HomeMy WebLinkAboutMechanical Permit #10-1149 & Building Permit #09-0828 O � pRj�� CITY OF PRIOR LAKE Date Rec'd
� � HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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j �'NES� Z. �ee� �;t PERMIT NO. O ����
3. Yellow Applicart
lease or ' t and si at bottom
ADDRESS ZONING (ofleice use)
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LEGAL DESCRIPTION (oflFice use only)
LOT BLOCK ADDITION PID
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(Name) h V� �Q� (Phone
(Address) IVI �
{Name) ANT � � (Phone) 1��+ ) t '�"� 1 � "� l� �
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(A dress) (Ci (Zip Code)
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APPLICANT SIGNATURE ATE t �, � �l . �
APP CANT PLEASE COMPLETE BELOW
❑NEW CONS RUCTION REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL 1�1.O�1/� ��,� FUEL ��
FLUE SIZE RETURN OPENINGS INPUT � OUTPUT l�- �
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑� Mechanical ❑ Radiation
ir Conditioning ❑ Special Devices Fireplaces with Boz Additions or
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEESCHEDULE
Industrial, Commercial & Multi-Family 1% of job cost Residential, Gas Fireplace $49.50
- $49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ � � Building Permit #
HEATING PERMIT FEE $ L • ��
STATE SURCHARGE $ , �
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid �� S'� R c ipt No. ��� v
Date, (
Buildine Ofticial Date � � r � `� � �
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED � C
ADDRESS � LO �� �T� �.l'���� )
OWNER CONTR.
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PHONE NO. PERMIT NO. R"�2��_
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING � WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
}�FINAL si� ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION � MECH FINAL ❑
COMMENTS: �i�` ;
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�WORK SATISFACTORY, PROCEED
❑ CORRE A TION AND PROCEED
❑ CORR CT K, CALL FOR REINSPECTtON BEFORE COVERING
Inspector: Owner/Contr:
CAL 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY.�
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