HomeMy WebLinkAboutMechanical 03-1322
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
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~. ~e:' ~~~ PERMIT NO. (J'? _/'??_'7
J. Yellow Applicant ~ -> V ~
(Please type or print and si2ll at bottom)
ADDRESS .
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZ5_ 2-'17.010.0
OWNER
(Name)
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(Phone(g~) ~5215l1iL
(Address)
APPLICANT ~_ (\ r ~r..C..., , 1 .
(Name) IUl ~ \5J1l1\OY\
(Address) \) ~~. ~vJ(~:t SS
(Contact Person) Am 4 -R'w
APPLICANT SIGNATURE J (~f\iv.Q
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(Phone) 1lJ1; 3f6~ 6393
(JL\pyY)~ -mN SSLf4J
I (City) (Zip Code)
(Phone) 1M~ ?:8~ ffil b
DATE- ~/~3
APPLICANT PLEA~E COMPLETE BELOW
DNEW CONSTRUCTION ta.REPLACE~ -JT 0 AL TERA TIONS
FURNACEMAKEANDMODEL1l2A1\J6 -ru ()1~O ~ Vr)K FUEL ~.. 6>,~
- INPUT _ Lk) \ &) () OUTPUT l1J) 6b
REA TING OR POWER PLANT
RETURN OPENINGS
FLUE SIZE
TYPE OF SYSTEM
<E1w arm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Estimated Cost $
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Building Permit # 03 -/32 Z-
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
Sq. !9J
, I W50
L-f1J.
ffice Use Only)
Building Official
Date
pai'40f uf)
D~.SO.OS
Receip~..5z, 4--S'
By jRL
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
T
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
IV7/D.3
DATE nME
ADDRESS
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OWNER
CONTR.
PHONE NO.
3tL3ZZ-
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL A
[] MECH FINAL
[] EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
[] GAS LINE AIR TST
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COMMENTS:
o
IWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINS PECTIC
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Inspector:
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CALL 447-9850 FOR THE NEXT INSPEC
CODE REQUIREMENTS ARE FOR YOUR j
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