HomeMy WebLinkAboutHeating Permit 10-0962 CITY OF PRIOR LAKE
INSPECTION NOTICE DATE TIME
SCHEDULED 2- 7-2--
ADDRESS 4/47
'
OWNER ///•1` ��
CONTR.
PHONE NO,
PERMIT NO. 40` �/
❑ FOOTING FJ
C7 FOUNDATION 0 PLUMBING RI
❑ FRAMING
❑ WATER HOOKUP❑ MECH RI ❑ EX/GRAD/FILLING
❑ INSULATIONFRAMING
❑ COMPLAINT
❑ FINAL
CI SEWER HOOKUP ❑ FIREPLACE RI
0 SITE INSPECTION 0 PLUMBING FINAL ❑ FIREPLACE FINAL
O MECH FINAL 0 GASLINE AIR TST
COMMENTS:
illiallillenlilillialf
1,11 011110,11a
1 at ran v/moi
❑ WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT, •RK,CALL FOR REINSPECTION BEFORE COVERING
Inse /�
p ctor
' OwnerIContr.
CALL 44 •:50 F•R THE NEXT INSPECTION 24 HOU
CODERS RS IN ADVANCE.
QUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY,
INSNOTI
C
RIo�P CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
4 ,.PinkFlePERMIT NO. !a` q6. 21,
VESD�A 2.Green City
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
kl1LS 0 0(\ f1� ` v\i. M j
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(Name)R \k r h \. G\r . ' \ 6 (N— G, (Phone) q S .1--'40 ".t ` q
(Address) —1 I k , C C> C L V. 0l ki."‘ L r N
APPLICANT ---
^ 1— (Phone) C-1-S _\All \/3,
a�
(Name) r `�, L
D 0 \NIe\ L v 0--.K.. ,1 Q. ° C, 0 l(N\� s s" 's1 I
(Address) 1 la
(Address) (City) (Zip Code)
NI'
(Contact Person) CNI`N 1. -\ (Phone) cl 1-V1 u 1 ^ o t ay
APPLICANT SIGNATURE DATE \ O - \1^ I O
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION iNt REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL CS cm)
c v‘\ 3 S Z (- V O %4 0 FUEL Ni e
FLUE SIZE RETURN OPENINGS INPUT , 0 OUTPUT t or,
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
:Went.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 $49.50
Estimated Cost$ .1 S Building Permit #
HEATING PERMIT FEE $ ",
STATE SURCHARGE $ S ASO
TOTAL PERMIT FEE $ S y . S'3
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid Si/S 3 Recelio6(6 4,,
Date p, z.0 1 3 By
Building Official Date
`
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 /
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372