HomeMy WebLinkAboutMechanical Permit 04-0111
CITY OF PRIOR LAKE
tlEATING/AIR CONDIlIO~ll~G/FIREPLACE PERMIl
Date Rec'd
~:~ ~:~ PERMITNO.OJJ_ 11/
3. Yellow Applicant 7
\.dease type or print and sign at bottom)
ADDRESS
I..J05~ fJJLndsnnJ1 e," r
ZONING (office use)
PUSD
LEGAL DESCRIPTION (office use only)
LOT~BLOCK ;ZADDmONW~~ tntti.e C1CL1l.e
I
(Address)
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4{JJ7'..G' 10' lJd 50 JA!J
PID c)S''- c73~ OO~--{)
95d. -
(Phone) 9/j,J. - 37 t// 9
OWNER
(Name)
,-
t,'~, e..,
APPLICANT . A _ L I "-- L I _" _ Q5:J -
(Name) F\\re~/~ 17 f!-aY'fA r a.cLJM P", (Phone) ~t?'//-CJ75>3
(Address) 3 gso W, +.f /JlI J /3 J'5IAYH,({/,1Ie LJiI/1I... S-D37
(AddreS~ (City) (Zip Code)
(ContactPerson) J<Cf ~ ffi~. (Phone) -J.J;;z.-~-erJSd
APPLICANT SIGNATURE' .AP ~/!. ~ r~" DATE, ~ / ~ / t't/
(/ .... "
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT au ll"uT
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
FIREPLACEMAKEANDMODEL tL J- !V-rrl!JfJ1a1t) : /J/J1rlTBt ;J:.;lJ1f1Qs 'I'.toe~""
~ V /Fi~~i
FEE SCHEDULE f/t./It 1''''tJC~
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 P"uuit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERl\-.u..l FEE
$ ~ 9-CO
$ ,50
$ l./().---
,. ',..mee Use Only)
lhis Application Becomes Your Building Permit When Approved
~/
Building Official
Date
. Paid l/O.-----
Date 8-d~~
. ReC(/~qO 6
By f
~
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
INSPECnON NOTICE
ADDRESS 4 D 5 ~
OWNER
PHONE NO.
o FOOTING
[J FOUNDATION
o FRAMING
o INSULA TIOH
o FINAL
[J SITE INSPECTION
COMMENTS:
DATE TIllE
SCHEDULED
3-5-0 t/
LV i v-v:2 ~ ciY1~
CONTR.
PERMIT NO. '-I .., t II
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
D SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
D EXlGRADIFILLlNG
o COMPLAINT
~FIREPLACE RI
o FIREPLACE FINAL
.E"'&A!JJf4E AIR TST
[J --f'~"
~RK SATISFACTORY, PROCEED
/ 0 CORRECT ACTION AND PROCEED
[J CORRECT. RK. CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
'REMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
M.ltl ~_. .I