HomeMy WebLinkAboutHeating PErmit 09-0927 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED .Z
ADDRESS y �� � (�.1 QJ" _
OWNER CONTR.
PHONE NO. PERMIT NO. '�j — r 'f�,��I
O FOOTING ❑ PLUMBING RI ❑ EJUGRAD/FILLING
❑ FOUNDATION 0 MECH RI ❑ COMPLAINT
0 FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL O PLUMBING F1NAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ��..MECH FlNAL �
COMMENTS:
�WORK SATISFACTORY, PROCEED
O CORREC TION AND PROCEED
❑ CORR CT W , CALL FOR REINSPECTION BEFORE COVERING
Inspector: OwnerlContr:
CALL 7-9$50 FOR THE AfEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
�NSnor,
. �� P R Ip�
CITY OF PRIOR LAKE vate Rec'd
�� D� HEATING/AIR CONDITIONING/FIREPLACE PERMIT
�
l NN E S��
'. �"' F '�° PERMIT NO.� �. U `'JZ
z. c� c�a
3 Yellow Applicant
lease or riat and si at bottom
ADD ���� I o W�./� J�� �/ �� ZONING (ofl'ice use)
LEGAL DESCItIPTION (oflFice use only)
LOT BLOCK ADDITION PID
OWNER '^
(Name) �X I � � �i ��1, l/7)�i Ul,� (Phone) �5� � 3 �
(Address)
(lvame) �C��i�U�p . � hN (�Phone) � _ �D7�v7
(Address) s ��� l�i������ • • ��! � � /��i./ l�.- �� `7oW�
(Address) (City) (Zip Code)
(Contact Person) � I � � (Phone)
APPLICANT SIGNATURE o2 �ATE I 1 �— C��
APPLICANT PLEASE COMPLETE BELOW
QNEW CONSTRUCTTON REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL w�t�.L�, � q S(��U / 1 V� Mp� � FUEL
FLUE SIZE RETURN OPEI�TINGS INPUT OUTPUT
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.
❑ Mechanical ❑ Radiation Fireplaces with Boz Additions or
❑Air Conditioning ❑ Special Devices
❑Vent System ❑ Other Devices Cantilevers to the Outsfde of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commereial & Multi-Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alteradons $49.50
Residential, Hearing Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $ • �
STATE SURCHARGE $ . 0 •
TOTAL PERMIT FEE $ �
(Offlce Use Only)
This Application Becomes Your Building Permit When Approved Paid 50 .� Re t No. � OG �
— t
Date � ( � � a B
Building Ofticial Date �
24 hour notice for all inspections (952) 447-9850, fas (952) 447 245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372