HomeMy WebLinkAboutMechanical Permit #03-0960
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
REQUEST FOR FINAL ~t? IV {".~. ()J *'0 9~1
INSPECTION SENT TO r1(. l/I'
HOMEOWNER 11/03 ~ ~:~ I PERMIT NO. - I
Yellow Applicant 0:3 ~
(Please tvoe or orint and si2ll at bottom)
ADDRESS
\ 4-C9 Z-~
~~
LEGAL DESCRu- uON (office use only)
LOT (I-BLOCK 3 ADDITION vJ{;JIJ b
OWNER
(Name)
<Address)
-IIi//
J6~ ~~.
,
t4'(Q~? ~d M
(Phone)
ZONING (office use)
J{l/5J)
PID ~ 5- 3/0- tJ3 7--1...'
V}0L-'%"?> . ~::f!>V;
AP(NPamLIeC) ANT '1"~._ ~)clc.-. u.. n rr I t_ ... \ d___ - ~.-.... t""!. ~
r \f ~v .or,.L\:I.A '-\-f"\ ~ \\OT~.... (Phone) - ~ -"bot{) - [f1, ~ b
(Address) ~riJ() Wi *,V \Y'J) ~rnMlk" Cin?31
~ \ (Acldrets) - (City) (Zip Code)
(Contact Person) ~e..,. (Phone) ~n /
..
APPLICANT SIGNATURE - DATE II l (P / ()~
( - ~PPLICA~T PLEk GOMPLETE BELOW '
ONEW CONSTRUCTION q~;LACE;-mNT 0 AL TERA TIONS
FURNACE MAKE AND MODEL ~_!~ FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL ~()
HEATINGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
\'ocrof(L!.
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
.--
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
?f1.~
.50
qt).~
flee Use Only)
This Application Becomes Your Building Permit When Approved
Paid 'I () , ---
Date I'" e?;). ,- 3
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
Re~& /
BY~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/%z~ (-l1,~ v~
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
o EXIGRADIFILLING
o COMPLAINT
~FIREPLACE RI
Mo FIREPLA, CE FINAL
ASL~ TST
o ?
COMMENTS:
~V ~T - i0CvS~
("~~h) ~ ~ , \.
~~ L~~
n~~ :!-v\ tU6~l6W\,
_ _ A ,
VVV~ VU ~U~ r
,. ~ /I L ",," 1 '" · ':,
"t ~J (~'~'".,'/" ~.
~/Ds~d -~~ "trL.L. _
,p~r.i-l-; $ ~~ - qs!1
o WORK SATIS~.v rORY, PROCEED . ,
o .5P"RECT ACTION AND PROCEED / \ v-'
j;(" CORRECT WORK, CALL FOR REJ'::t..~1N 8E~~RlNG
Inspector. ~ Owner~
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETYI
L floW ~ j .