HomeMy WebLinkAboutHEATING PERMIT 16-1297 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS Z e ,IJOA/h- C.D-
OWNER CONTR.
PHONE NO. PERMIT NO.
❑ FOOTING 0 PLUMBING RI 0 EX!GRADIFILLING
❑ FOUNDATION
0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
FINAL
0 PLUMBING FINAL \9/GASLINE AIR TST
❑
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS:
❑ WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
PRI
�p� �'�'� CITY O P 6'LORI ,AKE Date Rec'd
HEATING/AIRC�NDIT ONII1�/FI " E ''LACE PE IT
U ti]
INNEs0;
1. FilePink
Green CittPERMIT NO. /4 1
2. y /2_ 7 9 /
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
11 G0i1citexnec, Q,--t- 3t_-
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER ---I
(Name) ro,o\ QQ (Phone) (91 a- -3, 9 - osaz7
(Address) 1 0)0 UL) I OCX c c--n
Mame)CANT n V`in._c 7C 1 C C- X SIN-ej (Phone) a U D - `T n " I g
(Address) 1-1c6(4a,6 �`10.� CCS- - 6 . CN �f` JJ'
((tress) (City)
r 2 p((Ziip Code)
(Contact Person) �r�C� �5 D�� ) (Phone) (-�J)-9 b5- I a - •
APPLICANT SIGNATUI C y i BilAti. DATE 1 0 la---/ (i
U
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
PLEASE NOTE: Air Conditioner
❑Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
['Gravity ❑Hot Water into Required Side Yard Setbacks.
❑Mechanical ❑Radiation Fireplaces with Box Additions or
❑Air Conditioning 0 Special Devices
❑Vent.System 11.Other DevicesCantilevers to the Outside of Buildings
O y� � Require a Building Permit.
FIREPLACE MAKE AND MODEL e
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,, n#
HEATING PERMIT FEE S `-C l .
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $ 6x.)•C
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid .J�.f X511 Re ipt No.� ? V �} _
Date k, t,t J(u By �X
Building Official Date tt V� "
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 A tr�.0