HomeMy WebLinkAboutHEATING PERMIT 16-1344 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED a 2-
ADDRESS f �I WL I24 ' '��
OWNER CONTR. u
PHONE NO. PERMIT NO. /G 3
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL 0 ,GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL _
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COMMENTS:
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❑ WORK SATISFACTORY,PROCEED
CORRECT ACTION AND PROCEED
❑ CORRECT W K,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
04 PRrp� CITY OF PRIOR LAKE Date Rec'd
H e HEATING/AIR CONDITIONING/FIREPLACE PERMIT
INiVEso�/ I. ,ink pile ��- /3
2Green City PERMIT NO. 4 ///
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3. Yellow Applicant /
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
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LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
O((NaWNER (� 3k\ S1. v C rr, 0-N14 n < Q 1'N (Phone) Q -5 S ( -- J a
(Address) \ 4 ci, 9 S , . y C. ' L 5C4
APPLICANT I
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(Name) L 6,r-, CT, �V rT, ti r rl1G. (Phone) 1 `4J 9%--7-%1 \-1
(Address) \ w V 4 C` L OV1-4 't,N) Q. Q t- -1 ur' L–V1L. S. 5 3'
(Address) (City) (Zip Code)
(Contact Person) \ VL\J (Phone)Ct c. <'' kA.1-(�O t q
APPLICANT SIGNATURE\j DATE \\– 14\--
APPLICANT PLEASE COMPLETE BELOW
['NEW CONSTRUCTION REPLACEMENT El ALTERATIONS
FURNACE MAKE AND MODEL S� h"1 J,1 s A 0 ab() S l y FUEL IN 4-
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air Plants PLEASE NOTE: Air Conditioner
❑Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water
El Mechanical El Radiation into Required Side Yard Setbacks.
['Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
❑Vent. System EI 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 $49.50
-.2ost$ Building Permit #
The M § 6B.148
"SURCinnesotaHARGE"Statutes has been extended32HEATING PERMIT FEE $ ��
until June 30,2013, STATE SURCHARGE $ I .90
The minimum surcharge for a
"fixed fee"permit is$5.00 TOTAL PERMIT FEE $ S O.S5
This Application Becomes Your Building Permit When Approved Paid 5v 5-6 Receipt No. /204—
Building Official Date Date ji fig-!G By ,t /
t.s
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372