HomeMy WebLinkAboutMechanical Permit #01-0654
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date'Rec'd
1. Pink File
2. Green City
3. Yellow Applicant
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PERMIT NO'I-o~5 'f
'~:ZONING (office use)
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(Please type or print and sign at bottom)
ADDRESS
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01' .' cJ-t...
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LEGAL DESCRIPTION (office use only) ..
LOT ~LOCK ~ ADDITIOW O~ s-e Eo+- 3 rei-
OWNER / '
(Name) Or, L v b~... s I. . / (phone)
(Address) L.j (;'J '1 t.rJ; '"",,:rl ,J DI" 'v~ ~) G
APPLICANT n
(Name) L...A ~ u:/ f" -)1 <41v:) LA, '/
(Address) '7J~1 L '"---,.- 1II/~ ,../ L q "-~
n J (Address)
(Contact Person) 0./\../
APPLICANT SIGNATURE ~ ~p-
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PID dS - 3/1- tJ d~~
fj). -S-rs-- 37r1
'-('10 - ~) d-%
I:,'P/ f",-~~ /1LA../' ;9!5-'??:l.
(City) (Zip Code)
(Phone) t-j t.t c..' ~ '-t ) d... ~
DATE 7-.). - d I
(Phone)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
DWarm Air Plants
DGravity
o M~chanical
~r. Conditioning
./[jVent. System
D Steam
o Hot Water
o Radiation
o Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % 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 PERMI. FEE
$
$
$
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'(tJ/OU
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid LI~, oU
Dat7_d.--o I
Receip~Ej~ I) L/
By
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
:SCHEDULED /j - (p/O J d ~ :J (:)
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CITY OF PRIOR LAKE
INSPECTION NOTICE
.....
ADDRESS
OWNER
CONTR.
PHONE NO.
f:tERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECt-! RI
o FRAMING 0 WA TE:R HOOKUP
o INSULATION 0 SEWE:R HOOKUP
~FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECHI FINAL
COMMENTS: /9 / (l .-
I
DATE TIME
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
l WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~LL FOR REINSPI:CTION BEFORE COVERING
Inspector: V ~ I Owner/Contr:
./
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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