HomeMy WebLinkAboutMechanical Permit #01-1353
G)
~..~
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
//-3 ()p'O /
1. Pink File PERMIT NO
2. Green City . ()I-I
3. Yellow Applicant , ..
(Please type or print and sign at bottom)
ADDRESS
~~ ~ '3 tf () In ~ !J tJ. J;-o i I S (;'.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
110 rf R a fl S (. h
J_5'~3L/
(Phone)
9f~ - tjq{l-tJg}(~'
OJYJ~ Trr)l'( Sc-.
If
APPLICANT . A.. IJ I III " /J r J jjl e I).
(Name) {=:'I' ~I!'~ CoO ("arIItJ II (!/y I'r ti<:; (Phone) 99-tJ 9'tt- 07srJ
.37?~{J !1i::JfwJj IS PtfD/5//r'l/e 1!!!4/r 53~';;~COde)
(Contact Person) ,J( iJ t~ fit S' . j (Phone) tjS~ - J':.i1J -.O?~~
APPLICANT SIGNATURE \. '- _fJ _%I4b1P DATE ./!.Itu/,. ~tLt-{"//
tI' . /
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
(Address)
(Address)
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
~ ent. System
REPLACE ~ND MODEL
'1:;;. _
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIl FEE
$ 31.50
$ .50
$ 4-0.00
(Office Use Only)
Date
pai~.OO
Dat~ -.30 -0 I
This Application Becomes Your Building Permit When Approved
1- $0- 0 l
-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
I?-/f. d( 4; c.rD
/5S~ CJn6G14 ~r/VL-
SCHEDUI:€D
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
1-(353
o FOOTING
o FOUNDATION ~
o FRAMING
o INSULATION
~FINAL
I] SITE INSPECTIO
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
~o COMPLAINT
0... FIREPLACE RI
~FINAL
~ G^~t.l'JIR TST
~
COMMENTS:
~/
~~
1;1
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~L F:R REINSPECTION BEFORE COVERING
Inspector: - . vr:y- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl