HomeMy WebLinkAboutHEATING PERMIT 16-250 DATE TIME
CITY OF PRIOR LAKE J L. 1�
INSPECTION NOTICE SCHEDULED J f(
ADDRESS 1-1 `j
641 k. eAr
OWNER CONTR.
PHONE NO. PERMIT NO. 1 L
❑ 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 ❑faASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
4-)•
COMMENTS:
C
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: Qi2,41,22Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
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CITY OF PRIOR LAKE Date Rec'd
(4 7 A N e
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
jvNEsO�'v o nuo
I.PFile PERMIT NO.
2. Ginkreen City IG . 6,
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
1'70( L/ Wr (dXAQSS j(
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
( 4
meLEi iOY\ `� &C RJO (Phone) 6(d.- ?s—(0S
(Address) 11061 I W i l Ns w ("Pr,70, L <f' r 5931)
APPLICANT il
(Name) (05t11Z-- P. a.Jrn (Phone) !(�/c 9- M7-1000
(Address) O t 1 13bo 2 r.S v l '('i° al N 5 J337
(Address 7.1 (City) �} /� ip(Zip Code)
(Contact Person) \t f' n,--.‘ (Phone) l ca -- 7 ` W
APPLICANT SIGNATURE ///66);& G ------- DATE
APPLICANT PLE 4 SE COMPLETE BELOW
[NEW CON TRUCTION CI i' PLACEMENT ❑/ALTERATIONS
FURNACE MAKE AND MODEL . /1 nDX �j - % u HMO O X U 3(o. CFUEL 96LS
FLUE SIZE RETURN OPENINGS INPUT rr OUTPUT g /
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.
❑Mechanical 0 Radiation Fireplaces with Box Additions or
❑Air Conditioning 0 Special Devices
❑Vent.System 0 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 $49.50
Estimated Cost$ Building Permit #
HEATING PERMIT FEE $ 07 JPO
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $ r 6-
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid J� Receipt No.¢ 7i l
Date 3_3 /. !G By gA_____
Building Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372