HomeMy WebLinkAboutMechanical Permit #01-1369
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
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(Please type or print and sign at bottom)
ADDRESS
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3. Yellow Applicant I' ::::>CP ~I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PIDZS-/e7- ~__~
OWNER
(Name) a,n~-" ~# J,..... (Phone) q~;;) -~~c;I _a:? / / .r
(Address) /6/9'7 ~//~o~ 4./e
APPLICANT
(Name) S~kM~ c;;.( .G/V", r:...r-
(Address) ~/ ~Jc .4"b.,M &4
(Address)
(Contact Person)
J()~I K:
(Phone) 9?oJ- ~~.,..)- ? ~ "7?
WCJC'~~~''l 553 !'?
(City) (Zip Code)
(Phone) ('01;>- ~7o-~~
APPLICANT SIGNATURE
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DATE
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,
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT ~ AL TERA TIONS
FURNACE MAKE AND MODEL H#~~i~ ,/J,t,(-,~ ()(/lZrJ"ft~.rr FUEL~-/:
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FLUE SIZE 7 RETURN OPENINGS INPUT eiJ 7, 7'0(,) OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
o Gravity
D Mechanical
DAir Conditioning
DVent. System
D Steam
o Hot Water
D Radiation
D Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
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
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit # 0 I-I J (p q
I
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3'1. S7)
.50
4-(). 0 0
(Office Use Only)
This APP~~Uilding Permit When Approved
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B I ing Official Date
Paid 4<J I uV
Date
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Receipt N~ q 1~
By 1/1.--
I
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
. OF PRIOR LAKE
.t4SPECTION NOTICE
ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED I~~I
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CONTR.
PERMIT NO.
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o PLUMBING RI
o MECH R'
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
~O COMPLAINT
(~ FIREPLACE RI
~ FIREPLACE FINAL
GASLlNE AIR TST
o
COMMENT~M ~ r ~~
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o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ J
'-"....) ~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ