HomeMy WebLinkAboutMechanical Permit #01-0991
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~NU'V
CITY OF PRIOR LAKE P
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
Si:.P i 0 2001
I. Pink File
2. Green City
3. Yellow Applicant
, ~...' - .. . j-I./ / !
PERMIT r:!?-OJ-tJ lfCfT j
(Plliase type or print and sign at bottom)
A{?ORESS
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ZONING (office use)
R1SD
-
L~GAL DESCRIPTION (office use only)
L~)T~LOCK ADDITION '11 oitt.J.ooocl
O)VNER
(Nflme)
(Aydress)
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t\~ ~ ~ ~V""\
f~'~\\ ~- Y'\ ~-\- \. \ r t ~
PID~5 J l'-f 1- o/~-C.
9S"~-~",{"\ t J("\~ II
(Phone) "-'1 '-' J....'1
AVl~LICANT "" \ \
(~ame) \<\~ -\:f\.) ~,r- -\- n ~
(Ardress) \~ ~ ~\J \.J ~\ L(j~ (-\, V "-
(Address)
(Cvntact Person) "\ (,\ V\ '---\/ S L"" I( 'L.\ \.
AB.PLICANT SIGNATURE 0'{\ VWA....1 L~
(Phone) ~ S :~_. '-\ \\ l- ~ \ ~ l{
~" (1- ~~\~ \'~ SS~'Id.
(City) (Zip Code)
(Phone) C)~. ~ - \;\ ~ t- ~ \ \J_,--\
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION JQ REPLACEMENT 0 ALTERATIONS
FU~NACE MAKE AND MODEL FUEL
FLVE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM REA TING OR POWER PLANT
. OWarm Air Plants
DGravity
....I:J Mechanical
~Air Conditioning
DVent. System
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
FI,EPLACE MAKE AND MODEL
Inq..tstrial, Commercial & Multi-Family
Re,ldential, Heating & AIC (New Construction)
Re~jdential, Heating Only (New Construction)
FEE SCHEDULE
t % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
~~
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT :FEE
$
$
$
.~ ~ -~9--
.50
Ya~
(Ol\ict list Only)
.'7
lhis Application Becomes Your Building Permit When Approved
Building Official
Daft
Paid
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Date /J . AI
7/ //-(/
Receipt,No. . a
LlD~.!::> -,
BY~
U
24 hour notice for all inspections (952) 447-9850, fllx (952) 447-4245
OF PRIOR LAKE
.iPECTION NOTICE
DATE TIME
SCHEDULED 3 - J -03
II :q:j
ADDRESS
317t{ DcJ~ruJ- ~r
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
,t ·
CONTR.
PERMIT NO.
01- ~'i/
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o G~SLlNE AIR TS]
)11 .BL. 6~~
_ _.A._
(! l~ ~ htr~ cr6 ac. ~(Vll_O.
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT . ~LL FOR REINSPECTION BEFORE COVERING
Inspector:
CAL'
o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl