HomeMy WebLinkAboutMechanical Permit #01-0655
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
S$
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5.G
LEGAL DESCRIPTION (office use only)
LOT BLOCK (;Z ADDITION
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OWNER
(N ame)
S i..-/',,~ ~~ ~
J [ 0 f J ~ r h ...Q 5 S (v C\r, '
(Phone)
'-II-{ 0 - S-7 ~ S--
(Address)
SE.
APPLICANT
(Name) I- It l. Vi J/ J / <J2
(Address) 71 S-I
(Contact Person) Q, N
9I-e~ .~,' ~"-j
L'or9 1/1 '-eW
(Address)
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Afr
(Phone)
J.1'1D ~ '13 ~ <6
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(City)
..N' .A./
,5- '3 7 )..
(Zip Code)
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APPLICANT SIGNATURE
J..4 LA () .- Lf 2.) ""'.
(Phone) ~~-f ~ L)
DATE 7 - d - l I
APPLICANT PLEASE COMPLETE BELOW
.
DNEW CONSTRUCTION o REPLACEMENT %ALTERATIONS v fi~). ., I .. #"f:J
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
o Gravity o Hot Water Air Conditioner Units
xechanical o Radiation Cannot Encroach into
Air Conditioning o Special Devices Required Side Yard
Vent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCH]~DULE
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 #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Office Use Only)
Tbis Application Becomes Your Building Permit Wben APprov~
Building Omcial Date =--J
By
24 hour notice for all inspections (9~S2) 447-9850, fax (952) 4474245
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEttULED
7.2,..0 J
z.~ 00
ADDRESS
1&902- W/L,067ZlV6SS 772-.
OWNER
CONTFt
PHONE NO.
PERMIT NO.
01-0(055
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING IRI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING IFINAL. a\ ~ GASLJNE AIR TST
o MECH FINA~ (V:::J f'.' t'l:fC ~
'.,""iIIL
)
P'
~WORK SATISFACTORY, PROCEED
S CORRECT ACTION AND PROCEED
:.:::O:ECT WOR~ORr REINS:::::::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl