HomeMy WebLinkAboutF/P Permit 04-1185
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS IS(009
lh I JA.<uf
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
DATE TIME
{~ 7:~
u~
o EXIGRADIFILLlNG
o COMPLAINT
~IREPLACE RI
FIREPLACE FINAL
~.$E AIR TST
o .
d< 1~
c~ _J4--flP
~- ...............-
· ALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
Date Rec'd
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
II.ZJo4-
~: ~e~n ~::y. I PERMIT NO. A4-" 1/~51
3. Yellow Apphcant . C/ .
Cf5) - t.jL/(j - ..f/l/30
#l !/-:S-.37
f; \ r q S I' C~ Q # ~a. (' f h rv- f-J IJ i11 (i - (Phone) CJ 5 'J. -?9' tf' -# 2~-g
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· , (Phone) Q5:J'?f-?tJ -{l7~-;;
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.~ type or print and ~t bottD~
JDRESS
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LEGAL DESCRIPTION (office use only)
LOT
ADDITION
OWNER
(N ame)
(Address)
APPLICANT
(N ame)
(Address)
(Contact Person)
DATE
APPLICANT SIGNATURE
ZONING (office use)
~JLJ
PID 25. ')3:5. 061- 0
APPLICA T PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
..LJRNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
() 4-., lIeS-
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 3 7. J'1J
$ .50
$ 4(/... t/lJ
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid~
7'(/ ...--VV
Dat71'. .LJ _ ,,' f-
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
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OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
-...zp:z
$39.50
$39.50
$39.50
Receipt No. ?t-f"J t
By