HomeMy WebLinkAboutHeating Permit 15-0165 CITY OF PRIOR LAKE DATE
INSPECTION NOTICE TIME
SCHEDULED 2 l y
ADDRESS i-/ S-
/9'zflrL 7'. ;-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
❑ FOOTING
❑ FOUNDATION
0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FRAMING 0 MECH RI
0 COMPLAINT
0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION
❑ FINAL 0 SEWER HOOKUP
0 PLUMBING FINAL ❑ FIREPLACE FINAL
❑ SITE INSPECTION �'GASLINE AIR TST
��K MECH FINAL 0
ll�
COMMENTS:
WORK SATISFACTORY,PROCEED NN
❑ CORRECT ACTION AND PROCEED
0 CORRECT W ,CALL FOR REINSPECTION BEFORE COVERING
Inspector.
Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
WSNorr �'
PRr04. CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT 2. 2315
U tr1
2
1.PGreeink n FC PERMIT NO./J.r /(,S
NNEsoC . ty
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
331y $ycc..ntoee T I SW
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER ,---,
/fa c . go it, 01 (Phone) ? .3 -3 A oCy.S
(Address) J3 ZK SicCouto/e Th( StAi
,APPLICANT
(Name) /77/4P/c n i ,tc a (Phone) 9.s2- Y69- $3 c//
(Address) /Was- /lui7,ie d /3/0e Ake ,
(Contact Person) , tc4e.l(C (Phone) 1.172- 2(C7-e3c( I
APPLICANT SIGNATURE —� DATE 2.23-/.$
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION 0 REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
❑Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water into Required Side Yard Setbacks.
❑Mechanical 0 Radiation Fireplaces with Box Additions or'.
El Air Conditioning 0 Special Devices Cantilevers to the Outside of Buildings
0 Vent. System 0 Other Devices
LAY� 'equire a Building Permit.
Eassiatiltalggomciewitsomman r� I ♦7^4
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 � ,i$ No. /5 �
Building Official Date Date 2_, Z3 `S B
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372