HomeMy WebLinkAboutHEATING PERMIT 16-993 DATE TIME
CITY OF PRIOR LAKEC1 1 (f= ----
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
C---'(C------------e _._
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PHONE NO. PERMIT NO. I ‘
0 PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOOTING 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP
❑ FOUNDATION 0 FIREPLACE RI
(REPLACE FINAL
❑ INSULATION 0 SEWER HOOKUP XGASLINE AIR TST
p FINAL 0 PLUMBING FINAL
MECH FINAL
❑ SITE INSPECTION 0
COMMENTS:
lk
'WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Owner/Contra
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURSIN &NCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH
❑4SNOTI
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lalYVl' YKIVKCAUSE' Date Kec'd
4HEATING/AIR CONDITIONING/FIREPLACE PERMIT �j, 3o• fC
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'. Green File PERMIT NO. I 993
2. City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
5--1 / 0 Moi CumE -6L vo.
LEGAL DESCRIPTION(office use only)
PID
LOT BLOCK ADDITION [���
OWNER AA HI Lt LMS /2 '� g--11— --11.(Phone) � z u
(Name) /
(Address) 5-3 /0 /40 tdikrr euptiE
APPLICANT I £ V AI Q lr116 4'S T K-A �'" (Phone) t.S.1 v 2S-3- /P g.3
(Name) /0
reci PlaCe IS�C-ems. g�E Sr, iikr/t- y
(Address) (Address) (City) (Zip Code)
� �J (Phone) CJ—)" r3- /0�3
(Contact Person) ...- -.46. I "I �
APPLICANT SIGNATURE r DATE 1"----2 7—
_
APPLICANT PLEASE COMPLETE BEENT LOW ALTERATIONS
*NEW CONSTRUCTION 0 /
FURNACE MAKE AND MODFfi F1k r45LGA®4Oft 6t64-40101, C,'- 3,4
3 FUEL A.)4
.OUTPUT FLUE SIZE RETURN OPENINGS INPUT
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 Cantilevers to the Outside of Buildings
❑Vent.System 0 Other Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE job cost Residential,Gas Fireplace j $49.50
1%of
Industrial,Commercial&Multi-Family
$49.50 minimum
Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations $49.50
Residential,AC Only $49.50
Residential,Heating Only(New Construction) $64.50
Estimated Cost$ Building Permit #
HEATING PERMIT FEE $ 4-q 5z)
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $ SZ_5Z7
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid `
50 Receipt No.
�DateDate B T�G, �� y
Building Official /o,to
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