HomeMy WebLinkAbout04-0934 Fireplace Permit
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CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ~ V~
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ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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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
o EXIGRADIFILLING
o COMPLAINT
~ r-.REPLACE RI
~PLACE FINAL
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40RK SATISFACTORY, PROCEED
~ ~ORRECT ACTION AND PROCEED
o CORRECT ~C;:~;)10R REINSPECTION BEFORE COVERING
Inspector: //? f Owner/Contr:
~ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
INSNOTJ
CITY OF PRIOR LAKE
hEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
q" 'S- vf4-
1. Pink File PERMIT NO
2. Green City .AA - ~ 0 q ~ A -
3. Yellow Applicant ~. ~
151"
~=R Pn.'1V'\'C I... d.-;j cJu {;-CU1l1..Q.J4 (Phone) 9.5J---l/(js:-~.?
4!1D9 l/1arilh~a[~ __\'f,J1/i5.
APPLICANT,-, ,/J f / t L ~/.L/ _ 0'lY/1 /"'}~Ll?
(Name) --\V'fJSJ~~ ljl:>Clf: rJ -'-17VJIt1~ (Phone)-Y?a-O-Zl/-c"//..JQ-
(Address) -:S8-~O {)j, If:lf8 Jk"./2 (5UY'Y6"t/I'JIel)n/tJ, ~~33/
(Address) f-.IJ4L-::Y (City) / (Zip Code)
(Contact Person) 1~ t+ ~~'2-.ev ~,~ (Phone) 9~ -?Cl{J-o ~5'11
APPLICANT SIGNATURE ~4f/U - ~' DATE Sr!fJ'lILff! 0 'I
r APPLICAK"PLEASE COMPLETE 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 si~ at bottom)
. ADDRESS
'-;1 tJ 9 f)1aY'1lk d-a Ie Sf ~ IV 6,
LEGAL DESCRIPTION (office use only)
LOT " BLOCK 7- ADDITION J111)I
(Address)
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL 1-1 ea.1-flJ-crlo rwJ.J II" m-J;JJJr~S'e.c+
(,
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
Building Permit # tJ~~ 0 'lJ4-'
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMI. FEE
$
$
$
j 9. 50
#J" f/l)
.50
(Office Use Only)
l'his Application Becomes Your Building Permit When Approved
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Dat'l.I('...O~
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 z.r.. 07l,.. 0 z,3" D
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39,50
$39.50
Recei~ No. 41Plftl
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