HomeMy WebLinkAboutMechanical Permit #03-1344
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
REQt1:eST FOR FINAL
INSPECTION SENT TO
(Please type or print and sian at bottom) H 0 MEO WNER 11/03
ADDRESS
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(Phon&\cq-t44 7~5~5-
LEGAL DESCRIPTION (office use only)
LOT 7 BLOCK I ADDITION
OWNER ~." 1
(Name) ~C- \-\6\""'\ ~
(Address) \ ~ ~ -, . ',-0..", ~ \ (n Ci.r. c:::J::
1. Pink File
2. Green City
3. Yellow Applicant
Date Rec'd
PERMIt NOO8-/gQt{
ZONING (office use)
APPLICANT ' ..
(Name).! I y'h~ "" \ -\-to~ (Phone) Q th)-L\:3- ,a:tq
(Address) (cA::D \.J.). \L-\( ~ G\ .;t- \(::L, r. ~~ l)Cl\ \G.A SS \,:)..y
- (Address) 1 (City) 0 (Zip Code)
(Contact Person) ~ ~\~ (Phone) q5~~I-~CHq
~PPLICANT SIGNATURE JQ~ Q ~ DATE 10-2--03
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL ~\ \ \ \ d.:: l lliPKQ, roUCR. FUEL ~rlL\
FLUE SIZE ( n II RETURN OPENINGS INPUT''::> i) ~ ~ OUTPUT <OO,CC()
)
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
TYPE OF SYSTEM
FIREPLACE MAKE AND MODEL
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ ~~a::::>
I
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERl\'lll FEE
lice Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$
$
$
3C\ . SCJ
.iO
qD~
Paid t;tJ .'-
Date /0 ' b---03
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
$39.50
$39.50
$39.50
L/ 539 d--'"
ReclO~o~__03
By ~
U
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Jo
.
Job Address
Heatlrig ColWaCtor
Name of Teater
Date
Percent 0
Percent CO2
Percent CO
Stack T8"1).
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
!L23"7
Frti'1tf,~ c (~
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
o MECH FINAL
Fi/II"i't "U- /
COMMENTS:
/ 10 C'R
(/l J'---
DATE TIME
2 -/!b:J Cj
1- Iti"2
... 13~~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
1-{;.4 I~,,~,
C; I p
I ' '-
i WORK SATISFACTORY. PROCEED
, CORRECT ACTION AND PROCEED
o CORRECT ~~R~;t!'-L FOR REINSPECTION BEFORE COVERING
Inspector: Y V r Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!