HomeMy WebLinkAboutHeating Permit 15-0047 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED 3.4E_
ADDRESS \—I L\ \ ,r
OWNER CONTR.
PHONE NO. PERMIT NO. L4 1
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❑ FOOTING 0 PLUMBING RI
0 CA
ILLING❑ FOUNDATION 0MECH RI ❑ COMPLAINT❑ FRAMING
0 WATER HOOKUP OKU
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❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE RI
❑ FINAL 0 PLUMBING FINAL ❑ FIREPLACE FINAL
❑ SITE INSPECTION 0 MECH FINAL ❑ GASLINE AIR TST
COMMENTS: ,y.-,
OcatK SATISFACTORY,PROCEED
CORRECT ECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector.Calt, _______
Owner/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
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4 PRI°. CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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1.Pink File
a''NNESo°.* 2.Green city PERMIT NO. /5 ,47
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS 1.111 -ttr § Nye ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
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OWNER
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(Address) \-1L-MP MY6-0 V(Nt
APPLICANT y r
(Name) un (1�� �Cith n ouv GL_ 11'1 r (Phone) .QS t' L 31 " (7 I
(Address) j nn O`i )4.,\ � L [AA
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(Contact Person) CLkS S(.Q.,
(Phone)
APPLICANT SIGNATURE (AMA' `-Q(,0, DATE 121?i( i q
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION !i ' PLACEMENT, ITERATIONS
FURNACE MAKE AND MODEL V(I.(V I`} (V�� �� FUEL Nc . M
FLUE SIZE RETURN OPENINGS INPUT OUTPUT $ , •1
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
❑Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water into Required Side Yard Setbacks.
GI Mechanical ❑Radiation Fireplaces with Box Additions or
❑Air Conditioning ❑Special Devices Cantilevers to the Outside of Buildings
❑Vent. System ❑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 11=1111=11i Re ipt,E.
Building Official Date Date By
24 hour notice for all inspections (952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372