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HomeMy WebLinkAboutHEATING PERMIT 16-200 DAT TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED 3 1 ADDRESS 3 2 2llq OWNER CONTR. PHONE NO. PERMIT NO. ( p , U ❑ 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 FINAL yASLINE AIR TST ❑ SITE INSPECTION ❑ MECH FINAL COMMENTS: / A C.' b , {1-sc, Ci PiNORK SATISFACTORY,PROCEED �/❑ CORRECT ACTION AND PROCEED ❑ CORRECT K2,WOORK,CALL FOR REINSPECTION BEFORE COVERING Inspector. p��,. Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY! INSNOTI r~,z). PRI on 9 CITY OF PRIOR LAKE Date Recd i HEATING/AIR CONDITIONING/FIREPLACE PERMIT /r rAW E S° /1CJ 1. Gre File PERMIT NO. . Green City 3. Yellow Applicant I O003 (Please type or print and sign at bottom) ADDRESS ZONING(office use) 3& 8G Kerr+ 5-hre-e± / l 5� LEGAL DESCRIPTION(office use only) ,� /,, / LOT l BLOCK / ADDITION LY YW q/%3&7 '/� y d PID Z-- //l-®0(D -0 OWNER (Name) ?h i 1 t is W or rP_i t (Phone) C/59,- 1S a-317 l c) (Address) 3 a39 Ktsrt-1- Vv, Yl 0,r I.o_K2. N 55 31 a APPLICANT (Name) rrtrc 11-eA r (Phone) 15 V L{l p O Lo D a.a. 24 (Address) a.l a.1O C(�tDV Av'E W\U VVax ( - \ c M . N (Address) (City) (Zip Code) (Contact Person) \--ie-CL,tCX uAi,Vi to (Phone) APPLICANT SIGNATURE �2 i� i� DATE 3 -8-1(4; APPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION g REPLACEMENT ❑ALTERATIONS FURNACE MAKE AND MODEL ]�►� e_ X V:3 S FUEL NQ FLUE SIZE RETURN OPENINGS INPUT (CD,COO OUTPUT S TYPE OF SYSTEM HEATING OR POWER PLANT ❑Warm Air Plants Steam PLEASE NOTE: Air Conditioner ❑ Units and Fireplaces Cannot Encroach ❑Gravity 0 Hot Water Mechanical ❑Radiation into Required Side Yard Setbacks. ❑Air Conditioning 0 Special Devices Fireplaces with Box Additions or ❑Vent.System ❑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 $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 # HEATING PERMIT FEE $ L .S© STATE SURCHARGE $ 1.00 TOTAL PERMIT FEE $ So.Sp (Office Use Only) This Application Becomes Your Building Permit When Approved Paid 50 O Receipt No. 00 it By 3 1 p ) Building Official Date Date 0 + c 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372