HomeMy WebLinkAboutHeating Permit 12-0733 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED Z,_. �e()L
ADDRESS /1-1/r. - t `-��K•
7�
OWNER CONTR.
PHONE NO. PERMIT NO. l Z-
0
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI
❑ FRAMING 0 WATER HOOKUP 0 COMPLAINT
0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUPFI
❑ FINAL 0FIREPLACE FINAL
❑ FININSPECTION 0 PLUMBING FINAL Q GASLINE AIR TST
0 MECH FINAL
COMMENTS: 1
h - A
WORK SATISFACTORY,PROCEED
❑ CO RECT ACTION AND PROCEED
❑ CORRECT WO K,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!
/NSNOT!
( pRiO CITY OF PRIOR LAKE Date Rec'd
(„4
' � HEATING/AIR CONDITIONING/FIREPLACE PERMIT
"30.b r33ct:)--i5o 45`A, 5c)
x_.
ilfiNNEs��P I. Pink File PERMIT NO. ,
3. 'Gt. City /�� ��+z (
3. Yellow Applicant L ,�
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
I LI k r ( ',3 ` :
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER: . t
(Name) `� (. '--A. ' t'` A- _-( c,,` 12..x..t , <'i it'", (Phone) J). 111--00-- t I.
I.(Address) !ti 15 soi -T."` fl Y (.0.A44... l`-'1 /
APPLICT t
(Name) . '" 1'� (Phone) l.. i- t�.. - Li1�
b5033S
(Address) h��� � �'..
" ( .1iV��. � ' \''' T\� `�'���t�
(Address) (City''� (Zip Code)
(Contact Person) I _. ,1.) (Phone) k..t "l "t"' L Lin
if
APPLICANT SIGNATURE , _ • `..._...� . —.. DATE (*Jr ill r
III APPLICANT PLEA E COMPLETE BELOW
['NEW CONSTRUCTION . REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL V3 FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
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.
Mechanical ['Radiation
u Conditioning ❑ Special Devices Fireplaces with Box Additions or
❑ ent.System El 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 1 `' ,` 0
$49.50 minimum
Residential,Heating&AIC(New Construction) $149.50 Residential,Additions&Alterations ltj$•
Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50
' Estimated Cost$ 4C1Building Permit #
HEATING PERMIT FEE $
STATE SURCHARGE $ . ("k..)
)041.
TOTAL PERMIT FEE $ SLI. )
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid I-z) Receipt No. di._
Date By
Buildin¢Official Date 7/41/2-
ie, i_ii.......,
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372