HomeMy WebLinkAboutHeating Permit 11-0378 DATE TIME
CITY OF PRIOR LAKE / / /
INSPECTION NOTICE 4 . l I 5 — IL.
55 DPl- r'
AND AP A
ADDRESS
OWNER CONTR. /
PHONE NO. PERMIT NO. `L - 3
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION • CH RI ❑ COMPLAINT
❑ FRAMING �_��AT • •KUP ❑ FIREPLACE RI
❑ INSULATION ►- I ' Ti • KUP ❑ FIREPLACE FINAL
❑ FINAL ❑ P UM :ING INAL (GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL
/
COMMENTS: C�i95 C�I
);WWORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WO , C FOR REINSPECTION BEFORE COVERING
Inspector: OW' eOl r:
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
pRI? CITY OF PRIOR LAKE Date Rec'd
��-� HEATING /AIR CONDITIONING /FIREPLACE PERMIT
b L�3 C
n';NNESO L I ' U' I2. Ye. Pink Fi ty y')
PERMIT NO �/
/�
3. Yellow Applicant /
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
155 QS �%rn 6 'ci<t rat �S
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
((Name) ; - V3 se r "I Yom' ci� - E?'S (Phone) `1 " 7 �/ - D Y 6�
(Address) 1 « 5 (; trYl e_ __ — Fret \ C E Pr ■ vf LV �' SS . ---),
APPLICANT
(Name) 0. 641 e Po i n, _411. (Phone) "7 103 . - TS - 7 - D
(Address) -, li1 i 8 I V She 1 6-41A ii e 5
s
(•,• •ress) (City) (Zip Code)
(Contact Person) 1 0 A V\ 1 Zt ►� k-' Y1 (Phone) —1 (03 .- -15-7 "-& C%�
APPLICANT SIGNATURE -i r` 'vi� � i�� i / i DATE "57/5i/ / _
1
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑ REPLACEMENT VALTERATIONS
FURNACE MAKE AND MODEL 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 Wate into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation
['Air Conditioning 111 Special Devices Fireplaces with Box Additions or
['Vent. System Other Devices �y� C`�s Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL l 'n .e (UAL Lit e
I`Gc {'e
FEE SCHEDULE J
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 $ q . CO
STATE SURCHARGE $ c 66 414 -
TOTAL PERMIT FEE $ 5 •
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5 d-D Rec o. /
(v24)6_0
Building Official Date Date / . ` I 1 B
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 /
4646 Dakota Street S.E., Prior Lake, Minnesota 55372