HomeMy WebLinkAboutA/C Permit 04-0915
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
r~~ME
/e;c, ~ S;.. r'
ADDRESS
$70/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING .{J PLUMBING RI 0 EXIGRAD/FILLlNG
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION q ~R HOOKUP 0 FIREPLACE FINAL
o FINAL ~LUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION J ,Q&-MECH FI~ 0
COM~NTS;- ~/~~.~ C-L4~/~/~_
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11' WORK SATISFACTORY. PROCEED
/it ~ORRECT ACTION AND PROCEED
o CORRECT WOR:. // ~EINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNon
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
'ase type or print and si~ at bottom)
JDRESS
S)()!
I /.d)-J,A <<~+
LEGAL DESCRT'PTION (office use only)
LO'l X D~UCK .x-ADDITION
(/~
OWNER
(Name) 1)e\ be,\- ~""'~ ~~
(Address) S- J 6J J ~O-fA S +- $,2.
APPLICAN'h
(N ame) fJr' \ 0 r J-t:- J( <... ~ t. fJ I c..
""-l
{Address)~~4 &J:J2J~ ~rDDK. e,+-
(Address)
(Contact Person) ~ e n...~ tJ toe v-.J... ~
APPLICANT SIGNATURE (l_)"'.A~ _~
\.
Date Rec'd
~: ~~n ~!~ PERMIT NO. Otf- rJ ,,~
3. Yellow Applicant f 7/'
ZONING (office use)
I2d
PID &5- to ,/4 ~-O
(Phone) !lsJ-tt!JJ-3~ ~
(Phone) 9.6).-1./ 'I 7- ~ I J D
~/Or- I-~ 'JnIL/ ~37:t
(City) (Zip Code)
(Phone) ~ ,Ml.j .,-gj/D
DATE 9-l'3-:JtJDY
APPLICANT PLEASE COMPLETE BELOW
D ALTERATIONS
FUEL AI J:) r-
9, {)/X) OUTPUT 8' l) ~
,-
DNEW CONSTRUCTION -ENrnPLACEMENT
. l1RNACE MAKE AND MODEL . ~ U\. t' JU ho... ~
~l\
FLUE SIZE ~ RETURN OPENINGS
TYPE OF SYSTEM
HEATING OR POWER PLANT
INPUT
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
a-Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERl\'lll FEE
(Office Use Only)
1'his Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
$39.50
$39.50
$39.50
Building Permit #
$
$
$
39,..sl)
.50
.yl),OD
Paid LI 0 ~ ..----
Date q -/~4
Receipt 1:;/74 (p q
By
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