HomeMy WebLinkAboutHeating (F.P.) Permit 09-0061
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
SJ!lj 67
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ADDRESS
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CONTR.
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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/ ENL ~\o..~LL
t
'--
PERMIT NO.
Cf1- DOG,/
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
J'- MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
,M GASl,lNE AIR TST
o r:V
1'\ n
-+- N .k L..o
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/
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'it WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT 'J'f1~LL FOR REINSPECTION BEFORE COVERING
Inspector: I j~ OWner/Contr:
CALL ~-91o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
lNSNOTI
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
2.2-7 0/
~l~i<ant I PERMIT NO. 0 9, OO(P / !
I. Pink
2. Green
3. Yellow
(Please type or print and sill:n at bottom)
ADDRESS
/ 5 3 f/
;}(L(f' 1:7
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I J-
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
OWNER
(Name)
CIII/(L ~ 7D~
;11/ G-tld&u!L
(Phone) 1;7 -LI'1/- )J5b
(Address)
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If- .
(Address)
f=l a.2::> ,j)~ l~F\fL i\1 ~ Hpv,C (Phone) G~ 1- (p 33 - J0~ 1-
2/00 FAtl.VIL:>\.J PN~ f,J, ~)Ev,u~ lM~ $1/3
APPLICANT
(Name)
(Address)
(City)
.... (Zip Cod~
~'::)/~ <P3J-1 0"-/ L
(Contact Person)
. (phone)
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL . FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWann Air Plants
DGravity
o Mechanical
DAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
S39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ .f 1. SV
$ .50
$ 6b . C/2)
(Office Use Only)
This Application Becomes Your Building Permit When Approved
I Paid SO. CIb
Date Z. 2-7 . 0 1
RecefNo. 57z.50
BY}.
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Buildin2 Omcial
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245