HomeMy WebLinkAboutMechanical 03-0724
CITY OF PRIOR LAKE
REA TlNG/ AIR CONDITIONING/FIREPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 8/03
Date Rec'd
1. Pink
2. Green
3. Yellow
~:~ I PERMIT NO'()3 ..... -1 '1/1
Apphcant I 0\."1'
. lease ~ or print and si~ at botto
I ADDRESS
:54.\/
\
6rccrt:.'S
C-.a.dc
LEGAL DESCRIPTION (office use only)
~
LOT It BLOCK 3 ADDITION I'M~ i...J, / ~ ()zA-.,
. . .
ZONING (ollice use)
/{1
PID {)5- t) C)./-O d.-8-o
OWNER
(Name)
S>~'puty.R.. C1, t 1.u.J II T~
lL..~LtO we....\ctCAV\f- Ave- - fkt'fL L~~
(phone) <jt:;2---Wl-(tt17Y
W\IV S~5 J )"Z.
(Address)
. APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Contact Person)
APPLICANT SIGNATURE
/j : J (Phone)
( / ".-L.:..., /k.4/~ DATE
--
(Zip Code)
t'-,/~!t;.3
,~ APPLICANT PLEASE <;;OMPLETE BELOW
DNEW CONSTRUCTION [R1ffiPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL - ~E-<<" _ FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVen!. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
D Special Devices
o Other Devices
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
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
71q~SO
.50
LjI'J dJ{)
. paidf/;lfo .00
.Datefo_S-3
~~mce Use Only)
Chis Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
ReceiPl)Z:/ 57fc
BY~
"uun.l:o;)o;)
-J ( , {
D~O",-".Jo (..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 ANAL
o ME~INAL
-//I/YV(4CC
COMMENTS:
-----
/ r
/ / I ?v-_
I / j(PC-
\ L.-/'
'3/72."'1
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE ANAL
o GASLINE AIR TST
D.
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~J\RK&L FOR REINSPECTION BEFORE COVERING
Inspecto~ f vr' g ~ }K' ~ner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
U<SNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!