HomeMy WebLinkAboutMechanical 03-0975
r'RIOR LAKE
,....fCTION NOTICE
SCHEDULED
ADDRESS
I "'2"G J C-/~"C. f,J
OWNER
CONTR.
PHONE NO.
PERMIT 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
k"r\<i~
COMMENTS:
DATE TIME
7 - '? (J
:J-Q7S-
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~--:- ~)
/ /' /or~ h~ /
( (/t" ~
"'- - ~
crV;'ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~R~,>>LL FOR REINSPECTION BEFORE COVERING
Inspector: .Ilff 7- 3~~Owner/Contr:
CALL. 447-~850 FO~ THE: NISXT IN~PECTlON 24 HOURS IN ADVANCE.
UtSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
"~'''~"'''-'''-----'<''~''-''-'--'''"- -. I
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink File PERMIT NO ~~
2. Green City . 0 3- ~ 'l
J. Yellow Applicant c..-r
(Please type or print and sign at bottom)
ADDRESS
\ ~ ~ \.c-:' \.A ""'- R \ ~ liv
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION ~ I~ ~
~=~R G.\.R. n-S \) \v~ 01"") (Phone)
(Address) ~ c..... ~
02-
PID as 1.3 3-0t~-tV
~ (S'..}~ V\ \,\ 1- ~ 9 to tn
APPLICA1-U'^ . >I"'i.'-
(Name) l '( \. k\-~ \\),......., '\ t\ ~
(Address) \ ~ '\ ~ t> \...l '-\ l O~ \\. \\ ~
(Address)
(Contact Person) (\J ~"\ l' ) <; '-~
. /
APPLICANT SIGNATURE ~ 1..-~
(Phone)
~'-
5~~lJ..
(City) (Zip Code)
(Phone) ~ ~ ~ -~l\, -~) d- ~
DATE 1- ).~3
APPLICANT PL&ASE COMPLETE BELOW
DNEW CONSTRUCTION ~PLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL C_t\""'r~ \_ ~Tf\"""I ~ - ,~ FUEL rv \i~
FLUE SIZE RETURN OPENINGS INPUT ,,~~ ~ Q OUTPUT S"3 J ~~\)
TYPE OF SYSTEM HEATING OR POWER PLANT
~arm Air Plants 0 Steam
DGravity 0 Hot Water
o Mechanical 1 ~ 0 Radiation
~Air Conditioning (c."V"r-\:-~ '" 0 Special Devices
r[]\rent. System \ ~~ ~~, o Other Devices
~ -Te,,,, \~ s "->-Y
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$ \.i\ (\ oy
") C\.s;o
.50
nee Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid Llo~-----
Date 7"' ;}'3" :!J
Receipt NOf/tj f fa r;
~
L--J
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
T
- - - _.__..- _..~---; - - -- - -- -- - -'- - ._.~--_.-
('') ;; _~ ""') ,r--
- .,
"JobAddr_ tr,rhJ .L.~_,.#
"Heating ConlrecIor Me I nO AIR
~..._~
.Permit...... -
-
~ S"~
"T eslers/Signllture
2!!!
Ii!!!!
Pounds
Pressure
"Gas Une
Pressurized
Inspected
PERFORMANCE TEST
"Percent CO2 ? '!
.Percent 02 ?~C/
"Percent CO 0
??C/
.Slack Temp. . . T
F inallnspection
Dale
-