HomeMy WebLinkAboutMechnical Permit 16-681 DATE TIME
CITYINSPECTION OF PRIOR LANOTICEKE SCHEDULED U 2IC-
ADDRESS
ADDRESS
OWNER CONTR.
PHONE NO. PERMIT NO.
❑ PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDGATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP
❑ FR0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL '9O GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS:
:
'a SATISFACTORY,PROCEED
• RRECT ACTION AND PROCEED
❑ CORRECT W RK,CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
eR/04),e7 C` 5DlSD !lf/rl/ O CITY OF PRIORLAKE f ++`�" l��Q 2Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
r*N E 5O�F'
'. re'
Fe PERMIT NO.
2. Yello City //; 6 G-
(Pleasetype orprint and sign3. Yellow Applicant ({J �/
at bottom)
ADDRESS
5--- r. , e_a_Adj SEZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID 7/
OWNER1-61/4"--
(Name) ��. 1A- LCA q.5"-g--
yycc�� fJ L/
(Phone)64e,
7Jo�^�'3/ � /���(Address) 57 3 G. C. / Z- �" �6 / o I / N .. Z�
APPLICANT ae/i
(Name) Z—4G"--) (Phone) 7��_7j 7-70z767
� /' Phone /J c,P/
(Address) (9 t-ft- )L 13 w /3 urns V 1( k MA/ 5 Y5 7
( dress) (City) (Zip Code)
(Contact Person) �j G C�
i 0 (� Gt.n ���(Phone) / -7 -2" l0
`"'�
APPLICANT SIGNATURE ' 66L'ti "- DATE -13--/
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION `REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air Plants PLEASE NOTE: Air Conditioner
❑Gravity ❑ Steam
❑Hot Water Units and Fireplaces Cannot Encroach
❑Mechanical
by
.e into Required Side Yard Setbacks.
>tclr Conditioning 0 ion
Fireplaces with Box Additions or
(aSG/ Jy Special❑ Devices P
[Went.System 5 TOr? ❑Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Y 1%of job
Industrial,Commercial&Multi-Familcost Residential,Gas Fireplace $49.50
$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 #
HEATING PERMIT FEE $
STATE SURCHARGE $ 1.00
(Office Use Only) TOTAL PERMIT FEE $ ,97S—C)
This Application Becomes Your Building Permit When Approved Paid '
"ecei o. I
Building Official Date Date JUN 2 2 2016y
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 -