HomeMy WebLinkAboutHeating Permit 11-0039 DATE TIAAE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 2 � ��
ADDRESS I (,fdD 4M� � `
OWNER CONTR.
PNONE NO. PERMIT NO. ��+ dG �/
O FOOTING O PLUMBING RI ❑ EX/GRADIFILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP � FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP O FIREPLACE FINAL
O FINAL ❑ PLUMBING FINAL O GASLINE AIR TST
❑ SITE INSPECTION �MECH FINAL ❑
COMMENTS:
�
O t
. Z _?Q .� � �
�WORK SAT FACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORR WORK, CALL FOR REINSPECTION BEFORE COVERING
I nspecto OwneNContr:
CAL -9850 OR THE NEXT INSPEC710N 24 HOURS IN ADVANCE.
CODE RE REMENTSARE FOR YOUR PERSONAL NEALTH dc SAFETY!
uvsrvor�
O � p RIp� CITY OF PRIOR LAKE Date Rec'd
� � HEATING/AIR CONDITIONING/FIREPLACE PERMIT /_ Zp , ��
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�I�'NESO�� 1 Pmk F�le
2. Green Crty PERMIT NO . t� D O�
3 Yellow Appl�cant {
ease or ' t and si at bottom
ADDRESS ZONING (ofl�ce use)
��b/8 �Gtr» D�'; ca� � ;rc�c
LEGAL DESCRiPTION (office use only)
LOT BLOCK ADDITION PID
OWIVER /
(Name) �Q �� I'Gt. �o Q, C� i h-� (Phone) �P �� — 70 9— 7' 7 y�
(Address) 6D (.�- a /»�/' � d � ( ���c �� � � o e �l S 537�
APPLIC t ?
(Name) P.�L i �'l �� �if2 P/'l� ! CP L�l C► �(Phone) 9sa — '�p — / / /a
(Address) �� �l � 1/c°n7`�u-ra ,�urT �'�+2 ����.��al�p,peP /�70V ,S 37`�
(Address) (City) (Zip Code)
(Contact Person) � �e Z. a. L (Phone) �S'a��--
APPLICANT SIGNATURE DATE � /� //
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION PLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL �8 /T D�C O�Q �/ /�o FUEL �A.7�Gc ra�—
FLUE SIZE oZ � RETURN OPENINGS INPUT 8D 000 OUTPUT 00
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
�Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
[�'IVlechanical ❑ Radiation
�Air 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
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 #
The Minnesota Statutes § 326B.148
HEATING PERMIT FEE $ y,�O "SURCHARGE° has been changed for one
STATE SURCHARGE $ , q�!�p year effective
TOTAL PERMIT FEE $ s/j/SO July 1, 2010, until dune 30, 2011.
The minimum surcharge for a"fixed fee" permit
(Office Use Only) is �, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid 3� � Receipt o. /_ ��
` (Q
suildin¢ ofticial Date Date /���( By
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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