HomeMy WebLinkAboutHeating Permit 11-0014 DATE TIME
CITY OF PRIOR LAKE /
INSPECTION NOTICE SCHEDULED 7��Z/�/
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ADDRESS � C.0 � �� �' t�t.(b�t�
OWNER CONTR.
PHONE NO. PERMIT NO. �� ``
❑ FOOTING O PLUMBING R{ ❑ EX/GRAD/FILLING
❑ FOUNDATION O MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FiREPLACE Rf
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL D PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION O MECH FINAL ❑
COMMENTS: R2,1/�,,.,J� fit�R�,�c,,�
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WORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORREC RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: OwnedContr:
CALL 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH dc SAFETY!
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4 rRi CITY OF PRIOR LAKE `���� ' � Date Rec d
� �� HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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`�j� 1 Rnk File
Z . ��� �, PERMIT NO. �` �(�Q `
3 Yellow Applicant
lease or ' t and si at bottom
ADDRESS � ZONING (oflfl�ce Use)
c � v � G �� '
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) +"`l� '�.y- (Phone) ��-�� � � ��
(Address) � � / /�`'Lp r C �1`'�-- �' � •
APPLTCAN "�� r . t �
(Name) ' 4' / /" I � (Phone) �� ��� 2"'�
`
(Address) � � / �� l� l /� �
(Address) (City) / (Zip Code)
(Contact Person) !�-C� � �� (Ph e) ��� � ��' ����
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APPLICANT SIGNATURE DATE
PPLICANT PL COMPLETE BELOW
�NEW CONSTRUCTION PLACEMENT ❑ ALTERATIONS
FURNACE MAKE AN MODEL �,,;0-� N%� ��� /��� � FUEL /1L� �
FLUE SIZE j r RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam , Units and Fireplaces Cannot Encroach
ravity ❑ Hot Water
into Required Side Yard Setbacks.
Mechanical ❑ Radiation
DAir Conditioning ❑ Special Devices Fireplaces witH Boz Additions or
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEESCHEDULE
Industrial, Comxnercial & 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) 4.50 Residential, AC Only $49.5
Estimated Cost $ Building Permi #
� The Minnesota Statutes � 326B.148
HEATING PERMIT FEE � � "SURCHARGG" has been changed for one
STATE SURCHARGE $ year effective
TOTAL PERMIT FEE $ Ju�y �, zo�o until June 30 20� i.
(Office Use Only) The minimum surcharge far a"fixed fee" permit
is S.S, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid �� Receipt No. ��� �
�
Buildine Ofticial Date Date �/ �/ By
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24 hour notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372