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HVAC Permit 11-0274
DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED 5 /34( �1 ADDRESS A iCp c2 C o(, p( c OWNER CONTR. PHONE NO. PERMIT NO. • ❑ FOOTING ❑ 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 ,IEC MECH FINAL ❑ COMMENTS: ,a. /G. vN < < A(' v.- --- t.. 6Sg— f---■ �'`G Rl WORK SATISFACTORY, PROCEED ❑ CORRECT ACTION AND PROCEED ❑ CORRECT WORK, CA FOR REINSPECTION BEFORE COVERING 0 Inspector: Owner /Conte CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTI P �RI CITY OF PRIOR LAKE o Date Rec d ° l HEATING /AIR CONDITIONING /FIREPLACE PERMIT � V 1 , ::°, er , ....--voi., IivNESDcP L Ye Pink Fil i C ty e PERMIT NO. �2 3 3. Yellow Applicant LL•••• �T7 (Please type or print and sign at bottom) ADDRESS l X ZONING (office use) `MCP 9' - ev 1e va dd 6 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER '--t" / / •�' ' / T I E� & 2 /7'7 (Phone) ( /7 /22 ' (Address) z/69?)- Q ©1,,A do s gt -- /zif d4...) 5 APPLICANT J ,r� (Name) t IPA/ ,i ` (Phon � 27 � �^ (Address) ,/, W / / L_. _ / -.5 Ch- J dG/�/rJ;'/��3 7 ` ,j (Address) (City) (Zip Code) (Contact Person) 1—cc c _. r r G i 'hone) ?% ' 7 S APPLICANT SIGNATURE AgrA ► - DATE .4760 - // APPLICANT PLEA E COMPLETE BELOW ❑NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL / Oo & 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 Setbacks. ['Mechanical ❑ Radiation \ir Conditioning ❑ Special Devices Fireplaces with Box Additions or ['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, Residential, AC Only $49.50 7 8 0 0 Estimated Cost $ 0 0 Building Permit # OD HEATING PERMIT FEE $ 7, 3 STATE SURCHARGE $ v 00 TOTAL PERMIT FEE $ _ _,� ,.. (Office Use OnIyi .f a0 . 4 This ApplilA l o ecomes Your Building Permit Approved Paid gQ . � Recei o. & � 1,1 J "[ ' (/ t . 1 l Date,/ . 7 (. / By But I Official Date v • 1 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372