HomeMy WebLinkAboutHeating Permit 11-1321 DATE TIME
CITY OF PRIOR LAKE 1
INSPECTION NOTICE SCHEDULED t2-) (c I ( f
ADDRESS 16 q i 11 ,1- ci, ?.k k ai,
OWNER CONTR.
PHONE NO. PERMIT NO. / / 13 21
❑ 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 ❑ MECH FINAL ❑
COMMENTS:
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4 WORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORRE' • - CALL FOR REINSPECTION BEFORE COVERING
Inspector: a Owner /Contr:
or
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
( --:- P R70� CITY OF PRIOR LAKE Date Rec'd
HEATING /AIR CONDITIONING /FIREPLACE PERMIT /i Z '1
F t, . ,.., 1 — L_:_ `II'NNESO 1 Pink File
2 Green City PERMIT NO.// . / 3 /
3. Yellow Applicant LLrr'
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/5'3 / A Ac) e/ rz—1 e
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) b C.D c-- 5c_ U � \e--JL (Phone)
(Address)
APPLICANT -I , /
(Name) ? r �) L 4' Al/- L ' (Phone) -_9 44 'JJ2)
(Address) / - i _� / . io D_ 0 A/ ArOi ■ X
(Address) (City) (Zip Code)
(Contact Person) , _ A re--n.ot f (Phone) 9, l. — 44 7-te//Zs
APPLICANT SIGNATU • ' ; : %A__.fd - DATE j__272/21/ l
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE E AND MODEL FUEL
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
❑ Mechanical into Required Side Yard Setbacks.
❑ Radiation
it 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, AC Only $49.50
The Minnesota Statutes § 3261-3".148 h ost $ Building Permit #
"SURCHARGE" has been extended
until June 30, 2013, HEATING PERMIT FEE $
The minimum surcharge for a STATE SURCHARGE $ .'150
"fixed fee" permit is $5.00 TOTAL PERMIT FEE $ TZ
This Application Becomes Your Building Permit When Approved Paid G°''ii e ipt No6 /
Date/ 6, -, , , `I
Building Official Date !
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372