HomeMy WebLinkAboutMechanical Permit #13-0407 �_ ATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULEO 5 (�j
ADDRESS � �CI� �� ���
OWNER CONTR.
PHONE NO. PERMIT NO. ��� 7 v �
0 FOOTING 0 PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMtNG ❑ WATER HOOKUP ,�(FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL O PLUMBING FINAL � GASLINE AIR TST
❑ SITE INSPECTION D MECH FINAI. ❑
COMMENTS:
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� WORK SATISFACTORY, PROCEED
❑ CORRE A TI N AND PROCEED
❑ CORRE T , CqLL FOR REINSPECTION BEFORE COVERING
Inspector. OwnedContr:
CALL 447-9850 FOR TNE NEXT INSPECTION 24 HOURS IN ADVANCE
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY,�
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CITY OF PRIOR LAKE Date Rec'd
� D� HEATING/AIR CONDITIONING/FIREPLACE PERMIT � /
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� I. Pink File pERMIT NO. � 2 �
� . 2. Green Ciry
3. Yellow Applicant ��
Please e or rint and si at bottom
ADDRESS � ZONING (oHice
/ { � C,(,>�-��L1.' � � ' / 5�
LEGAL DESCRIP'TION (office use only)
LOT BLOCK � ADDITION � �� /� ID �� 3� r Op� —
OWNER �/�
(Name) � � �Li� � � �'� �;, (Phone) �j 1d 7�7
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(Address) / 6 (• ���� ,(j k+,�,,i� /L i� ��
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APPLICANT HEARTH & HOME TECHNOLOGIES
(Name) dha FIRESIDE HEARTH & HOME (Phone)
�ic BC662656
(Address) 2700 FAIRVIEW AVENUE N
ROSEVILLE, MN 55113
(��e�3.2 (City) (Zip Code)
(Contact Person) �� (Phone)
APPLICANT SIGNATURE DATE
APPLICANT EASE COMI'LETE BELOW
ONEW CONSTRUCTION ❑ REPLACEMENT �ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air Plants ❑ Steam PLEASE NOTE: �
❑Gravity ❑ Hot Water Air Conditioner Units
❑ Mechanical ❑ Radiation Cannot Encroach into
❑Aer Conditioning ❑ Special Deviccs Required Side Yard
❑Vent. System ❑ OtherDevices Setbacks
FIREPLACE MAKE AND MODEL ^�� � N+� �� 3� �f�
FEE SCHEDULE v
Industrial, Commercial & Multi-Family 1%of job cost Residential, Gas Fireplace $�9s5t1' lI �!'�
$39.50 minimum
Residential, Heating & A/C (New Construction) $99.50 Residential, Additions & Alterations $39.50
Residential, Heating Only (New Conshuction) $64.50 Residential, AC Only �39.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $
STATESURCHARGE $ �
TOTAL PERMIT FEE $ j r�/
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This Application Becomes Your Building Permit When Approved 'd �� Receipt No. /_
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Dat By
Building Official Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245