HomeMy WebLinkAboutHEATING PERMIT 16-209 (fireplace) DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 3 13/ (1(o
ADDRESS {G S 1 1_ \-\ca\c,lpvr 1)L,
OWNER CONTR. ✓ ,/
PHONE NO. PERMIT NO.((o - I ko CJ 3
❑ 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 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS:
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: LGA Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
uvsnoTI
PRIo*C
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
U tri
Irl 's7
ArNESo
2. Gr
'. P'nkeen city Filc PERMIT NO./6, 2 6q
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
451a Harbor ?I NE
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) S 1 1{4 dbI1 GUdm un Son (Phone) -IN-ayb-
(Address) X05 la Harbor P1 Nt
APPLICANT
(Name) y rA: .hCL S 4S#'@.,rh S (Phone) sq6 -933-/9 LDS
(Address) 4 34a.b �1nO, ( 1Y . d ptinS 553L1
ddress) (City) (Zip Code)
(Contact Person) i • P floes• (Phone) q6I--Q31!i sus
APPLICANT SIGNATURE 'AeXUA,48,...11/4. DATE _3116 II LD
APPLICANT PLEASE COMPLETE BELOW
['NEW CONSTRUCTION ❑ REPLACEMENT IWALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants El Steam Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water into Required Side Yard Setbacks.
❑Mechanical 0 Radiation
❑Air Conditioning El Special Devices Fireplaces with Box Additions or
DVent. System ❑Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL (re, kok eta- RS—1 P
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 $49.50
Estimated Cost$ P500 00 Building Permit #
HEATING PERMIT FEE $ 4 q.El 0
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $ 50.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 51) . 5-D Receipt No. n3
Building Official Date Date . - - I I_ By •
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372