HomeMy WebLinkAboutHeating Permit 11-0024 DATE tIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /5 �
ADDRESS � � G+�O"�J� `
OWNER CONTR.
PHONE NO. PERMIT NO. ��-- ��9'L� _
❑ FOOTING 0 PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION � MECH RI O GOMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE W
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
� FINAL ❑ PLUMBING FINAL ❑ GASUNE AIR TST
O SITE 1NSPECTION ,�MECH FINAL O
COMMENTS: �e,�p��� ���,�,�„��
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� WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
� CORRECT K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr.
CA 9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH � SAFETY!
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� 4 pRro�� CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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�jNNES��P �. P� File PERMIT NO./� D�Z
2. Green C�ty
3. Yellow Applicant
ease or ' t and si at bottom
1 D��� � 1/ ` Y �/ ZO1�TII�TG (office use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
�aWNER t l� v � h �" �� f��'L (Phone) - l 501 �`'1 ��O I I
(Address) �O� �j �,�/�( d � r J�
APPLICANT
(Name) (Phone)
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(Address) 1313 D^ � � �� � �'
Sh�d�co�ee, ��� 5537� cc� �z�
(Contact Person) (Phone)
APPLICANT SIGNATURE w ` DATE '�V ` O
APPLICANT PLE E COMPLETE BELOW
❑NEW CONS UCTION PLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL ��� ��' �� rn�li "� OV FUEL
FLUE SIZE RETURN OPENINGS 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 5etbacks.
❑ Mechanical ❑ Radiation
❑Air Conditioning ❑ Special Devices Fireplaces with Boz Additions or
�Vent. System ❑ Other Devices Cantilevers to t6e 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 & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $ �t � �✓V
STATE SURCHARGE $ . — �9�
TOTAL PERMIT FEE $ �1�, ��
(Office Use Only) '
This Application Becomes Your Building Permit When Approved Paid�/1 S� Re pt No. /_ ����
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Buildine O�cial Date Date / // r / B
24 hour notice for all inspections (952) 447-9850, faz (952) 447-0245
4646 Dakota Street S.E., Prior Lake, Minuesota 553'72