HomeMy WebLinkAboutMechanical Permit #03-1570
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FlREPLACE PERMIT
Date Rec'd
/2-,,+.03
I. Pink File PERMIT NO
2. Green City · 03_ /570
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
{;f)ql SHA 10..,JJ6 ~
~A-\L Sic
rJrL.' D'v- t-AKe M v.
6--1- '3 ? 2.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
A- rU \"\-\. ~ U \...)
,
T<; A Ie::. A t.<. ( f
ZONING (office use)
PID 2.? /79. 0/4-. lJ
(Address) )" 1 6t I .s- f.t A.u I-l D iJ (R.A-" ( L 'S I ~
(? ..
V\6v l4kl-'
(Phone) <7 s-' Z- l.( '( 7 ~? S 'I
11-1 ~ J . S- S- 3 ? L-
APPLICANT
(N ame)
(Phone)
(Address)
(City)
(Address)
(Contact Person)
(Phone)
DATE
APPLICANT SIGNATURE
(Zip Code)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT ~ AL TERA TIONS
FURNACE MAKE AND MODEL --G-~ rl A& eke A "t' G" ~. FUEL tV A-, GA-S-,
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % 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)
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Estimated Cost $
Building Permit #
0.3 , /57D
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERl\'lll FEE
$ 3'1:50
$ .50
$ 4-tJ. ao
'lice Use Only)
'~is Application Becomes Your Building Permit When Approved Paid4- O. 0 0
Date
Building Official Date I ~" 4-" a.3
24 hour notice for all inspections (95~7.985~,~(952) 447.4245
.s / t::;;v6 ~~ 7 "" 18 S 4- 16200 Eagle Creek Avenue, prior-LaKe, Nl1~ 55372
. Receipt 4~ 0 {q 0
By ft&L
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
, ~ltf (
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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SCHEDULED
Slf.PI1IJ ""'1
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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DATE TIME
~-L-Ol-(
1r/
, ....,
5- (S/~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ASLlNE AIR TST
o
~WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORRECT,WJ'f~Y9=OR REINSPECTION BEFORE COVERING
Inspector: /I JI V Owner/Contr:
II /
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY/
/NSNOTl