HomeMy WebLinkAboutMechanical Permit #01-1086
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
I Pink File
2. Green City
3 Yellow Applicanl
. f
PERMIT NO. () (II tJ 8' ~
(Please type or print and sim at bottom)
ADDRESS
'LDO'lD rr'mb-',dO(~ Q\rCJ€-> S~
20NING (office use)
RI
LEGAL DEsCRlPTION (office use only)
LOT3 BLOCK 3 ADDITION
P .NtYGW~ d~
PID ;;). 5 -()()Ci- Ol/-()
OWNER
(Name) Lerflj (; JOll~+ olsen (Phone) q~-4Lj7-LjLSB:'D
(Address) iLDD70 ec.u'"Y)br,~ O_ir-CJLJ S~
APPLICANT .
(Name) ~h'e--'(:~ ~I ~'deJ (Phone) q~ -4 ~ - 7c:f1Cf
(Address) ~r;;tJ L.t) . IL)W : "'\<:)J '. 1; 1<.:1...P ~\c..., \/0 t (e.J \ ~t--)l ~LI
(Address) ., (City) "-.J (Zip Code)
(Contact Person)1:X.t" L.ill1 \e.r-0 (Phone) qSd -Lj~, .- 7Cf:-tQ
APPLICANT SIGNATURE I~ A L~~ DATE g/;;lY Jat
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 00 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL CClr"r"et'r : ~U ~ V (')ty\- t " FUEL NC.:t+-u.C(1'
FLUE SIZE RETURN OPENINGS INPUT ~,~ C1....'D OUTPUT ~D
TYPE OF SYSTEM
DWann Air Plants
i . OGravity
o Mechanical
DAir Conditioning
DVent. System
Cl.\O (' .
RR.E:f L. ;~ MAKE AND MODEL rl.(fl e-r :
HEATING OR POWER PLANT
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
3B TiQ O;~ (~tnl)
/,'
FEE SCHEDULE
I % of job cost Residential. Gas Fireplace
$39.50 minimum ~.
$99.50 '--B..esidential. Additions & Alterations
$64.50 Residential. AC Only
$39.50
Industrial. Commercial & Multi-Family
Residential. Heating & NC (New Construction)
Residential. Heating Only (New Construction)
--'"\
$39..50 _
-$39:50
Estimated Cost $ ~~ Sl"):-
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PE&'iIT FEE
$
$
$
\. ~Q .~L.)
.50
40 . C.D
(Office LIse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 2/0.cV
Date -0 I
I~ -- ;<
Rece!p~ No. '0
'70 &:,Lfl .
B't;jC--
..
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
2-J-O
ADDRESS
Ie Of 0 UW\ ?-,.d~~ C,-
OWNER
CONTR.
~
Of -/Oy"-^
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
ItJ-o '>rOIL.- / Ac v'" i-r
~N) I 1\\
V / tf )
"--'"
COMMENTS:
~
/ /Io.r..
t L~ t U L
"'-
--- ----
-.............
;:,./~ )
--------------
;K WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: y1iJ )-- 2tJ-o '} Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY/
IftlSNOTl
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