HomeMy WebLinkAboutMechanical Permit #01-0490
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS ~ 0/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING ~
o INSULATION
j!D FINAL
10 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
I-Lf10
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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* Permit # " OJ.: LJ'f9D
* Job Address t..j ill) / fJJ~4 ~ GAIt $ 1-
* Heating Contractor _ Pr ~ I) r L.~ /(,. II-I-e..
I ) ~ A. __ A / / -'
* Testers/Signature ~ ~
){ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPE(
/6... Inspected
Inspector: . r J~ I Owr PERFORMANCE TEST
CALL 447-9850 FOR THE NEXT INSI * Percent CO2 J, / * Percent CO
CODE REQUIREMENTS ARE FOR YO * Percent O2 7/ D * Stack Temp.
~~
* Gas Line
Pressurized
INSN Final Inspection
Date
Pounds
Presssur~
Time
Do/D
~ '100
Date
. CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink File
2. Green City
3 . Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
L/~o/
fJkUJ~-;-..sf SF
LEGAL D:t;SCRIPTION (office use only)
La CJ.- I .3
LOT BLOCK3 ADDITION
~ 1l:;W
PID;:z5~ 00;)-030-,0
OWNER ~
(N ame) (" )[ /} II c;,e:,
'V I
(Address)
/J{l fe"r-nLO--rJ
(Phone)
~ Jhdt~il r n/C (Phone)
jJ-d~ '&~k- CL+
(Address)
(Contact Person) 'b e 0....10 ~ r- e..", ~~ .
APPLICANT SIGNATURE ~ ) ~ ~~
\.
APPLICANT /J eo
(Name) 1/ /}UrU
l &~t;<? If
(Address)
'75)-- L/L/7-Y/(6
(J~ ~ ~b3h'-
(City) (Zip Code)
(Phone) ~~J.-l../Y7-gJ / D
DATE 5-;U-OI
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION
FURNACEMAKEANDMODEL ~met'\ c..~tJ
(If
FLUE SIZE 0 RETURN OPENINGS
TYPE OF SYSTEM
~REPLACEMENT 0 ALTERATIONS
S'-\--cO IIUDllJlJe 93& FUEL /(J4t- 6~s
)J).?- INPUT It> 01 tJOD OUTPUT ~6, (0
HEATING OR POWER PLANT
~arm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices .
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
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
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ..61,S-D
$ .50
$ LlO ~O 0
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid if tJ I' 0 ()
Da~/_ ~~ J
Rece~q6 j 3
By gu
24 hour notice for all inspections e~52) 447-9850, fax (952) 447-4245