HomeMy WebLinkAboutBuilding 16-0086 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED ANAL)
ADDRESS up p cq 5t k 01`
OWNER
CONTR.
PHONE NO. PERMIT NO. / (e
t7 FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION ❑ 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 711
COMMENTS: FUl.u, , Q..
cQ ooJ'loQyt 1(I\PS 4k-e 6
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❑ WORK SATISFACTORY,PROCEED
CORRECT TION AND PROCEED
0 CORRECT - , ALL FOR REINSPECTION BEFORE COVERIN
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Inspector. r Owner/Contr.
CALL 44 -' -' FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
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1
(c--s0R,170,\\ CITY OF PRIOR LAKE Date Rec'd
! � \i HEATING/AIR CONDITIONING/FIREPLACE PERM 2- C,
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6
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I.Pink File PERMIT NO. 1/_
2. Green City /T I aot�
3.Yellow Applicant r 4
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
/6 6./4 FJ2 c&pi k /i0 7-12. S i°i2/oli2 ia,
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID Z5'/ eVO ZO
OWNE(Name)R�J7 //n'J/7`€d Az-41,77'7'01 /f'C- (Phone) QS?) 2q2 -513. 2.
(Address) /66/4 FRa-i/L//it fit SuE /`"R/'r712 La/Le--
APPLICANT/0
A'/Le-
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(Name) T� g'd e2fr � GZC (Phone) 9'5Z Y 0 7 `Y O 3/
ame real a�i�'l�f' q
(Address) l37F1 1eMc/i2q !'/ f/l'e /r 19/2J02 lrde, ,,V/7 .�7�.3 -7Z
(/ (Address) (City) (Zip Code)
(Contact Person) 5-e,r/ ' (Phone) 45 Z - 11:174' - 0 3
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APPLICANT SIGNATURE gJ
� DATE 2 / / 6
(KANT ICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL ,Y A vy ENt�� OW...( � FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air PlantsPLEASE NOTE: Air Conditioner
D Steam Units and Fireplaces Cannot Encroach
Gravity
0 Hot Water
into Required Side Yard Setbacks.
Mechanical ['RadiationFire laces with Box Additions or
['Air Conditioning 0 Special Devices p
['Vent. System 0 Other Devices Cantilevers to the Outside of Buildings
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 $49.50
Estimated Cost$ l/ 6 70 Building Permit #
HEATING PERMIT FEE $ ( .. J O
STATE SURCHARGE $ 1 1.00
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 6-6 5z7 Receipt No. 4706 O
7
DateBy
Building Official Date 2S 'D'-.....---------
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372