HomeMy WebLinkAboutHeating Permit 15-0104 DATE TIME
CITY OF PRIOR LAKE r
INSPECTION NOTICE SCHEDULED 2
ADDRESS 3 a (Scs`,^`1-`c
OWNER CONTR.
PHONE NO. PERMIT NO. f 5 . 1011
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL Dek r_
COMMENTS:
ti
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector. CCOwner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
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of rxro4, CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT Z,Z it5
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1.Pink File
'�IivNEso'°P PERMIT NO.
2.Green City /5 r04 .
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
3 "; `t ' vL4 S S (
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER.,---‘
(Name) \O v‘!` Q h (Phone) �S ,)-33�- <�
(Address) _5* -2, 1g CS U 11., -.1) S k S`L
APPLICA
(Name) -A-1"o V\>' 4-h L (Phone) ci-c-Z- ' fl -g I 'a
(Address) %y0 Q C\ lv.. . .� & Q c., 4,v �,4
(Contact Person) (,,Nr\ `/ r l �,-�,�, (Phone) 9 a.N Y1'1),_ r----
APPLICANT SIGNATURE jk4 \ DATE ( ' 3, is-
,
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ,]REPLACEMENT ❑ALTERATION
FURNACE MAKE AND MODEL C)'\)tom^'* � 'S1) •17.0 k) �I t 11 FUEL 1 " C
FLUE SIZE-" RETURN OPENINGS INPUT 64 1 t CfJ OUTPUTS
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
❑Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water into Required Side Yard Setbacks.
❑Mechanical 0 Radiation Fireplaces with Box Additions or
, Air Conditioning 0 Special Devices Cantilevers to the Outside of Buildings
❑Vent. System 0 Other Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial&Multi Family 1%of job cost Residential,Gas Fireplace $49.50
$49.50 minimum
Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations $49.50
Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50
Cost$ Building Permit#
HEATING PERMIT FEE $
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $
•
This Application Becomes Your Building Permit When Approved Paid 5 „� gp_ipt No. 5# 0
Date I.., 'Z ( E44
Building Official Date •
24 hour notice for all inspections(952)447-9850 0
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372