HomeMy WebLinkAboutHeating Permit 10-0936 Y
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED (�
ADDRESS � ["���C 11Q��
OWNER CONTR. �/���„ �l/k���
PHONE NO. PERMIT NO. �b -� N2� N�
❑ FOOTING O PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION � MECH RI ❑ COMPLAINT
� FRAMING � WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP O FIREPLACE FINAL
❑ FINAL O PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: - w�� ��-
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WORK SATISFACTORY, PROCEED 4�Z -��O —�2�
❑ CORRECT ACTION AND PROCEED
❑ CORRE , CALL FOR REINSPECTION BEFORE COVERING
Inspector: OwnedContr:
CALL 44 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL KEALTH dc SAFETY!
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Q � p R CITY OF PRIOR LAKE Date Rec'd
H � HEATING/AIR CONDITIONING/FIREPLACE PERMIT �a f�� j�
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� '. P "''` F ` , ` PERMIT NO. �
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3. Yellow ApplicaM �
ease or ' t and si at bottom
ADDRESS ZONING (oflFice use)
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LEGAL DESCRIPTION (oi�ice use oaly)
LOT BLOCK ADDITION PID
OWNER h
(Name) � i ti... � � .� N�-p► �� (P one)
(Address)
APPLICANT
(Name}� cv A.'� �c�is�9. e a � ��s : t.` S (Phone) `I (o'� - 2 � 4 $ ? k�'
(Address) R? 1�( �it?���c2� s� C� , d.,r-n c-�* SS3C� 2
• (Address) (City) (Zip Code)
(Contact Person) ��s�--� � ��• e (Phone)
APPLICANT SIGNATURE DATE / 4 � `l � �
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNAC KE AND MODEL FUEL
E RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATIlVG OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation Fireplaces with Bog Additions or
❑Air Conditioning ❑ Special Devices
�Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $ �� � v
STATESURCHARGE $ f �
TOTAL PERMIT FEE S �� �
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(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid s/l r--U Re ei No. /,.l �
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Building Official Date Date�� .!_!, J B
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372