HomeMy WebLinkAboutF/P Permit 04-0508
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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CONTR.
PERMIT NO.
4 ~s-C)r
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATERHOOKUP@"IREPLACERI
o SEWER HOOKUP , FIREPLACE FINAL
o PLUMBING FINAL ." /, GASLlNE AIR TST
o MECH FINAL If
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~RK' C L REINSPECTION BEFORE COVERING
Inspector: -/J Owner/Contr:
CALL 447-985 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTJ
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. Pink
2. Green
3. Yellow
~!~ . PERMIT NOj)IJ~ ~O)j'
Applicant if!
(Please type or print and si~ at bottom)
ADDRESS
/9138 foI25'17>% (2i)
ZONING (office use)
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LEGAL DESCRIPTIO:N (pffice u~ 9p1~y./fj. .
I~f lip e;A fV "r-c-, .
LOT BLOCK ADDITION
Ii
(Phone) <f5l -'1'1.; - <j 1~7
(Address)
(Address)
(Phone) q\ l- 870 -u") ) t:J
/3 I i/t ("(,,e ;tvJ . 53'1 J 7
(City) J (Zip Code)
Cj':;2 -B'iJ .' 07 )fJ
571-'1;;7
(Address)
] B"SD
(Contact Person)
- /) (~1/~:...91 (Phone)
U.~ /fir- .~ DATE
lPPLICANT PLEA~ COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
~ll
.APPLICANT SIGNATURE
TYPE OF SYSTEM
HEATING OR POWER PLANT
OWarm Air Plants 0 Steam
DGravity D Hot Water
o Mechanical 0 Radiation
DAir Conditioning D Special Devices
OVent. System 0 Other Devices
, FIREPLACE MAKE AND MODEL J1ekf- ~ ...Gw - Fjl,- l$lltV.i}) - 4D .000oN'-,
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$gt/~
$ .50
$ tI()/
Estimated Cost $
'ice Use Only)
This Application Becomes Your Building Permit When Approved Paid Lf(),"----
Date ,Daty-". f} / -/V J
Building Official ~ & ~ ~I
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
Recei~0f 3~
By
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