HomeMy WebLinkAboutHEATING PERMIT 16-0924 DATE TIME
CITY OF PRIOR LAKE SCHEDULED `s
INSPECTION NOTICE
�
1 C-, ,t--Q-L)
ADDRESS oC J 6-5 6 - ���
OWNER
CONTR.PHONE NO. / � �(�
PERMIT NO. L (�
0 PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOOTING 0 MECH RI 0 COMPLAINT
❑ FRAMMINGING 0 WATER HOOKUP
❑ FOAN 0 FIREPLACE RI
❑ FIREPLACE FINAL
❑ INSULATION 0 SEWER HOOKUP 0 IREPLA AIR TSL
p FINAL 0 PLUMBING FINAL 0
p SITE INSPECTION
0 MECH FINAL
COMMENTS: 1 C '' 0'
Aft
, i Loc-e-,- ' 4' �k.„
)(
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED BEFORE COVERING
❑ CORRE •RK,CALL FOR REINSPECTION
IIIOwner/Contra
Inspecto
CAL - -.: 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
PRIO
''*:411 ORIOR A
HEATING/AIR CONDITIONING/FIREPLACECITYFPLKE PERMIT Date Rec'd
Ar/vEso
1. Pink File
2. Green City PERMIT NO. / c 2 44
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
2* S Yecv-est Ruts N iN
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) 12vlyt/1 r A Vl l Si/PM (Phone) -- 2
(Address) 2-1---127 S—smeiCI'gst- Path NIIV
APPLICANT �
(Name) VII-101110 1-k' n rotIZ (kAlett,r1 x'11 I (Phone) "l/,"72.(,'>'7'7777
(Address) ---v-i(j 0 Cid/I1 (
(Address) �� (City) (Zip Code)
(Contact Person) (A - / ' 1<fAitie i(jj/ �ll/I/l Dm (Phone) q l-t97r'J'"-71"-21
APPLICANT SIGNATURE (A/40(--1
(4 ai - DATE b ' i-(
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION [REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODELIV/flat/IAA— 12119P2Wic p 9j V FUEL Pile,0 C,
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air Plants PLEASE NOTE: Air Conditioner
❑Steam
['Gravity Units and Fireplaces Cannot Encroach
❑Hot Water
Mechanical 0 Radiation into Required Side Yard Setbacks.
it Conditioning ❑ Special Devices Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
El Vent.System 0 Other Devices
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 $49.50
Estimated Cost$ Li2O0 Building Permit #
HEATING PERMIT FEE $ -I t<"✓v
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $ C ,O. t,0
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid c Receipt No.
Date / 1 . / By
Building Official Date i i
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372