HomeMy WebLinkAboutHEATING PERMIT 16-1286 CITY LAKE DATE TIMEIINSPECTIONOFPRIOR NOTICE SCHEDULED
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ADDRESS G C ''
OWNER CONTR.
PHONE NO. PERMIT NO.
❑ FOOTING 0 PLUMBING RI
❑ FOUNDATION 0 MECH RI ❑ COMPA
❑ FRAMING 0 WATER HOOKUP 0 COMPLAI FILLING
NT
I
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FRI
❑ FINAL ❑ FIREPLACE FI
❑ SITE INSPECTION 0 PLUMBING FINAL ❑ GASLINE AIR TST
0 MECH FINAL 0
COMMENT'
C. e.
WORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
❑ CORRECT 'IRK,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
�� PRIp�N-;,-, CITY OF PRIOR LAKE Date Rec'd
1 IREPLACE PERMIT
° HEATING/AIR CONDITIONING/FIREPLACE
21. Pinken FileityI PERMIT NO.�6 � (/
33 61
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3. Yellow Applicant
(Please type or print and sign at bottom) ZONING(office use)
ADDRESS
2q i3 ereeNe, R I VC'
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER ^ U`�^ ;� -52_01
(Name) D-Q,h\ 9 C?f ZV� (Phone)J
(Address) q el b f ce ).e' Q.. `Vd c rk a i L(l-.G 1 IAN) 5 3-1 2
APPLIC 1 C) CQ O
(Name) C3Cib`k.- COm (k MCC hainl-c� rj i l (Phone) (.0 b
3
(do(V- ,14.(-�- i�l� X5123
(Address) Q V ' " / (Zip Code )
(Address) (City)
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G '1 0-v Ce O-22(Contact Person) Al \, 5V/\ U v( (kC (Phone) �D
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APPLICANT SIGNATURE (2,61//�.•,. (i(.11-/g1.4— DATE /0— -I P
APPLICANT PLEASE COMPLETE BELOW
ANEW CONSTRUCTION REPLACEMENT 0 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.
0 Mechanical ❑ Radiation Fireplaces with Box Additions or
`KVu•Conditioning 0 Special Devices Cantilevers to the Outside of Buildings
ent.System 0 Other Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE $49.50
Industrial,Commercial&Multi-Family 1%,of job cost Residential,Gas Fireplace
$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 $
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $
(Office l se Only)
This Application Becomes Your Building Permit When Approved Paid np ,n) Re ipt Nol 3 ! 0
Date Y�, (� B
Building Official Date `� `
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 t O