HomeMy WebLinkAboutMechanical Permit #10-548 �
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DA E TUAE
CITY OF PRIOR LA1tE �
tNSPECTION NOTICE SCHEDULED /�
ADDRESS 3�� / � �� �� �,� -
OWNER CONTR.
PHONE NO. PERMIT NO. �� -� G-�•��`�
O FOOTING ❑ PLUMBING Rl O EXlGRADlFILLING
❑ FOUNOATION ❑ MECH RI � COMPLAINT
❑ FRAMING � WATER HOOKUP O FiREPWCE RI
❑ INSULA710N ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL � PLUMBING FINAL � GASLINE AIR TST
❑ SITE INSPECTION O MECH FINAI. ❑
COMMENTS� �j^,.�.:., ,,,,"� �i>' -�` �-��" ����.�
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�'VKIORK SATiSFACTORY, PROCEED
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❑ CORRECT ACTION AND PROCEED
❑ CORRECT WQR F R (NSPECT{ON BEFORE COVERING
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inspector. � � , r -� _ Owner/Contr.
GA� 44'�-9850 FOR THE NEX7 INSPECTION 24 NOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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o � r R lo � CITY OF PRIOR LAKE � Date Rec'd
� � HEATING/AIR CONDITIONING/FIREPLACE PERMIT ( . �,3� / j�
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�t�'NES��� I. Pink File pERMIT NO /'� /'�,
2. Green City •�O J� y)
3. Yellow Applicant ��
lease or ' t and si at bottom
ADDRESS ZONING (oflt'ice use)
`3 \ � \ �� �� S�-.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION P�
(rJa me) R � � `�'� �� �,� l � S (Phone) _l �� a � � � " � 1 V �
(Address) � � � , ( � � � S � �
(NameC� \ \ � l�l� �' ) � � �, (Phone) � � ^ � � � - � � 01 �
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(Address) `�R � � O `� `\ l C� �'v� �V�'l. � ,�1 G ,� l, 1 �� � 9 v �� , �
� (Address) (City) (Zip Code)
(Contact Person) � � � l-- � L � � � �-- (Phone) 9 , a r � � � - � i ��
APPLICANT SIGNATURE DATE �' a �� I�
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION J,�"REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL V^V (�•'�'1' 3, S� �.I UG� O� 0� FUEL ���
FLUE SIZE P�` RETURN OPENINGS INPUT u�, O dU OUTPUT 6
TYPE OF SYSTEM HEATING OR POWER PLANT
F PLEASE NOTE: Air Conditioner
�$Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
� ❑ Mechanical ❑ Radiation Fireplaces with Box Additions or
�Air Conditioning ❑ Special Devices
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEESCHEDULE
Industrial, Commercial & Multi-Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
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Estimated Cost $ V/ � / Building Permit #
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HEATING PERMIT FEE $�_
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ �(�l�/ _
(Oftice Use Only)
This Application Becomes Your Building Permit When Approved Paid� � cei No.� U � / �
Date . 2 3 � a B
Buildin¢ Ofticial Date ��
24 hour notice for all inspecNons (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372