HomeMy WebLinkAboutMechanical Permit #01-0583
CITY OF PRIOR LAKE
HEATING/AIR CONDJ.TIONING/FIREPLACE PERMIT
Gi''l #?5
(f\ gate Rec'd
~: ~~n ~!~ PERMIT NotOI_ OS~3
3. Yellow Applicant
(Please type or print and si~ at bottom)
ADDRESS
/tR13fJ
Wf>n8 {Jve; ~ Jlb ·
i
ZONING (office use)
c'R l Sf]
LEGAL DESCRIPTION (office use only)
LOT /?p,LOCK ~ ADDITION (J ~ acn~
I
PIr;i)S -6/ 1-03~-o
DflU I {i f0,{)6
~ M !}r:J:0
~;;~~ANT 0JA){l{Jjtl/j,6 /1ir, 1M. (Phone) gS9- (j'-lS-/9a.J
8~r; /9715 -If7 /JA fA), Jf7/Ut()tJtt, IfW o/5~q.
(Address) / (City) (Zip Code)
/]V 1h1 -. (Phone) 1J5~-l/LjS-lq(;()
.rnelial1 (1r:)W DATE !/Ji/-() I
APc:..,JCA~E COMPLETE BELOW
DNEW CONSTRUCTION q\ REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
OWNER
(Name)
(PhOne)?Sa- 440- ty::f10
(Address)
(Address)
(Contact Person)
APPLICANT SIGNATURE
TYPE OF SYSTEM
HEATING OR POWER PLANT
DWarm Air Plants D Steam
DGravity D Hot Water
~echanical D Radiation
ir Conditioning D Special Devices
~ ~~ Vent. System D .other Devices
1i'f;J::;~l~CL MAKE AND MODEL'\ ~ \" 'YD"2M ~
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Industrial, Commercial & Multi-Family
FEE SCH:EDULE
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
~9.5~
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3q.. )-0
.50
ljo\C1:;;L
pa~L/o , cP
Daie
(" .- J 3 -0 J
Receipt N~7 &>0 ?
By au
(/
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (9:52) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
Ie, 71f" L,Ydvt~ &
OWNER
CONITR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FlfllAL
AlG-
I
COMMENTS:
.-----
~ "
( /' /
\. (/( o~~'C
~-
DATE TIME
1 ~ r-'d].
1-~3
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
----..
L~: )
( (L'--/
----
r:rWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. jI1/ q ~- f/J Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNO'TI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!