HomeMy WebLinkAboutHeating Permit #04-0843
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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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
~ll:;vrt FINAL
or'-?r3
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: , .-' ./ /
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~ORKSATISFACTORY, PROC~ED ..
~~'~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspeelor. ~ Owner/Contr.
CALL 44~9850 F~THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
CITY OF PRIOR LAKE
HEATING/AIR CONDIIIONING/FIREPLACE PERMIT
Date Rec'd
8. /1,,() f-
1. Pink File PERMIT NO
2. Green City · 0+... aD ~_:;:.
3. Yellow Applicant O~J
ase type or print and sign at bottom)
r\.DDRESS tIC 4A,?
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LEGAL DESCRIPTION (office use only)
LOT I&BLOCK / ADDITION S77J/UI1S
1ST
OWNER
(Name)
(Address)
~;;~~Af;().~el /!t#1!k. J-f~ri)/!Jt:tr J 1d1C
(Address) /~ 1]0 0.' ~ 11l~ 5 ,
, ~~ess) ,
(Contact Person) fl.!! fJ 'J (Jf5 rAY' _
APPLICANT SIGNATURE !JL/VVI:..., \ Jh !'\._"
ZONING (office use)
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PID 25:" z,z, q () 18....0
(Phone)
(Phone)
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1 J P f ^
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(City)
(Zip Code)
(Phone)
DATE
, ,
2 /)7/(J~
APPLICANT PLI\A~ COMPLETE BELOW
.- ~ . DNEW CONSTRUCT,IO-ZN 'REPLACEMENT 0 AL TERA TIONS
~RNAC~KE AND MODEL ~ r.J: Y"' ..I FUEL
FLUE SIZE RETURN OPE GS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Building Permit # (J ~; 0 s q
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Beating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
"'his Application Becomes Your Building Permit When Approved
Building Official
Date
$39.50
$39.50
$39.50
$
$
$
3 ~. 5lJ
.50
40- () 0
Paid ~
,u,f/V
Date
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Receipt NO./71S' /-
By
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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