HomeMy WebLinkAboutHeating Permit 09-0904 OATE T1NIE
CITY OF PRIOR LAKE
INSPECTlO1V NOTICE SCHEDULED Z� / I
ADDRESS �I7a� w�
OWNER CONTR.
PHONE NO. PERMIT NO. ��-- - 1 D�
O FOOTING ❑ PLUM8ING Ri ❑ EXiGRADIFILUNG
❑ FOUNDATION ❑ MECH Rt ❑ COMPIAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL �LUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ECH FINAL O
COMMENTS:
C �
� WORK SATISFACTORY, PROCEED
❑ GORRECT ACT AND PROCEED
❑ CORREC , CALL FOR REINSPECTION BEFORE COVERING
Inspector: OwnedContr:
CALL 447-985 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
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CITY OF PRIOR LAKE Date Rec'd
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lease or rint and si at bottom
ADDRESS ZONING (oer« nse)
4�ot.C� To w� s��ee� S�
LEGAL DESCRTPTION (oflI'ice use only) '
LOT BLOCK ADDITION PID
OWNER �' ,µ �,,,/,
(Name) �m `/ ` �w � r✓�d (Phone) � � � �
mmc�h � oh
(Address) j b�,t,r
APPLIC T 'ttnn j�� n/y �� /� 76-,
(Name) C c�� WIIfA! IN (�Phone) �-�� �D
(Address) s`��1�► ► � V l � 1 ' , Y�- ' • W� � J /�Ul./ f�.. �� `70�
(Address) (City) (Zip Code)
(Contact Person) (Phone}
APPLICANT SIGNA Z DATE � ���
APPLICANT PLEA COMPLETE BELOW
❑NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL � IN � FUEL
i
FLiJE SIZE RETURN OPENII�TGS INPUT OUTPUT
TYPE OF SYSTEM HEATIl�TG OR POWER PLANT
PLEASE NOTE: Air Conditioner
[]Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Graviry ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation
❑Air Conditioning ❑ Special Devices Fireplaces wit6 Box Additions or
❑ Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEESCHEDULE
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 8r. Alterations $49.50
Residential, Heating Only (New Construcrion) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Pernvt #
HEATING PERMIT FEE $ T'/ � J�/
STATE SURCHARGE $
TOTAL PERMIT FEE
(Oftice Use Only)
This Application Becomes Your Building Permit When Approved Paid �. � Re i o�
Date,� ,/ G
Buildine Ott3cSa1 Date �7� '
24 hour notice for all inspections (952) 447-9850, tax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372