HomeMy WebLinkAboutMechanical Permit #01-1203
;fj PRIM
€~~
~~..V
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
.~~J;t~~"
~q3~- ~~du~
~: ~~~:w ~J~icant PERMIT NO"",~ ld(;y3
,,*',?"
tt~ONING (office use)
, PaS'O
(Please type or print and sign at bottom)
ADDRESS
LEGAL DESCRIPTION (office use only) rc1
LOT ilBLOCK;A ADDITION a~d 1?/~;e...:1 PIDd~--3/"-O/9-q,
O~bK
(Name) /~-rKE ~"'T?- (Phone)
(Address)
APPLICANT
(Name) S, A 7}::-w.:rn.r- ;;!.A-.5 . ~~ 4' ..s
(Phone) 9~- Y~;J...- 3f~o
//Ac.6..v..rk ~ $:s3f" '7
(City) (Zip Code)
(Phone) ~~.
~ DATE /O~~
/ /
(Address) -'71:.7 A&~c..A;eA- ~-I
(Address)
(Contact Person) / ks- ./)
APPLICANT SIGNATURE -f/ (2,
.... ~
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
OUTPUT
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
fP ~~/rftJh _
FEE SCHEDULE - a--
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
1 % of job cost
$39.50 minimum
$99.50
$64.50
Residential, Gas Fireplace
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
8CJ, S-D
.50
iIO.IOO
(Office Use Only)
Building Official
Date
Paid l/{J 100
Date --0 'J
IV-~
Re~eipt No.} J .'.."";;1
lI0 ''J, ;;
Byr~
U
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE
INSPEC-TION NOTICE
ADDRESS
5932-
SCHEDULED /.!i~~,
~
'1:30
OWNER
CONTR.
PHONE NO.
PERMIT NO.
OI-I2.D~
o PLUMBING RI (P) 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP Jd FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL ~ II GASLlNE AIR TST
o MECH FINAL ({.I5/:J r=: P,
COMMENTS{\) ~ ~ ().4-
~-~ ~~~
~Fi-AJ I ~ ~
o -
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
L-,s*
All: crL
o WORK SATISFACTORY, PROCEED
~CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~. Owner/Conlr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI