HomeMy WebLinkAboutMechanical Permit #03-1606
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/~lKEPLACE PERMIT
Date Rec' d
~: ~:en ~~~ PERMIT NO. ~ 2 _I J Q I
3. Yellow Applicant U..:.J co?b
(Please type or print and sign at bottom)
ADDRESS. I. . /_
/53 ~~
hSA. PtOY7f f1oa!l-
ZONING (office use)
tel SD
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
I-
PIDrJ5-0IfJ- 007--"?
OWNER
(N ame)
. ~ r (Phone) 9S;-Cf'ItJ- 29~
/5 :t r::;~. &rm tJlJ · frlDV hC/K.,lJ j Jf;Yl/~ Sb3 ? -2_
~~;~~AN1-:i(.c?g,J1 f!emrfh tf-tJoJth tJ_ (phone) 9f:-1-OtJCJ--{J7~
(Address) ~:1-D 11L~ HfA/ fA /3 B/.IfY1)J/~'l0/#/1I~ 62;"33,1
(Address) ~ (City) (Zip Code)
(Contact Person) Kit .. (Phone) tt.5~ -t90'""fl?6J:t
. "-'PPLICANT SIGNATURE ~ _~. DATE /Jet': ~ ~ M zi:3
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT~AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(Address)
TYPE OF SYSTEM
OWarm Air Plants
o Gravity
o Mechanical
OAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL ~-f
HEATING OR POWER PLANT
o Steam PLEASE NOTE:
o Hot Water Air Conditioner Units
D Radiation Cannot Encroach into
o Special Devices Required Side Yard
D Other Devices Setbacks
-livio JuoJt2/,~ Efi-J-J!j/'-{Jar 1~~Y"t-J
v
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
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
/'
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERlVlll FEE
Building Permit #
$ ~q-~
$ .50
$ t4L' ~ ---
(Ofiice Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 11 (J .:---
Date/:J-'" "d-tj - '3
ReCr;~f/fi)
~
U
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
/91C 2-
/J-0-o'7
hs4 (/r /lei
SCHEDULED
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
COMMENTS:
/
/ /1__
( L/l~
\
~.
.--- --
~-/ca;
o EXIGRADIFILLlNG
o g)MPLAINT
,er-FIREPLACE RI
o F~CE FINAL
~ASLlNE AIR TST
o
--
~~
1".. I )
r/(-<-
- /'
~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT 7~ FOR REINSPECTlON BEFORE COVERING
Inspector: I J- - }~~er/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNon
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!