HomeMy WebLinkAboutMechanical Permit 04-0040
CITY OF PRIOR LAKE
REA 1 INGI AIR CONDITIO~l~GIFIREPLACE PERMIT
Date Ree'd
I. Pink File
2. Green City
3. Yellow Applicant
PERMIt NO.O~_ OO'l()
~ease type or print and sign at bottom)
ADDRESS
C),707 tdJli/ LIW~ AJtJ
ZONING (office use)
p~p
......
LEGAL DESCR1rll0N (office use only) 0 '
LO~1BLOCK J ADDmoNrA~jt<a;tti..t/f/~ PID;;<5"301-0a--r()
OWNER
(Name) ~ E( ,J(~J.Jol-~ - (Phone)
(Address)
ArrLIC~ .
(Name) ~ \ EA.. t}1 tl.- JAJ e .
(Address) "'01 "od S,- tL,
(Address)
(Contact Person)
J~),J
(Phone) 0UI-'~j-/ZO&
~~tIJ" Mt/ SJ0S7
(City) (Zip Code)
/ ::ro~~hOne)
L. t
~h. ~/o~
APPLICANT SIGNATURE
DATE
PLICANT~EASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL ' FUEL
FLUE SIZE RETURN OPENINGS INPUT au 1 t'lJT
DWarm Air Plants
o Gravity
D Mechanical
DAir Conditioning
DVent. System
HEATINGORPO~RPLANT
D Steam
o Hot Water
D Radiation
D Special Devices
D Other Devices
J(1)~ S(J3{, tJ~ ~.
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
TYPE OF SYSTEM
FIREPLACE MAKE AND MODEL
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERlVll.l ~EE
$
$
$
l~q 5tJ
.50
t{() ~ .,
,--4>ffice Use Only)
~his Application Becomes Your Building Permit.When Approved
Building Omcial
Date
Paid L/O,- --
Date/~ J--7- {j 'i
Re~~1
By
/d
U
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
INSPECTION NOTICE
DATE nilE
l-?J!>-~
SCHEDULED
ADDRESS :J:J ()? ~ ,. \clf;, ~
OWNER
CONTR.
PHONE NO.
4 - t(()
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILUNG
o COMPLAINT
dFlREPLACE RI
o FIREPLACE FINAL
~~EAIRTST
COMMENTS:
~l~ J C'~~-<-\_ +\a~~~J +0 V~
~ 0
LRK SATISFACTORY, PROCEED
~~;~ T CTION ANO PROCEED
o CO ECT K. CALL FOR REINSPECTION BEFORE COVERING
Inspect~. Owner/Contr.
CAt: . ~o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
. COD RE UlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
/NSNOn
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