HomeMy WebLinkAboutMechanical Permit 04-0026
ClI'i OF PRIOR LAKE
HEA TINGI AIR CONDITIONINGIFIREPLALE PERMI.'
Date Rec'd
- 0
Illb~ 'I--
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1. Pink File PERMIT NO
2. Green City · O~. OOz P
3. Yellow Applicant
(please type or print and si.KQ at bottom)
ADDRESS
.gs~1
}CO)I feu" / ---rrall
. ,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z6~ J 7". 0 rr"" -0
C?SA- ~
(Phone) c22fJ-Pl3 7~
OWNER
(Name)
n; /J/t'tflt 8. K81)
'65";(./ I-oyfai../ I r~
(Address)
~:;~fANT Fi'v-I1-'L[f~ !fearfUf/gntt1, (Phone) 95'~-8'9'Gl-rJ?~
(Address) 3 &, () CV. If Uli!I/3 &. /' JI)J/ I j /~ j )JJ ~ 55':33,7
(Address) (City)' (Zip Code)
(Contact Person) K," f- _t _ (Phone) 97':?<-8!l(J-(J7.s:g
~PLlCANTSIGNA~ f;Jcu.tf~P !l,v~' DATE r.Y'1 b /Gf~_, 0</
. APPLIC~ PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 ALlbM TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT au 1 t'lJT
TYPE OF SYSTEM
HEATINGORPO~RPLANT
DWarm Air Plants 0 Steam PLEASE NOTE:
o Gravity 0 Hot Water Air Conditioner Units
o Mechanical 0 Radiation Cannot Encroach into
DAir Conditioning 0 Special Devices Required Side Yard
DVent. System 0 Other Devices Setbacks
FIREPLACE MAKE AND MODEL -fieaJ - vV'Gd.o JIJ1.(JJ.f}I ::: &' 2- '} 2lJ T 4!. '.JfM II 'ft' .it veVl"1-
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1 % of job cost Residential, Gas Fireplace $39.50
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations $39.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $39.50
Estimated Cost $
Building Permit #
/.--.
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PEffi\iu ~ FEE
$
$
$
'J 9. (7)
.50
4'<J"d1l
lice Use Only)
Building Omcial
Date
Paid~. 00
Date} ,. +-
,. ID . (/
Recen~/5
""'"
By Z
o
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
cITY OF PRIOR LAKE DATE l'ME
INSPECTION NOTICE SCHEDULED I - ~O _Ot..{
ADDRESS .352\ F;,x \-Q.~ \J
oWNER CONTR.
PHONE NO. PERMIT NO. '1. - 002 (,p
!:
t
t o FOOTING o PLUMBING Rl o EXlGRADlFlLLlNG
I o FOUNDATION o MECH RI o COMPLAINT
I o FRAMING o WATER HOOKUP ~REPV<CE RI
o INSULATION o SEWER HOOKUP o lREPLACE FINAL
o FINAL o PLUMBING FINAL ASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
-
--
--
)('WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~T RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: owner/COntr: - -
CALL: 50 F(lR '(liE NliXT INSPECTI!lN 24 HOURS IN ADVA,NCE.
CODE REQUIREMENTS ARE FOR YOUR PEllSONAL HEALTH I. SAFETYI
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