HomeMy WebLinkAboutMechanical Permit #13-0116 `-� nME
DATE
CITY OF PR{OR LAKE gCHEDULED �` 1� -
INSPECTION NOTICE
ADDRESS � Z `� � � � L.'"3' �'�-�L' -
OWNER CONTR.
PHONE NO.
PERMIT NO. � �' - � � �= �
O FOOTING O PLUMBING RI ❑ EX/GRADIFILLING
❑ MECH RI O COMPLAINT
❑ FOUNDATION p FIREPtACE RI
p FRAMING ❑ WATER HOOKUP
� tNSULATION O SEWER HOOKUP ❑ F{REPIACE FINAL
❑ FINAL O PLUMSING FINAL O GASLINE AIR 7ST
Ct SiTE tNSPECTiON O MECH FtNAL
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COMMENTS:
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'p. WORK SATiSFACTORY, PROCEED
❑ CORRECT ACTtON AND PROCEED
❑ CORRECT WORK, CALL F�R REINSPECTION BEFORE COVERING
� Uwner/Contr:
Inspector. � + �
CAL� 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOX YOUR PERSONAL HEALTH & SAFETY!
(NSNOTI
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p Rrp CITY QF PRIOR LAKE D�te Rec'd
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�°.�;;� ���'� HEATING/AIR CONDITIONING/FIREPLACE PERMIT , i3
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; �jMYES��� �. r`"k Fa` PERMIT NO. �� / �
2. G�een Ciry
� 3. Yellow App�icant
(Please e or rint and si n at bottom
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ADDRESS ZONING ���� U��
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LEGAL DESCRIPTION (otjFice use only)
LOT BLOCK .A.DDITION PID
(Na R ��_��� (Phone) ��D�J" �1 Y � �1 `L��
(Address) � 1 � �S ( �
APPLICANT--� /y_ -�,
{Name) � l��-G.1 LDM,� � � (Phone) � � 3 � 1�� ����
(Address) l�� � i nn�.l-L�a IAc�� �� 5 sy a �
(Address) (City) (Zip Code)
(Contact Person) ` � (Phone) � � 3 ��3 �cS �, �
APPLICANT SIGNAT ` DATE - �
A PL ANT PLEASE COMPLETE BELOW
QNEW CONSTRUCTION REPLACEMENT ❑ ALTERATfONS
FURNACE MAKE AND MODEL��!�`S�;T2���� FUEL , C�,�' ���L
FI,UE SIZE RETURN OPENIIVGS INPUT �ol� �p0 OUTPUT
T'YPE OF SYSTEM HEATIl�'G OR POWER PLANT .
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
�4echanical ❑ Radiation
� ir Conditioning ❑ Special Devices Fireplaces with Box Additions or
]Vent. System ❑ Other Devices Cantilevers to the Oatside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEI,
FEE SCHEDULE
Industrial, Cornmercial & Multi-Family l% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.So Residential, Additions & Alterations $49.50
Residential, Heating Only (New Conatruction) $64.50 Residential, AC Only $49.50
Estimated Cost $��(�. � Building Permit #
'i'he Minizesata St�tutes (+ 32GE3.1�8
HEATING PERMIT PEE $ l,�'� 5 � "�<<KC:I li�s been chttnged I'or one
ye�r cffectivc
STATE SURCHARGE $ 4� ()n �9 - .yn�,� �, 2��ro, �,r�t;� �«nc 3t�, zr.�� �.
TQTAL PERMIT FEE $ � y � S� '�'he minimam surcharge fa• a " fi�ed fec" �ermit
(Oflice Use Onty) �- is u�, be�inning ,Fuly l. 20111
This App6cation Becomes Your Building Permit When Approved Paid Receipt No.
Date By
BnildinE Ofticial Date
24 hour notice for all inspections (952) 447-9850, fax (952) QA7-A245
4646 Dakota Street S.E., Prior La&e, Minaeaota 55372