HomeMy WebLinkAboutMechanical Permit 13. 0658 1
CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED
ADDRESS r
/ / C 1
OWNER CONTR.
PHONE NO. � "` °�`�
PERMIT '• . _
❑ FOOTING • w. , e.44. ❑ FOUNDATION ❑ PLUMBING RI - :. • /FILLING
❑ FOAMING ❑ MECH RI ❑ COMPLAINT
INSULATION ❑ WATER HOOKUP ❑ FIREPLACE RI
INSULATION ❑ SEWER HOOKUP ;$'FIREPLACE FINAL
AZI❑ SITEA INSPECTION ❑ PLUMBING FINAL ❑ GASLINE AIR TST
iit MECH FINAL ❑
COMMENTS.
i \ e
��ir�►6immomewf�_-:u -mss_
)i)\j/ _
7 t -
, ...:w�■
\ \)/ ,. f
I / )
JWORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner /Contra
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH& SAFETY!
twsnon
•
4 !Rib CITY OF PRIOR LAKE Date Rec'd
o
a, 41 L � HEATING /AIR CONDITIONING /FIREPLACE PERMIT
r~
Q
`till,NESe 2. G 1. Pin ree k n F ty PERMIT NO. A3 _ 4,
(Please type or print and sign at bottom) 3. Yellow Applicant
ADDRESS ZONING ( Office use
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER i \' v 0") l' Ju ' ` (� (21 1N) (Phone) � 2- MO — C t 01'S •
1 (Address)
APPLICANT i ,, Q � 0 Q� -7
(Name) S (Phone) YJ I C/ (/ -I
(Address) 4' (./ -IVY W 555
(Address) (City) (Zip Code)
(Contact Person) A i MIA.% (Phone)
APPLICANT SIGNATURE Al . Aid DATE 10 2.4 k 3
APPLICANT PLEASE COMPLETE BELOW •
/ 1 1NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT •
['Warm Air Plants PLEASE NOTE: Air Conditioner
❑ Steam Units and Fireplaces Cannot Encroach
kMavity ❑ Hot Water p echanical ❑ Radiation into Required Side Yard Setbacks.
❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
DVent. System ❑ Other Devices
Require a Building Permit.
FIREPLACE MAKE AND MODEL f �'� +"{'\'C i 0 (90006- I p` 1 1
FEE SCHEDULE y
Industrial, Commercial & Multi- Family 1% of job cost Residential, Gas Fireplace _ 49 5t g+ -
$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
W
Estimated Cost $ 0 VV Building Permit #
The Minnesota Statutes § 32613.148
HEATING PERMIT FEE $ "SURCI IARCiI has been changed for one
year effective
STATE SURCHARGE $ 50 .1111) 1, 2010, until ,June 30, 2011.
TOTAL PERMIT FEE $ 1 q 1 50 The minimum surcharge for a "fixed fee" permit
(Office Use Only) is 5, beginning July 1.21110
This Application Becomes Your Building Permit When Approved Paid r j / 5 7 J Receipt No. j J V?
Date i By D EG /
Building Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372