HomeMy WebLinkAboutHEATING PERMIT 16-1388 TIME
DATE
�3 1 �
CITY OF PRIOR LAKE
SCHEDULED
INSPECTION NOTICE
I , 1 r rte. 1=-
ADDRESS ~
CONTR. 7 ?,�
OWNER —��-- PERMIT NO.
❑ F�UGRApIFiLLING
PHONE NO. ❑ COMPLAINT
❑ PLUMBING RI ❑ FIREPLACE RI
CI MECH RI CE FINAL
❑ FOOTING ❑ WATER HOOKUP �IREPLA
• FOUNDATION 0 SEWER HOOKUP GRELINE AIR TSL
TION 0 PLUMBING FINAL ❑
CI• INSULA ❑ MECH FINAL
❑ FINAL
❑ SITE INSPECTION
COMMENTS / IG * , -
WORK
SATISFACTORY,PROCEED
PROCEED COVERING
CICORRECT ACTION AND
❑ CORRECT W
RK,CALL FOR REINSPECTION BEFORE
Inspector:
pwnerIContr. ADVANCE.
OURS IN AD
447-9850 FOR THE NEXT INSPECTION 24 H TH&SAFETY!
CALLREQUIREMENTS ARE FOR YOUR PERSONAL HEAL
CODEE RIJSNOTJ
CITY OF PRIOR LAKE Date Reed
4 IlEATING/AIR CONDITIONING/FIREPLACE PERMIT
o
S0 L
IS j:kre Fa, PERMn No. 1 )
1 10 go
3.Yellow Applicant i It
(Please type or print and sign at bottom)
ADDRESS
ZONING(office use)
1 21-3 1 3 S ko\t' _ov-eA-i— -1 \f P Ub
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION 0--e-i-relis ,044 1-t AD:6v pm Z ' - 50/-' o(q.-0
OWNER
(Name) 1-",,t• IrL.-at,A-,n (Phone)
(Address)
APPLICAW4 .. ii 1 ,, c\ ,--1 _
(Name) ' 1 IA1 I v\ ohi--k-t vs-up to 66 <grtlxv-C-Aphone) (1621 11'7 1--4112-
(Address)
(Address) (City)(City) (Zip Code)
(Contact Person) ( i :11 . 0iie.s.--ate-rove- (Phone)
APPLICANT SIGNATURE /y1() q citia„---- ----- DATE 1) ) Lt1 11 ce„
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION .121EPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
OWarm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
0Gravity 0 Hot Water
into Required Side Yard Setbacks
0 Mechanical 0 Radiation
Fireplaces with Box Additions or
DAir Conditioning 0 Special Devices
OVent.System ceOther Devices ...-{kktWir kArtit..." Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial,Commercial&Multi-Family I%of job cost Residential,Gas Fireplace $49.50
$49.50 minimum
Residential,Heating&AJC(New Construction) $149.50 Residential,Additions&Alterations $49.50
Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50
Estimated Cost$ z4 000,00 Building Permit #
HEATING PERMIT FEE $ 4-CI. C30
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE S .0, -.C.'2.-CD
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid )....ge) Receipt No.
Dateia:// "167 By 5
Building Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372