HomeMy WebLinkAboutMechanical 03-0932
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
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DATE nME
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5- tf3L
o EXIGRADlFlLlING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~K~FOR REINSPECTION BEFORE COVERING
Inspector: JI V r Owner/Contr:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETY!
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---=-=-~,. J:.t\J..U.K LAKE
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CITY OF PRIOR LAKE
REA TING/ AlR CONDITIONINGIFlREPLACE PERlVIlT
Date Rec'd
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2. Orc;n
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,~~~ I PERMIT NOO 3-q ObL-
Appll:.nt I 1
. ..:'l,,~sc: type or -or...nc 3.llci siEn at bcrtcm)
ADDRESS . .
35fc,~8(\-L'3SWLLd. Q:l rc_lO
ZONING (office use)
LEGAL PESCRIPTION (offi'ce u5coni~)' ,
LOT (, BLOCK 3 ADDITIO~ WLllo~ ~ yC
I O\VNER
I (Name)
I (Address)
PID7-S-- II 0-0) goO '
\1\1 () n\p J Ph\ \ \ '\ flS
~5t:.Y f?D..~~\l\\()C'jrl-
(phone) g5~- Q~ - ~ I ~ \
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APPLICANTr
(Name) r--,m-r01.\.pf\ A:\'f" (Phone) (;..,5'-.L\H~-~~;:l
(Addrcss) Q \ ~ t [) E.(:\ +hn A Vr:' (\ l tP j ~ (jr~(\ f)8{)r9~
(.....ddms) tC)ty) (Zip Code)
(ContaccPerson) -0J~.w-, n\ \ \-e_0_ J (Phone) (Cf)1- 4w- f",tb>Q -b(f. ~53
APPLICA.NT SIGNATURE _(7 /laLi.dLl:il.--' 19t.V~ DATE ~-<1-D~
~- - APPLICANT PLEASE C~PLETE BELOW
ONEW CONSTRUCTrON $ REPLACEMENT 0 AL TEM TJONS
I FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETuRN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWa.-m Air Plants
DGravi!)' t3r
Q Mechanical . \ rCL~
f;JAir Conditioning
OVent. System l../TIX ~03b
HEATlliGORPOwnRPLANT
o Stearn
o Hot Waler
o Radiation
o Special Devices
o .Other Devices
PLEASE NOTE;
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE A:N"D MODEL
indus:rlal. Commercial & Multi-Family
FEE SCHEDULE
J % of job co~t Residcntial, Gas Fi,eplace
S39.50 mir-irnum
$99,50 Reside:1:itd, Additions & p..ltcrarions
S64.50 Resld~rct1aL AC Only
539.50
K"sidCi1t!::.l. hCallng & }.JC (NcvY Consuuction)
R,e,sidtt.tiaL P~cat\ng Only (New ConstructIon)
S39,50
S395D
Estimatd Cost $
Building reanit #-
HEATING PERlv1IT FEE
STATE SURCRARGE
TOTAL PER~T FEE
$ ~C1,50
$ .50
s LiD,on
(Ome: Use Only)
.-1 Tbis Application Becomes Your Building Permit When Approved
Building Official
D3Ce
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I Date 1- f '1' 3
I ReceiP?/Lf ~ 5' to
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24 hour notice for all inspedi6ns (.952) 447-9850, (ax (952) 447-4245