HomeMy WebLinkAboutHEATING PERMIT 16-1380 PRLA
TI
IOR NOTICEKE DATE
SCHEDULED �, TIME
ADDRESS ` S- y
4i"I
OWNER � .�
CONTR.
PHONE NO. PERMIT NO.
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❑ FOOTING 0 PLUMBING RI
❑ FOUNDATION 0 MECH RI ❑ EX/GRAD/FILLING
❑ FRAMING 0 WATER HOOKUP 0 COMPLAINT
❑ INSULATION 0 SEWER HOOKUP FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL 'FIREPLACE
❑ SITE INSPECTION 0 MECH FINAL �GASLINE AIR TST
COMMENTS:
I .
p.-
4,-(WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contra
CALL 447_9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY.
INSNOTI
( '7\��
\ CITY OF PRIOR LAKE Date Recd
,:),.'.'(6/ HEATING/AIR CONDITIONING/FIREPLACE PERMIT //� Z j` /,
*ikiktESof
1.Pink Filc PERMIT NO. go
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2.Gwen City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
SS/W.-) IOS), t'fbY'Ntovt LArc-1e. , ?rl or L c<1-e
LEGAL
�DESCRIPTION(office use only) Q J
LOT ( BLOCK ADDITION 54 i7//e/ C/ l PID /4r o16' ` D
OWNER `
(Name) J )S \ N+sSS-e--V \ (Phone) 32() `S%3-42-9 tO
(Address) 5 1-. -G LO `- 170,(1 C“OR Yinv Late--
i
APPLICANT
(Name) *Ot\t `V4- 5L-Vr2.YY\S (Phone) Lc2f ( -437-(3 3'S
(Address) t 2-2- v.J 3 r! S4- {aSt\AGE S ri M 550 3 3
(Address) (City) (Zip Code)
(Contact Person) N l CU\.,, rr YCZ�•-L (Phone) �S(- 4 3l "0 33g
`tel
APPLICANT SIGNATURE �� X... DATE l l- 1 I - 1 (Q
APPLICANT PLEASE COMPLETE BELOW
['NEW CONSTRUCTION 0 REPLACEMENT D 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 0 Hot Water into Required Side Yard Setbacks.
❑Mechanical 0 Radiation Fireplaces with Box Additions or
❑Air Conditioning ❑Special Devices
:Went.System 0 Other Devices Cantilevers to the Outside of Buildings
t �� I ,,� Require a Building Permit.
FIREPLACE MAKE AND MODEL M^i`ANA-Otb I-teCt r 3O\?
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 $49.50
Estimated Cost$ 4 0 00 Building Permit #
HEATING PERMIT FEE $ 1 , 5 0
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $ S O . 5 0
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid56,�� Receipt No. z7,--,', J
Date� I• Z;- I� By CD
Building Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372