HomeMy WebLinkAboutMechanical Permit #03-1437
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
10. Z 7. gJ
1. Pink
2. Green
3. Yellow
~!:y I PERMIT NO. O.5-/A.2"7 I
Apphcant -r """ I
ZONING (office use)
Av~ ~ t
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 25./z4-. O~. 0
OWNER
(Name)
(Address)
\\ ~ \..." c, \.. \ \-~;., 1 '-'-\-
'<\ V Q..
(Phone) ~) ~- ~~ \- ,~~ a
APPLICANT l'v\ _ ~ -
(Name) \ \Jl \').--'V \'"\ ) \..-' \ l\ L
(Address) \ ~ C\ <g 0 \r-J '- \ l U {hJv (.\ ~
(Address)
(Contact Person)
N<.\V"\
(Phone) ~ ~ ~- \.{ \..\ .., -&' I ~ '-\
~ r\~y' ~~\~ (\\N SS:S,:)
(City) (Zip Code)
(~. )." -., - ?
(Phone)' , ~
\ 0- ~,-3
DATE
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT 0 AL TERA TIONS
FURNACEMAKEANDMODEL ("'-r\...._ ~"'f>' \00- \ ~ FUEL Nu-\-'
FLUE SIZE .~ V L RETURN OPENINGS INPUT (p,'). ~ OUTPUT S' \'. .JOO
TYPE OF SYSTEM
OWarm Air Plants
o Gravity
o Mechanical
OAir Conditioning
OVent. System
HEATINGORPO~RPLANT
o Steam
o Hot Water
o Radiation
\ ~ ~ 0 Special Devices
<'\ t> \ ~ ~ \. ~ 0 Other Devices
~.r",,",l\.
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, 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
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit # Q.J - /4.37
$ ~ ~ !O
$ .50
$ '--\ () CD.-/
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
lice Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 4-0, 0 ()
Dio. z..~. 0 J
Receipt No, efS9'2.3
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
0" TE TIME
\1-.(5'1 d'.:J t I ~
ADDRESS
tt.t31)() ~~1 ~~
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
f1 MECH FINAL
~
COMMENTS:
3-/t{3,
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~~ ~~fs-~~r~~
~ .- ~-- -D~::'r;-7------=----- ~-
"Permit.
. :=~ M~EIR
'" "Teste..-/Signature ~ ~ - '
/
"Gas Une
Pressurized
Inspected
. Percent C02
,0 )'ORK SATISFACTORY, PROCEED
(pf CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REIN~
~
.Percent 02
Final Inspection
Q!!!
TIm!
Pounds
Pressure
\=
0%
"Percent CO 1
.Stack Temp. (01
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Date
Inspector:
'.-'
Owner/Contr:
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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