HomeMy WebLinkAboutMechanical Permit #13-1354 C�7Y OF PRIOR LAKE DA E TIME
INSPECTION NOTICE
SCHEDULED � ��
ADORESS / � � �'� ��-� /�
l
OWNER � �
CONTR.
PHONE NO. PERMIT NO. � � '"'� � �
❑ FOOTING � PLUMBING RI
❑ FOUNDATION ❑ MECH RI � �G�D/FILLING
O FRAMING ❑ WATER HOOKUP � COMPLAINT
❑ INSULATION O SEWER HOOKUP � F�REPLACE RI
❑ FINAL O PLUMBING FINAL � F�REPLACE FINAL
❑ SITE INSPECTION �CH FINAI � GASLINE AIR TST
❑
COMMENTS:
i � ���
"�RK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORRECT , RK iCALL F . INSPECTION BEFORE COVERING
Inspector: � �,�- �'�
� " - Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH � SAFETYI
lNSNOT!
��r� CITY OF PIZIOIt LAI�E Date Rec'
�,°� {" �```� � HEATING/AIR CONllITIONING/FIREPLACE PERMIT
u � �� ��4:� �
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� '.'''�: F'ie PERMIT NO. f
'�IlNtvESO'�� 2. Green City /'� — ���
3_ le{to�v A�plicanE
(PleHSe type or print and sign �t Uottom}
ADDRESS ZONING (oflE'ice use)
� � �p�vv> c�.' �. � ��Q. �V � �
LEGAL DESCRiPTI�N (office use oniy)
LOT BI.00K ADDITION P7D
OV4�NER
(Name) (Phone}
Address
APPLICAN
(Name) �� 2 ��sL�0..n e� t�!� c�n����� ��a-R� 5� � � �1
(Address)� b �f D c�� � S ��f�Or�-�h �� �J���
(Contaet Yersan} ��� c�Y' ��v� n (Phone} ( - -ri b 5"�u7 (0�'1
APPLICANT SIGNATURE, ��x-C� �� D�TE �.� � �II
APPLICANT PLEASE COMPLETE BELOW
❑NEW C�NSTRUCTION �,tEPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL �v� o.rd7�� ��ZY� C 13� a u��a I FUEL
FLUE SIZE RETURI�T OPENINGS iNPUT OUTPUT
TYPE OF SYSTEM HEATING OR PC)WER PLANT PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑Steam Unfts and Fir eplaces Cannot Euc�•oach
QGravity ❑Hot Water into Requfred Side Yarc1 Setbacics.
� Mechauical ❑Radiation Fireplaces tivitl� Box Acldit[ons or
ir Condifioning ❑Special Devices Caatilevers fo ti;e Outside of Buildings
❑Vent. System ❑Other Devices Require a Build'rng Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
tndustrial, Coininercial & Mutti Fa�nily 1% of job cast Residetstial, Gas Fireptxce $49,50
�49.50 miniim�m
ResidenEial, Heating & A!C (ATe�v Cons#ittction) $149.50 Residenfiai, Additions & Alterations $49.SQ
Residential, Heati�tg On1y (Ne�� Constructio��) $54.50 Residec�tial, AC Only $49.50
Cost � � -C/• �v � Bttitding Per�nit#
HEATiNG PERMIT FEE $
STATE SURCHARGE $ S.�
TOTAL PERMIT F�E $� �i. O :
Tt�is Appiication SecorrEes Yow� Building Permit When Appraved Paid r� Receipr No. � 9�
�7
Date �, j�� f�� By
Building O€ficial Date H /X-�
24 hour natice far aA inspections (952) 4�7-9850
4646 Dalcata Street S.E., Prior Lake, Minnesota 55372