HomeMy WebLinkAboutHeating Permit 09-0064
.cITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
q\tis
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
o FINAL
o SITE INSPECTION
COMMENTS:
(\
, .--."
'-"'"""'" ---
DATE TIME
SCHEDULED
3Jv./tf7
, "
W;~Clo
--.j
CONTR.
PERMIT NO.
1 - 00 ~c.!
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
;g.. FIREPLACE FINAL
o GASLlNE AIR TST
o
^ ......
~ -l-l' L
, c
tJ:, ~ ~ 12,n\ac... "X"K:l~,^", One:' m
, - -..-J <.J
~ WORK SATISFACTORY, PROCEED
o CORREC71fjTION AND PROCEED
o CORREC W K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: , Owner/Contr:
CA&9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
INSNOTI
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE P~RMIT
Date Rec'd
3. .1-1.
~: ~:~n ~:~. I PERMIT NO.!) 9 41'0' ./1.--1
3. Yellow Apphcllnt ,-
(Please type or print and si2\l at bottom)
ADDRESS
'il LIS-
ZONING (office use)
W/,",zclsd He; (JJ t
/
LEGAL DESCRtt" lION (office use only)
LOT
BLOCK
ADDITION
.PID
OWNER
(Name)
;j i/11 ~4e~
~/ ~~ tAJ/~~/t-<' ~A~/'
/" .-
(Phone) 95;) --L'/ f/o - lI'a6 '/
(Address)
APPLICANT. .
(Name) \.AJ &....'-~ (\'\ -e...c1d~V\ \ ~ \.. (Phone) __5i~~- ~/ ')- /99 :2.
(Address) //rt9 C' Cll\'t-'\P- ~, ~lJYI\Sv:~Le <s~.3-57
(Address) (City) (Zip Code)
(Contact Person) :')~ l--L}~\:~_ /.. ~ JPhone) ~t')-9::r/- 076Y
APPLICANT SIGNATURE. .<;;::~~~c.. DATE
APPrif~PLEASE COMPLETE BELOW
DNEW CONSTRUCTION Jf;7(REPLACEMENT '-gAL TERA nONS
FURNACEMAKEANDMODEL ~~~''''-G-\.o~ rg~<v.di /~ FUEL IU"---t-
~ tI '. /....
FLUE SIZE "') RETURN OPENINGS INPUT //cJ.o2JD OUTPUT p/ /J-
TYPE OF SYSTEM
DWann Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
~Other Devices E:4 S. ..:th.~e:a..'\
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE )
I % of job cost C_ d,tesidential. Qas..E.il:ef)kIee/
$39.50 minimum . .
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~.~~
.50
~ SlJ.vV
Building Official
paid.6ZJ /nJ
Dat:s> I J,-Q Y
(
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Date
I
Re1tNoS7J ~1
Y).
U
(Office Use Only)
This Application Becomes Your Building Permit When Approved