HomeMy WebLinkAboutMechanical Permit 01-0822
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLALE PERMIT
(Y'
Date Rec'd
(Please type or print and si2ll at bo~....&U)
ADDRESS
1. Pink File PERMI NO
2. Green City 1 y; 1_
3. Yellow Applicant V
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LEGAL DESCRIPTION (office use only)
LOT6BLOCK Jf ADDITIONfL}~c;0
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OWNER 0 f \
(Name) \,J~ , L'A~ kC\ (" b ~
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APPLICANT ( /1 () / I I
(Name) L A.I( ~ v t' ~ 7T~ -h'....'" A r \~r
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(Phone) J. ~ ( - 3 3 0 S
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(City) (Zip Code)
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(Address)
17~5"'
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5.1:=.
(Phone)
(Address) /1 ~l
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(Contact Person) ..--
APPLICANT SIGNA~ /()...... ~ f-
(Phone)
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION )(REPLACEMENT D AL TERA TIONS
~KE AND MODEL f<<-'J " ~ :). h.. T.. '" FUEL
FLUE SIZE RETURN OPENINGS INPUT OU 1 flllT
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OWarm Air Plants
o Gravity
~echanical .
. ir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL
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FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERlVlll FEE
$
$
$
3q,_~o
.50
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid '10,() ()
Dati',- ~ -lJ I
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Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
R~~'7
By r
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CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED ~-~
/'73 ({5' %dq~-+
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ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CJ / - ?,;l-d-
o FOOTING
o FOUNDATION
o FRAMING
~~~~TION ft/~
o SITE INSPECTiON
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADlFllllNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
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ErWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ 1("' (/fJd) Owner/Conte
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl
INSNOTl