HomeMy WebLinkAboutMechanical 03-0854
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DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED k-IQ-:v<,
ADDRESS jr.-w-N C411~f.,.t..__"',.)
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OWNER CONTR.
PHONE NO. PERMIT NO. .5 - Fi-~'-f
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o FOOTING o PLUMBING RI o EXIGRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o JXNAL 0
COMMENTS:
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I Yl~~
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Lil:{ ( - Cf~.>.2.
o WORK SATISFACTORY, PROCEED
o ;~ECT ACTION AND PROCEED
~ORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Kx-- Ii-kif) Owner/Contr:
CALL "'7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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Date Rec'd
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
#- & (,16
; ~.:" ~:,~ I PERMIT NO. -?.. D'5 / / I
). Yellow ApphCllnl , ') a ~
(Please tvve or Drint and sillll at bottom)
ADDRESS
/4 / Lf 4 (' avvi I f'U )()cri
[Rn;,
ME.
LEGAL DESCRIPTION (office use only) f)
LOT, '5 BLOCK,;z ADDITIoNAL:vnd
p~ Ll~
ZONING (officeu,,)
FUO
PIDd5- ;;)/S-615-0
(Phone) qf)';j., -1;q- ()fC)~
OWNER \~~ ._
(Name) --0 (J\'\(\\-r '().J[ '\ .:R::u~
(Address) lJl/44 (',OJ1r1 Jf.uJr'YvP LflN. Ai. 8 ,
ffrJvoll+aOf Pdr, JIl6 ' (Phone) q62- ctcJSlq()O
P. o. fDx pfY). rShtio/ce, !7IJN b6/37q
(Address) (City) (Zip Code)
(Contact Person) _ Dr ft!Jl.! ~ . (Phone) tJ:Yl -cj Vb - / 9 {l 0
A,.PPLICANT SIGNATURE I (J j~1--- / ~~ DATE - (f).. /0 () /r-'
(/
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 0 REPLACEMENT ~ AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
APPLICANT
(Name)
(Address)
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OWarm Air Plants
OGravity
o Mechanical
~r Conditigning
./\.lL-, OVen!. System
-rrrS:-,'tEB-MAKE AND MODEL 'heJ\mnre
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
\\l'>....L~;;)L\ {l-\a\i\ f-\\r CK:,V\Q.\;n<::::,Vle..v--
Industri~l, 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 & AIC (New Constructinn)
Residential, Heating Only (New Construction)
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Estimated Cost $ -e') _ ,() -
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 39,60
$ .50
$ q{). m
Building Penn it #
,Office Use Only)
This Applicatinn Becomes Your Building Permit Wheu Approved
I Paid !f{}J--
I Date6___ J- 7-1J:3
Building Official
Date
24 hour notice ror an inspections (952) 447-9850, rax (952) 447-4245
$39.50
$39.50
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Rece2/27y,?Y
By tJU"
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