HomeMy WebLinkAboutMechanical Permit #10-836 OATE TIME
CITY OF PRIOR LAKE -
INSPECTION NOTICE SCHEDULED �
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ADDRESS / `
OWNER CONTR.
PHONE NO. PERMIT NO. �� "' L�'�� 3�
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O FOOTING ❑ PLUMBING RI O EXJGRAD/FILLING
❑ FOUNDATION ❑ MECH RI 0 COMPLAINT
O FRAMING 0 WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOQKUP ❑ FIREPLACE FINAL
� FINAL O PLUMBING FINAL � GASLINE AIR TST
� SITE tNSPECTION ❑ MECH FiNAI ❑
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COMMENTS: � � � � ,.� ��-; � � � �
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�WORK SATISFACTORY, PROCEED --
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WO LL FOR REI ECT{ON BEFORE COVERING
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Inspector. - / ,--'-�''�, ~ Owner/Contr:
CA � 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R QUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFBTY.�
INSNOT7
� P RIp CITY OF PRIOR LAKE L/" Date Rec'd
� �� HEATING/AIR CONDITIONING/FIREPLACE PERMIT �' Z��D
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� '. p �"� F; '` PERMIT NO. ` . �
2. Green City �
3. Yellow Applicant
Please e or ' t and si at bottom
ADDRESS ZONING (ot�ice use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDTTION PID
OWNER
(Name) (Phone)
(Address)
APPLICANT �
(Name) Pc-� ac- L. t.� ����� (Phone) ���� ,�— � �� �
(Address) � �� � � ,�f �-��U� �1 �-- f f'1 dc' L.�l`C_ /�/L� �_S.S��� �
(Address) (City) (Zip Code)
(Contact Person) (Ph���'�`7� ����� �
APPLICANT SIGNAT DATE �
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water
❑ Mechanical into Required Side Yard Setbacks.
❑ 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
FEE SCHEDULE
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
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
(Oftice Use Only)
This Application Becomes Your Building Permit When Approved Paic]C c�� R pt No. �� d � +
7 .J v
Date
Buildine Official Date — . � � �
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372