HomeMy WebLinkAboutMechanical 03-0566
DATE TIME
SCHEDULED {, - 5-
4v-lM r~ hrrl
CONTR.
PERMIT NO. ?-~C,
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
14 {7s-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~
I/'J-
l I I C)bt:.-
" L.,.../"
'--~
o EXIGRAD/FILLlNG
o COMPLAINT
...Iit'"f~CE RI
~EPLACE FINAL
o GAS LINE AIR TST
o
-;,\
(tiC- /
/
..--/'
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: # fo- ;---03 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4c SAFETY!
CITY OF PRIOR LAKE .,
REA TING/ AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
1. Pink File
2. Green City
3. Yellow Applicant
PERMIT NO. 3 - 6-(. 4
(Please type or print and si2l1 at bottom)
ADDRESS
It; /75
#'aM M /n (fJ h /j.rd
- J -
{!fvf/)L
ZONING (office use)
y{1
LEGAL DESCRIPTION (office use only)
LOT/~BLOCK ~ ADDITION 7JJ~ ~ dpd
PID c95-'3lJ3- /J~5"-O
&~~R ~~, fIlrAicaA!J (Phone) j[;2-a3~-/(}f{7
(Address) I tj I 77 II 14 1M fJ1 J Pt>./D h /r-.!- ef: 1I/ E-
~~;~~Af1v^esido WeuLflt '{ IiaJ11JJ~ (Phone) qs:J.-?t1~-O?SlJ
(Address) .:;>g:C;-(J ILl. f..tfJlfJ J~ I3UfJ1S/lI/lPJ JIIJIl/ $"33,?
(A~ (City) / (Zip Code)
(Contact Person) fJlB Ii SJ'(.L. . (Phone) 9~~-t?I?(J-07~8
APPLICANT SIGNATURE ()~j_(l~~ .. DATE S I' 9_/ () ~
/ V . -
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVenl. System
o Steam PLEASE NOTE:
o Hot Water Air Conditioner Units
o Radiation Cannot Encroach into
o Special Devices Required Side Yard
o Other Devices Setbacks
tJ eqf-!lJr{;{ot11i1eJ .~,)l-..7SOL1<s -C O~~'\' dCv(J;tv~l-t ~ft.'1L
(/ -
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
FIREPLACE MAKE AND MODEL
I.ndustrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
.
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
SCj..5"D
.50
Lf{/.
lice Use Only)
Building Official
Date
P~
lP LjO, -
Date,J)/ 13~,'?)
Receipt N9-::? ^
LILlI? ,;1(./
BY~
J
Chis Application Becomes Your Building Permit When Approved
o
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372