
/ tJ }P/'IL<YY!lt?~ 'tJO-J11t2A
.:;..- y
//..:- dt, -()a
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.
1)'.;>\7J ~~/.aA X~ C-r
- u
.,
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
/J1J45
. Date: . 1;;)- 4-02-
Comments: ...sF!F! RF!vpn:ip ~irlF! for Arlrlitinn::!llnfnflJli'ltion!
~p.P. A tt:lc.hmp.nt". 1) r.":loing Plan, 2) Frn"iol1 Control Measure"_
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
F!h. 7. =003 =:45PM
GEN2 RVAN PLUMBING AND HEATING
No =801
p. 47
Date Rec'd
....~llii I'R/O+~
,.. .,.
- '"
U' In
,'.'''~- .
"', ;:,":',::' -
'> '<),;~;'~:::: \:'., NNe s 0 "\ ~
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
j. ~,':. ~i\;. I PERMIT NO. I\? - O' 0 (jO I
J. Gold A()(lUctnt U~ I
rPllt.!Sl: TV\'l~ OrtlM[ !.lld ~ atbottcm)
ADDRESS
ItJ~1t fMi~V\lIAj!r *t~Vlf3 Ck.
LEGAL DESCRIPTION (eIlicc us< o,uy)
LOTto BLOCK!/. AJ)DlTION&/~VWW #eiUl1fr:. WenJ7YAf1V'J jSf
. U '
. '/ I ZONlNG (ollk. U~)
Pro
OWNER
(Name) \o1ensmann Momes
(Address) 1895 Plaza Dr St" 200
(Addm,\
(l'hone) 651-905-3709
Eagan, MN 55122
(Clry) (Zi, Cod<)
APPLICANT
(Name)~M_-:B.:ls~ !'J."mb1n>: & !!<:':'.cJ."J'
(Phone) 651-423-1144
(Address) .14745 Sa Rab~rt T,..l
(Addresp
(ContactPmon) _ C\illQ.,l&t/ ttdlS'
TJCANT SIGNATURE 0;{)~} '-4..h/J
Rosemount. .~
(Cicy)
55068
(ZIp Code)
(l'hone) _ 651-423-1144
DATE.. ;{ - 7- -- 0:2,
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure
Type of sewer pipe. 0 ABC 0 PVC
Estimated length of sewer line feet.
Clean out (if required) located at _ feet from structure.
feet.
o Cast Iron
Resldent!al sewer and water hnc connection
Sewer connection only
$35.50
$1750
FEE SCREDULE
Indwtrial, Com'l & MultI-famIly
Water connection only
Estimated Cost $
Building Permil #
1 % of job cost WIth a $39.50 mmimum
$17.50
Q3- 0001
SE'WER AND W AIER PERMIT FEE
ST A IE SURCHARGE
TOTAL PERMIT FEE
$ fJ
$
$
~n
Building Official
Om
PAID WIllI
iUll.,DING
]::~ ~~~~
(Office Use Only)
This Application Become. Your Building Permit When Approved
. I
24 hour notice for all in.pection., (952) 44~O. f., (952) 447-4245___1
2001 2:44PM GENZ RVAN PLUMBING AND HEATING No.280i
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONlNG/FlREPLACE PERMIT
P 2 7
Date Ree'd
(PleASe w~ or onat and si2n a.t bottom)
ADDRESS
16a 1-8 ~/lU^lOcY ~ e ia his CA-.
~~".. J~,,~ I.PERl\fiTNO'OJ oooql
ZONING (ofCc.u..)
LEGAL DESCRlPTION (olliecusc01l!y)
LOT 0 BLOCK 4 ADDmoN~I~wa~ Jk!t.. VVe~lV1.fJ Vll1 ls+ PlD
OWNER
(N.une)._ye1"'le.....~....T'l 'R.........oe (phone) ~,l_Q..D..5.=31.D9
(Address) 1895 Plaza Dr Ste 200 Eagan, MN 55122
APPLICANT
(Name) G~n1.:-Rv~~.wn'hin~ ~ T:leat-~n~
(Address) 14745 So Raben TrJ.
(AdOress)
(ContacrPerson) _Q~~I&f1 ~I(\ .
l~^~)~1lA
(phone) ~ '" _~ ~ ,-, 1[. ~
Rosemount, HN
(City)
(Phone) ~"1_A1'_11 H
55068
(Zip Code)
APPLICANT SIGNATURE
___ PATE
;//1 --0 ~
APPLICANT PLEASE COMPLETE BELOW
"!':&NEW CONS1RUCTION 0 REPLACEMENT 0 A.L TERA nONS
FURNACEMAKEANDMODELL:tVl1'10)< tgOlJpG 3[4 -IO{) FUEL hA-r f:?/lts,
FLUE SIZE RETIJRN OPENINGS .q INPUT I DO, DbO _ OUTPUT q J..{ DDD
TYPE OF SYSTEM HEATING OR POWER PLANT
15fWarm Alr Plants
OGravlty
o Meohanloo.l
"[2tAlr Conditiolllng
DVont System
o Steam
o Hot w.t<r
o Radj.tion
o Special Dev1ccs
o Other D.vioes
PLEASl: NOTE:
Air Conditioner UnitS
Cannot Encroach into
Required Side Yard
Setbaoks
FIREPLACE MAKE AND MODEL
IOOUSlJ'lal, Commw;ial & Mult,-Famlly
Re.<ldenUaJ, Heating & AlC (New CODSU1JCtlOn)
Residential, Heating Only (New Con:ttuction)
FEESc:HEl>ULE
1% of Job cost Res.;dent1a.l.. Gas Fireplace
$3950 minimum
$99 50 Rcsidennal, Addilions & Allerauon::
$6450 Residential, AC Only
$3950
$3950
$3950
BUildlDg Official
DatE
Bulld\ngPerml! #Q..J-O?~ VV IlH
.50\ BUILDING
1:' bRMIl
~ ~~ ~ 0 \)][r ~]-l Receipt No.
JU ~ 1 0 2003 I By
$
$
$
Estimated Cost $
HEATING PER.IvfIT FEE
ST A IE SURCHARGE
TOTAL PERMIT FEE
("'- . Use 9nly)
r
. A" Application Becomes Your Building Permit When Approved
24 bour notice for all inspections (952) 44~50, r... (952) 447-4245
:003 ::45PM
GENZ RVAN PLUMBING AND HEATING
N Q : 8 0 i P 3 7
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
q'lease ,!YO! Of 'Dnof .and ~U'Jl u botmtn)
ADDRESS
\'C)~1--Q hAi~\fJat;} ~.{W0R C+.
I Bl'l" File I PERMIT NO
2.""" CI~ .O'?_QOoq I
3. ,,(~k>-" Applv-U.! ./
,
ZONlNG(_,1U<!)
, '
LEGAL DESCRIPTION (ollice ose only)
LOT L7 BLOCK J.j ADDmON fvcl/Qwa.~ r/trK'. WeVlslY\cu1Vlls.hro
OV/NER
(Name) Wensmann Homes (Phone) 6S 1-905-3709
(Address) 1895 Plaza Dr
APPLICANT
(Name) Genz-Ryan Plumbing & Heating
(Add:=s) 14745 So Robert Trl
(Address)
(ContaaPerson) Ji1K!.r~h &r (I S
APPLICANT SIGNATURE QC.~ -=f&.JJ~
Quantity
~
(
f
'.7.
'r
I
I
'2.
Eagan. MN
55122
(l'hone). 65 J.-423-1144
RosemOUDl:. IlN
(City)
55068
(Zip Code)
(Phone) _ 651-423-1144
_ DATE -2:. "1- o...?:.
APPUCANT PLEASE COMPLETE BELOW
Type ofFixtuTe
Estinlated Cost .~
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(om,. u.. Only)
This Application Become. Your Building Permit When Approved
I Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
I Lavatory (J3athroom Sink)
Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
Building Omdal
D...
24 hour noUce for o.lllnspect1oDS (952) 44 ~~~~~\ .. A'T '..,~-
Quantity
~
-/
~ -:J;
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Se,vage Ejector
I Backilow Assembly
Backilow Assembly Test
I L<IWll Sprinkler
Other
FEE SCJIE:DUL.E
Industrl.al, CommercIaJ & Multt.famtly 1 % of Job cost wIth a S39 SO minimum ReSldent:1ai, New One & Two~Famlly $9950
Residential, Additions & Altexotions $"39 50
BuHdmg Pe)JIlit # 0] - 0 0 0 '1
:0 PAID WIIH
:1UlLDING
1~I~al~ rn ::!~ ~u~fii~
, I ~ I1atiil 1 11 LUU~ ~ By
lu
$
$
$
,
I
--r
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
; ~;.':, ~::y I PERMIT NO. 3 - {)GO '11
3. Yellow Applicant
(Please tvDe or -print and sim at bottom)
ADDRESS
ZONING (office use)
15278 FAIRWAY HEIGHTS COURT
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Namel
WENSMANN HOMES
(Phone)
(Address)
APPLICANT
(Name) ATJJRD FIRESTDE DBA FIRESTDE HEARTH & HOME
2700 NORTH F AIRVIEW A VENU",
(Address)
(Phone)
ROSEVILLE
(City)
651-633-2561
(Address)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633.2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
2/17/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent. System
INPUT
HEATING OR POWER PLANT
D Steam
D Hot Water
o Radiation
o Special Devices
o Other Devices
OUTPUT
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
PLEASE NOTE:
Air Conditioner Units
Cannol Encroach inlo
Required Side Yard
Selbacks
FIREPLACE MAKE AND MODEL
HEAT N GLO 6000TR-OAK
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
(Office Use Only)
Building Permil #
$
$
l'DHE @ ~ /I \'lfH~~1
This Applicalion Becomes Your Building Permil When Approved I n < Paid I
. JU FEB 2 4 2003
Dale I By
lal, I
24 hour notice for all inspections (952) 447-9850,t"ax (9~~} ..4741 I! ~
ESlimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
.50
~ PA' ')
WtD.' -
I"'t.~
, ,l ) "~_I
'-" ~ ,
'r
Receipt No.
Buildine: Official
Date
av
I