HomeMy WebLinkAboutHeating Permit 11-0746 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 011fiL
ADDRESS LI bav - k _ ;
OWNER CONTR. �' `
PHONE NO. PERMIT NO. 1 1 — 7 (0,
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL G LINE AI TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS:
(46 At tie
II 1
r C ORK SATISFACTORY, PROCEED
ORREC ACTION AND PROCEED
❑ COR - • - I CALL FOR REINSPECTION BEFORE COVERING
Inspect ' •
Owner /Contr:
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
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�,• am " �
CITY OF PRIOR LAKE Date Rec'd
° ; ; HEATING /AIR CONDITIONING/FIREPLACE PERMIT g', /0,(/
H 1 � ►gi g
..... Opt' 1. Pdnk F A; PERMIT NO. t/ ��/-
.l. Yellow Applicant
I . 7`�a
(Please type or print and sign at bottom)
ADDRESS ZONING (Office use)
L +aS ,, e ,4ry
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(N r
' bdd IA Olaf) (Phone) U l "1 1411- `ICI(
(Address) V r' AS R.,4 . -
APPLIC
(Name) In PlU f( $ � Sin 1 „, (Phone) & )L _ gLILI.
(Address) ` - 1?i 1.)--) 3 ,S1nLil v {,. ..A, S51 c)
�? - l (Address) (Ci (Zip Code) U
(Contact Person) 1 ?SU I . WDl� \ P!?V\ SMAT _ (Phone) °) ()- (-4 # i I
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION O REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
[]Warm Air Plants PLEASE NOTE: Air Conditioner
❑ Steam Units and Fireplaces Cannot Encroach
DGravity 0 Hot Water into Required Side Yard Setbacks.
O Mechanical 0 Radiation
[]Air Conditioning Special Devices Fireplaces with Box Additions or
OVent. System ,Other Devices Cantilevers to the Outside of Buildings
Rvn rw4 ob { Require a Building Permit.
FIREPLACE MAKE AND MODEL 9 kileL, fo
FEE SCHEDULE
Industrial, Commercial & Multi- Family l % 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 $ ' 1 SD -- Building Permit #
The Minnesota Statutes § 32613.148
HEATING PERMIT FEE $ "SURCHARGE” has been changed for one
year effective
STATE SURCHARGE $ 5. w .--1 . 56 July 1, 2010, until June 30, 2011.
TOTAL PERMIT FEE $ ,S .S.9 The minimum surcharge for a "fixed fee" permit
(Office Use Only) is 5, beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid .¢ Rece/ o. 638!(
Baildinz Official Date Date 0 A . 1 By tO
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372