HomeMy WebLinkAboutMechanical Permit #01-1097
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
1. Pink File
2. Green City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT/bBLOCK I ADDITION
srtNO PI 'sat
OWNER
(Name)
(Phone)
Date Rec'd
PERMIT NO.
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:i{~tJtijNING (office use)
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PUO
PID25 -239-o/to-lJ
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(Address)
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r(Name) ~ 7-4,- C lA..//~ c. l..:{t:cr Q1.rv~{: )
(Address) J' 7 .~ 3 IV! q q a rq '- ') -t c..c.. -I I {/t:; cc~ I q
(AdJress) - (City)
(Contact Person) /)~<!...... _ __ (Phone) .<\;I1,yV! If'
~~LICANT SIGN~TURE ~ .fl&1~ ,<)Wt:;-r ~~ /ol'?/tJ J
e
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(Phone) 9Q-.Lf((cJ -39to
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
(~EANDMODEL
HEATINGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
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
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERl\'lll FEE
$ 39.S-O
$ _ .50
$ q{L~
(Office Use Only)
s Your Building Permit When Approved
paid4t? .07.:)
Date
/IJ.3'0 J
t k ..1- 'D (
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
(Zip Code)
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Receipt NJ>~
"fV(, .r-~
By ~ ..-
LD/s-(lt //:'50
~~~
CITY OF PRJOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
5~ 5L/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~NSULATION
FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOO
o PLUMBING
o MECH FIN
('J!
r
~
DATE TIME
! - t-G--11
o EX/GRAD/FILLING
o COMPLAINT
~ FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
~ ,::- J', ,A. .r,
\if WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WOR~ FOR REINSPECTION BEFORE COVERING
Inspector: ~ ~ I Owner/Contr:
"
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI