HomeMy WebLinkAboutMechanical Permit #01-1149
CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FIREPLACE PERMIT
(Please type or print and sign at bouuu.)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOTU BLOCK ADDITION ~ .p~t-
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OWNER,c? t? A
(Name) JrAL:. ORA Nt:?,;t<-SO/v
(Address) _s::;~
APPLICANT /l
(Name) S"7A-re-w::rn/p-&A-5 .s:;~tL:rcr..$ ~NC.
I. Pink File
2. Green City
3 , Yellow Applicant
Date Rec'd
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(Phone) 9S'~- YV7- ~
(Address);20 / ~',.#A..:rN
/J (Address)
(Contact Person) -t;..~ '" -) / /
APPLICANT SIGNATURE f-/ <L
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(Phone) 95" ~ -Y<;I'...~ 1" tI 7 ::3
~k..rk ~~:1Y7
(City) (Zip Code)
(Phone) 9~~- YY;2- ,--r~ 7 J
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APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
o Mechanical
~", "'., DAir Conditioning
~ " . DVent. System
C7~ANDMODEL
Industrial, Commercial & Multi-Family
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
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 #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERlVlll FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
$
$
$
3Qr50
.5..0
L-IO.d ()
(
Paid,L I 00
~O,
Date fo-II/' () I
au 1 puT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Recei~~fb i ~
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ADDRESS
/:;- 3~Y
DATE TIME
SCHEDULED ( ( )-; ?, /-cf 1/-;tJtJ
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CONTR. '- l,.A
CITY OF PRIOR LAKE
INSPECT\ON~NOTICE
OWNER
PHONE NO.
PERMIT NO.
) -/ IY 9
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 (M 0 FIREPLACERI
o SEWER HOOKUP is. ."P-"FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
COMMENTS: YfL; f' ro tu71.f2A.-,' - tS~
~fM/ . -.~
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W02. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ