HomeMy WebLinkAboutHeating Permit 10-1092 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 4.17/G�i
ADDRESS (01 C`0 DQ nese S ,.
OWNER CONTR.
PHONE NO. PERMIT NO. t 0 — /D
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 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 0
COMMENTS: gap- Q r
eL5e V,e_ 1-tc9......-
WORK SATISFACTORY,PROCEED
❑ CORRE ION AND PROCEED
❑ CORR . CALL FOR REINSPECTION BEFORE COVERING
Inspecto ' Owner/Contr:
CALL • -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
1
P-11,1,0,0 OF PRIOR LAKE Date Rec'd
`, th: HEATING/AIR CONDITIONING/FIREPLACE PERMIT
ti I Y
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1.Pink File
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2.Green City I PERMIT NO. /(2 /0
(Please type or B bottom) 3.Yellow Applicant / , p.......
print and si a at
ADDRESS
io Oe ZONING(office use)
6ricea, S,_ 51-- i E
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
•
OWNE
((Name)R 3L\\l e ) `0 V>r\ (Phone) /SZ —Cog I -3 i :
t.-� (''� Phone2,
(Address) 1 qb Oein est St- N E
(Name)APPLI �� �A.P C���i J�� 17��E2, lam'n� 2.� .�iJ(:,)
(Phone) 65-67) 3 g H— 776 /
(Address) i�7(oO A—cofn 1r .1 1:4f i 1c...I t
(Address) (City) (Zip Code
(Contact Person) o c r
only- *.... _ (Phone)(.6-612) 313— //3f
APPLICANT SIGNATURE DATE ll /S /fiZ=''
allIllw-
APPLICANT PLEASE COMPLETE BELOW
['NEW CONSTRUCTION rigIlEPLACEMENT ❑ALTERATIONS
•
FURNACE MAKE AND MODEL(('s C_( Si?MSL 8 SG - iti FUEL HR
FLUE SIZE PVC-- RETURN OPENINGS INPUT gO1C OUTPUT '7(g>vvaZI
TYPE OF SYSTEM HEATING OR POWER PLANT
Y Warm Air Plants ❑Steam PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water
4
Mechanical into Required Side Yard Setbacks.
❑Radiation
Air Conditioning
El Special Devices Fireplaces with Box Additions or
Vent.System ❑Other Devices Cantilevers to the Outside of Buildings
FIREPLACE MAKE AND MODEL Require a Building Permit.
FEE SCHEDULE
Industrial,Commercial&Multi-Family I%of job cost Residential,Gas Fireplace $49.50
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$49.50 minimum
Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations
Residential,Heating Only(New Construction) $64.50 $49.50
Residential,AC Only $49.50
Estimated Cost$ Building Permit #
The Minnesota Statutes§32613.148
HEATING PERMIT FEE $ "SURCFIARGF,"has been changed for one
STATE SURCHARGE year effective
$ .50 July 1,2010,until June 30,2011.
TOTAL PERMIT FEE $ The minimum surcharge for a"fixed fee"permit
(Office Use Only) is f+5,beginning July 1.2019
This Application Becomes Your Building Permit When Approved Paid /s---0Rei- No.
Building Official Date
Date Ll-ziZ,to
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24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372