HomeMy WebLinkAboutBuilding Permit #13-0497 r , ,;
CtTY pp pRtOR LAKE ��
lNSPECTION NOTICE / °A � T�ME
SCHEDULEp l,: f � ._ a �
ADDRESS �� � � 7� �' � ��J .��,
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OWNER
CONTR.
PHONE NO. PERMIT NO. a-
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O FOOTING � PLUMBING RI
O FOUNDATION ❑ MECH RI � �G�D�ILLING
O FR,qMING ❑ WATER HOOKUP O COMPL,4�NT
C] lNSULATION ❑ SEWER HOOKUP � F�REPLACE RI
O FINAL O PL,UMBING FINAL � F�REPLqCE FINAL
❑ SITE INSPECTION O MECH FINA� 0 GASIINE AIR TST
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COMMENTS:
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��WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WqRK, CqLL FOR REINSPECTION BEFORE COVERING
Inspector.
Owner/Contr:
CALL 447_gg50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YDUR PERSON,fL g�TH & SAFETY.�
INSNOTI
� PRIp �
° � CITY OF PRIOR LAKE Date Rec'd
�' � HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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I. Pink F+�e pE�IT NO.
2. Green City /� � �
, 3. Yellow Applicant
Please e or rint and si at bottom
ADDRESS Z�NII�TG (affice use)
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LEGAL DESCRIPTION (office use oniy)
LOT BLOCK ADDITION PID
O`VNE � ��fj �� � ' �
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(Name) � ( � ' ' t / (Phone) { � � �
(Address) ��� �' �� �I'� � - ��!(�'�, ��, j �f 4 -�l'l.'� � J � � `�'
APPLIC �(! �J � � � �d �,� , t� r -.
(Name) � (Phone)
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(Address)����� � { ��:![,� � , � Ity /' �
f � , ;-> (Address) ��� / �.��� ��
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(Contact Person) (Phone)
APPLICANT SIGNATURE rs��� DATE
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTiON REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL CC�.Y�Y�v - �.1� -�� _ FUEL 1�1'�
FLUE SIZE RETURN OPENINGS 1NPUT �,C�(�l� OUTPUT CX��
TYPE OF SYSTEM HEATING OR POWER PLANT pLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplai�es Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
Q'Mechanical ❑ Radiation Fireplaces with Box Additions or
❑Air Conditioning ❑ Special Devices Cantilevers to the Outside of Buildings
❑vent. System ❑ Other Devices 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
Estimated Cost $ Building Permit # _
HEATING PERMIT FEE $
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ . �_
(Office Use Only)
This Application Becom�s Your Building Permit When Approved Paid � j y �, Receipt No. a
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Date � BY
Buildiae Official Date
24 hour notice for all inspections (952) 447 fax (952) 447
d�d� tioL.,to C+roo* .0 F. Prinr T.akP.. Mi�nPC�tA 55372