HomeMy WebLinkAboutHEATING PERMIT 16-0979 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED '
ADDRESS JJL�i� f Cs
OWNER CONTR.
PHONE NO. PERMIT NO. /C4, ��l"7 ci
❑ 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 N'GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL ❑
COMMENTS: 1-1�(tl
1 WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: CSCUe; Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
�� PRIp�
CITY OF PRIOR LADate Rec'd
, HEATING/AIR CONDITIONING/FIREKEPLACE PERMIT `�
err `---��, 0 `
ArNE$0
I. Pink Fit PERMIT NO.I l r t
2. Green City
3. Yellow Applicant
ase type or print and sign at bottom)
DRESSZONING(office use)
357 curet-Qi r , s uo Poor- Line. Ail 53-37?—
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER /")L , / I �r� / ,`
(Name) C� r 15 1/'� AP {- L (/✓t t^ (Phone) �v(--" 7W_eo
(Address) 357g 77/cn.P f Or. 3--,,,j eft 6 r to kP //V 053??
l
APPLICANT J S d 261_ 7,./0
,.0 r 00 71
(Name) C 1 f'1--' ►� �- v (Phone) _� `7
(Address) 76 -TV/4 pf. Slit_J A I° 1 La k S-S---3 7d"_
(Address) (City) (Zip Code)
(Contact Person) 4 it. ( V _m. (Phone) 79/ - o'0. I
APPLICANT SIGNATURE ....illig DATE I 4%241' ,.
A' ' . . ASE COMPLETE BELOW
ENEW CONSTRUCTION ❑REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL �.ez,AUC- V b op 6O FUEL C-). 1q p
FLUE SIZE T " RETURN OPENINGS INPUT OUTPUT go &(,J
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air PlantsPLEASE NOTE: Air Conditioner
0 Steam Units and Fire laces Cannot Encroach
❑Gravity ❑Hot Water p
0 Mechanical ❑Radiation into Required Side Yard Setbacks.
DAir Conditioning 5k/Special Devices Fireplaces with Box Additions or
❑Vent. Systemther Devices (Way. Preath' 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 $49.50
Estimated Cost$ Building Permit #
HEATING PERMIT FEE $ 4'9.co
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $ S( , .co
(Office Use Only)
If
This Application Becomes Your Building Permit When Approved Paid 6--?)/ j Receipt No. G ?Z Z
Date ' l( 76, Bylial
Building Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372