HomeMy WebLinkAboutMechanical 03-1375
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE
Id-r;:-c6
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TIME
ADDRESS
Itf9lS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
.3>- 131!)
o FOOTING 0 PLUMBING RI 0 EXIGRADIFILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o F,RAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL 0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTI.ON (\1 I. 0 MECH FINAL D
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI
IliSNOTl
CITY OF PRIOR LAKE
HEATIl'T~1 A TR CONDITIONING/FIREPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 11/03
Date Rec'd
(Please tvDe or Ilrint and sian at bottom:
ADDRESS
I q 'l 9s }./-,' / !sr'k e; '(' .
~: ~ ~:~. I PERMIT NO. O'~-I''2/ic'
3. Yellow ApphClJlt J' /t-'"
ZONING (office use)
IJLJJJ ~
LEGAL DESCR.u- liON (office use only) (J, A ...
LOT~LOCK 1 ADDITION ~ 1,;" t21rtt.-~PID~5'-.3?7-t?3~r<~?
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0ohll1 ,yY/ t (,. ~ II e V all
1Lt!Lf/ ~ If/ //SlcJe-
(phone) ?.F:!.-!/lIS=- I/O 8
OWNER
(Name)
rodr L L~ .!JLW.
~~~~ANT8,,~~,\dp, ,~Y"th Cf- ~ (Phone) 9~~-('J<J58
II). HLt/(j 13 jJafrtsv,./le/IUYIJ. ~:>~:?9
(Address) (City) (Zip Code)
(Contact Person) /lA p-,{f\"f;..~ '. (Phone) Cj~,;l.. - f.t!)yJ-1J2_~"'ll
,->>PLlCANT SIG~ATlJRE ----J1u~/ 'Z( ~ #4~ · DATE //J / fl/rr'? ~
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(Address)
(Address)
3~.~n
TYPE OF SYSTEM
OWann Air Plants
o Gravity
o Mechanical
OAir Conditioning
OVent. System
HEATINGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
HUit- Yl/~&-In lUujpj,' &fJ{)0711.. aaL
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
a tf.S fAy, e if-
v
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
$39.50
$39.50
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
/-
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3Q,s7J
.50
LitJ -- -
lice Use Only)
Building Official
Date
Paid LI ()__ ----
Date 111--/ cr- ~
Re~~q~
~ -
v "'-
- '1'his Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372