HomeMy WebLinkAboutHeating Permit 11-0110 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 3�j0 ��
ADDRESS � L,,���, L��yI.C�l� � ,
OWNER CONTR.
PHONE NO. PERMIT NO. I� � � a
O FOOTING O PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL � PLUMBING FINAL GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ��u11.t4c,�
COMMENTS: ����
C o5e ; �-2
�
ORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORR R, CALL FOR REINSPECTION BEFORE COVERING
inspecto � Owner/Contr:
CALL 44 - 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOT!
� pRip� CITY OF PRIOR LAKE Date Rec'd
�, ° � �� � HEATING/AIR CONDITIONING/FIREPLACE PERMIT
N <.�,�; � �
..
� . `, h ,.
�"1jN� I. Pink File pERMIT NO . JJ'''\
2. Green City � � �
3. Yellow Applicant
(Please e or rint and si n at bottom)
ADDRESS I ��/ �� ��%�� -VC �-�' ZONING (ott �se)
LEGAL DESCRIPTION (oflFice use only)
LOT BLOCK ADDITION PID
OWNER '/ �/ �> /;
(Name) �0.v`d� C C � i � 5C�'1 (Phone) �Saz y7 �' (�7 9
(Address) Jf0` 5 �C..�i.l�� Sid i° /-►-(! � J �� �i^�` 1.�� /�� �S � 7
APPLICANT (�
(Name) �e���T'0 i�l.�' 4�qr'�' U (Phone) 7�.� `�J 7'"�0 o2Do�
(Address) �.3�U ��°�Y�° e.� ��✓� /v� S(,� j� 8 C.OU/'1 ���d S/��/v' fs`/��
(Address) (City) (Zip Code)
(Contact Person) �� �� ✓� z 1 V'L k. P� (Phone) ���� 7� 7' 1 °d���
APPLICANT SIGNATURE DATE � "`� `��
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION � REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL �(,�,�td '�Co'�LI � U��rI�Y1 I�� FUEL J�l.�'T�-ra..-( �Op�'
FLUE SIZE RETURN OPENINGS INPUT Col.� C� 0� OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
�arm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
Graviry ❑ Hot Water
❑ Mechanical into Required Side Yard Setbacks.
❑ Radiation Fireplaces with Box Additions or
❑Air 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 $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
" ' ' ' "ost $ Building Permit #
"�hc Minnesota Slatutes ,��' 326f3. idR
"SURCH�IRGG" has bccn changcd I<�r on� �EATING PERMIT FEE $ �' � J�
year cflcctive ;TATE SURCHARGE $ ,�� �
Juh� 1. 2010, iintil J�inc 30 2Qtl �. 'OTAL PERMIT FEE $ J¢ ��
The minimum surchar�c for �"fixcd fce" permit
is S;, be�inning July 1. 2U10
This Application Becomes Your Building Permit When Approved Paid�jL �� Re ei t No. �� �
T
Date � � �
Buildine Of�cial Date � � �
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372