HomeMy WebLinkAboutHeating Permit 09-0915 DATE TIME
C1TY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 2. Z
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ADDRESS 7�_�p(,v� 1"
OWNER CONTR.
PHONE NO. PERMIT NO. � — ��S
� FOOTING 0 PLUMBING RI O EX/GRAD/FILLING
CI FOUNDATION ❑ MECH RI O COMPLAINT
❑ FRAMING O WA7ER HOOKUP � FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP O FIREPLACE FINAL
D FINAL � PLUMBING FINAL O GASIINE AIR TST
❑ SITE INSPECTION �MECH FINAL O
COMMENTS:
,
�
WORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
O CORREC K, CALL FOR REINSPECTION BEFORE COYERING
lnspector: OwneNContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH d� SAFETY!
wsnon
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` P R I �j � l� Lw �� �U t!�
�°� °�' 9 CITY OF PRIOR LAKE vate Rec'd f "i �
� D� HEATING/AIR CONDITIONING/FIREPLACE PERMIT NOV 0 5 2009 u�
e
� � l NN E S O` � B
'. P "''` F; '` PERMIT O.
2 Green Ciry O
3. Ydlow Applicant
lease oi ' t and si at bottom
AD � S . �� ZONIl�TG (ots« use)
LEGAL DESCRIPTION (ofleice use only)
LOT BLOCK ADDITION PID
(Nam ) J GL�J � bC� �Lt.l'"1 � (Phone) � cJ��" t���
(Address) �(�,�'�-�— �L.er JO�j ��
APPLIC T (,� /� /� -�/
(Name) ��1���hd.i �s l"1�_,_��tJn� (�ph 'I�Z.�q�-�I_' 107�0 l
(Address) s��2�Y11J ��� V�ry L1 ��� ' J � — �� �U l s f'GW"l�. � �o�P
(Address) (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE I� ( ATE I L'� J D 1
APPLICANT PLEASE COMPLETE BELOW
�NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENII�TGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
OWarm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiarion Fireplaces with Box Additions or
DAir 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 549.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residenrial, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $ "/ � �
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ �D � Q7
(Oftice Use Only)
This Application Becomes Your Building Permit When Approved Paid �,�,'1 Rec pt o.�� g�
� LJ
Date � S �� By
Building Ofticfal Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372