HomeMy WebLinkAboutF/P Permit 04-0873
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
TIME
'1-2&
ADDRESS I 'J.J.. 3(p ~e ~~
SCHEDULED
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:
t.f - 873
o EXIGRAD/FILLlNG
o COMPLAINT
o fJREPLACE RI
;2I'FIREPLACE FINAL
~ GASLlNE AIR TST
o
fI~~' ~
I J i)/IV
~/' //
/'
~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORREC,lflt:::l . CALL FOR REINSPECTION BEFORE COVERING
Inspector: r;f~. // Owner/Contr
CALL 447 -9~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~UIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTJ
~)
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
t, Zz O~
1. Pink File PERMIT NO
;: ~~:w ;~~icant · () + , (;) g 7 J
ADDITION JIl1 Ct'l,r ; /J SO tv! .Is Ie:<. )./ d
(3,c ~ e-ii-
t; cis ~ \ill{t~ V' ~I' V' cf P
APPLICA.NI \. (J ^ L' ']- I ~ l I _. .._
(Name) \-'\'Y'f)~ ~ L- ea..c... 1\ r aaf/Yl Q_ (Phone) _Qr;-';1- r-CJ'O-c) 7~g
3't"srJ /J).l-!wr.13 Bt1b1s-v/j/e.; >>1M 5"f73'??
t / (Address)~' (City) (Zip Code)
(Contact Person) t\.1f- - 1A-'7;/ -. (Phone) 9'.sb?~ HtJ-ozsll
APPLICANT SIGNATURE ~)I. i~ ~I DATE --1lt.&' .4V' /;~ 0(/
APPLI~T PL~ASE C~MPLETE BELOW "
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
ase type or print and sign at bottom)
rlDDRESS
/523 (0
Edap_fJ.JQ.1pV' ~t'l'c/~_
J
LEGAL DESCRIPTION (office use only)
LOT ~ BLOCK
OWNER
(Name)
:fiVl/\
(Phone)
(Address)
/5~ :3 Co
(Address)
TYPE OF SYSTEM
HEATING OR POWER PLANT
DWarm Air Plants 0 Steam
o Gravity 0 Hot Water
o Mechanical 0 Radiation
DAir Conditioning 0 Special Devices
DVent. System 0 Other Devices
FIREPLACE MAKE AND MODEL ~-f - 1)- 61 o-wJe I. 'SJ.l/N-,,~ )(7
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit # 0 ~I () i' 1':;
$ :::r 9, 5?)
$ .50
$ ~
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
"'his Application Becomes Your Building Permit When Approved
Paid ~~.
~. f/l}
Date r/ 1 A~
I.J' .Or
Building Official
Date
....
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
ZONING (office use)
PID 7,1:}. 057. tJo e. 0
q/}:).- t.jLj') - /1/ Jl/
, .
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Receipt No.
4777+-
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