HomeMy WebLinkAboutHeting Permit 16-175 CITY OF PRIOR LAKE DATE
INSPECTION NOTICE TIME
SCHEDULED 3�r ��
ADDRESS •Cv` tY . I
OWNER
CONTR.
PHONE NO.
PERMIT NO.
❑ FOOTING ❑ PLUMBING RI
❑ FOUNDATION ❑ EX/GRAD/FILLING
❑ FRAMING ❑ MECH RI
0 COMPLAINT
0 INSULATION 0 WATER HOOKUP
0 SEWER HOOKUP 0 FIREPLACE I
F0 FIREPLACE NAL
❑ FINAL
0 PLUMBING FINAL
❑ SITE INSPECTION 0 MECH FINAL r'ASLINE AIR TST
COMMENTS:
WORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
0 CORRECT ,CALL FOR REINSPECTION BEFORE COVERING
Inspector: j
Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH SAFETY!
iNsnorr
o.. PR1p4 CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT 'T./6
,
U rrT1
t.Pink Fite PERMIT NO. !6 �.7�-
'�rNNeso'0P 2.Green City
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS / (office use)
/W X /-� 4 L1& 7I-). S,�
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER n /
(Name) e... &) e-�S OA) (Phone) G l 2-32 7- 1(O P
(Address)
APPLICAN '
(Name) r) b J c /1 .. ,in 2. (Phone) SS�— 94 � 11 0
(Address) /L�s>y P 4k B,' (
R i - f-`6' io, 537
(Contact Person) a,, n re--teNc-t i (Phone)
APPLICANT SIGNATURE ' - '/ ' i DATE 3-8.7a24016
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION PL CE ENT ❑ALTERATIONS OF
MAKE AND MODEL »1 `c FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
eacTarm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
0 Gravity 0 Hot Water into Required Side Yard Setbacks.
❑Mechanical ❑Radiation Fireplaces with Box Additions or
❑Air Conditioning 0 Special Devices Cantilevers to the Outside of Buildings
0 Vent. 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 $49.50
Cost$ Building Permit#
HEATING PERMIT FEE $
STATE SURCHARGE $ 3.00
TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid 5-0 Receipt No.11 3
Building Official Date Date _ a_ /4 By ��1�/J/
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372