HomeMy WebLinkAboutHeating Permit #13-1053 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED Z\24‘,
ADDRESS arZ
OI i �-- --
OWNER CONTR.
PHONE NO. PERMIT NO. / 3 . I U S t 3
❑ 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 FINALASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL
COMMENTS:
K.
,WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: e_cOwner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
msNon
PRIp CITY OF PRIOR LAKE Date Rec'd
O u ;r:,_r,1,,:4.
e HEATING/AIR CONDITIONING/FIREPLACE PERMIT
41lavlvEse 2.Gre1.Pinken PCitiley /PERMIT NO j3 -10. 3
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office Use)
9.17 7 Sr-1n7 I 411. fay ) a Nor LSI , m,0 S5-3 )L
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER I�
(Name) -10e--1 4 V a(4._._j LR (_ker- (Phone) 12 ) YP►/_ d 9' t •
(Address) 2 9 7 1 S f(4 LiAtt Pi SW i P i^Li k!, 4T 41 5573,7 L
APPLICANT
(Name) Me- 'fire p l u t:--- (-U.yS (Phone)
(Address) (SO \4e_ Ave_ 0 It-I Octidede theif 5 57 2
(Address) (City) (Zip Code)
(Contact Person) t.4 .t. A J. - (Phone) (4,f Z) 32E "12L') _
APPLICANT SIGNATURE AMR.. R. DATE / /i k/i_3
APPLICANT PLEASE COMPLETE BELOW
:NEW CONSTRUCTION E 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 ❑Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water
0 Mechanical ❑Radiation into Required Side Yard Setbacks.
❑Air Conditioning ❑Special Devices Fireplaces with Box Additions or
Y Vent.System Cantilevers to the Outside of Buildings
® y ❑Other Devices g
Require a Building Permit.
FIREPLACE MAKE AND MODEL 1-•\e a tJ G 1 a__G-ro a .T 45" T i tS.e14
FEE SCHEDULE
Industrial,Commercial&Multi-Family I%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 $49.50
Estimated Cost$ Building Permit #
The Minnesota Statutes§3268.148
HEATING PERMIT FEE $ n q. so "SL RC€-IARGE"has been changed i i'one
4 year effective
STATE SURCHARGE $ 5. CO .V- July 1,2010,until June 30,2011.
TOTAL PERMIT FEE $ j / ,5-0 The minimum surcharge for a"filed fee"permit
(Office Use Only) is:SS,beginning July 1,2010
This Application Becomes Your Building Permit When Approved Paid l�-,/ ! Receipt No. g a ��
Date 9 2_
Building Official Date 43 By2-2
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372