HomeMy WebLinkAboutMechanical Permit #03-1025
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/~It<EPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 11/03
File
City
Applicant
(Please type or print and sign at bottom)
ADDRESS I~ ItfJ... Cro.>~ ~Vlq rCt
I If' .~o tr L a ~-c.-.
C/'<-..
LEGAL DESCRIPTION (office use only)
LOT f BLOCK I ADDITION ~/N';rz.- J!!.A./)~ I./'I
OWNER
(Name)
iJ I" ,. er ,.,
F()41
./
(phone)
(Address)
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
Date Rec' d
g. If.OJ
PERMIT NO. 03-106
ZONING (office use)
PID zs: z..,e; t:1. 0 () lor 0
95), -;2;2h -~~ 90
(Zip Code)
(Contact Person)
., ~ (Phone)
J j _.~-. ~.. ~J---.. DATE Y~Lj~cJ3
APPLICANT SIGNATURE
/~
'./
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATINGORPO~RPLANT
o Steam
o Hot Water
D Radiation
o Special Devices
o Other Devices
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
FIREPLACE MAKE AND MODEL
lIe 4. .{
f G 10 '-<./
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
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ St:l.!)?J
$ .50
$ II'rO. tJ 0
lice Use Only)
Chis Application Becomes Your Building Permit When Approved
YlP~ '
Bunar6g Official Date
Paid
40,00
Date '"?
8. Cf,(/..)
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Receipt N0452.J 0
,
By ~.
U
RESS i& /4 L
DATE TIME
SCHEDULED q r ? -C/j>
( m% Ct ""- c!..-#t
CONTR.
PERMIT NO. 'Z- (~
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
PHONE 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
o MECH FINAL
o EXIGRADIFILLlNG
~c MPLAINT
REPLACE RI
. .. 0 FIREPLACE FINAL
~ASLINE AIR TST
o
COMMENTS:
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
}l1 CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~ q-)- ()} Owner/Contr
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl