HomeMy WebLinkAboutMechanical Permit 04-0141
CI.. f OF PRIOR LAKE
HEATING/AIR CONDITIONING/141KEPLACE PERMIT
Date Rec'd
~: ~ ~:~ PERMIT NO. ()' J __ II j J
3. Yellow Applicant '-1 1"1 /
(please type or print and sign at be. ~..--.)
ADDRESS
1305;2 f}' (j-ch ~(A,<.
ZONING (office use)
R rttzd
LEGAL DESCRIPTION (office use only) . . ~
LO~LOCK.:.:1 ADDmON f3-~, ~~(}..fl)
OWNER --P /' d
(Name) ~ a.JIYl ~}S ( or a Y' }IJ IJ (
1671,/5).. BLtuk em)< RoatJ--,
ArrLICANT r::; I 11 -I-L 01 U ^- IAA /'i
(Name) I .;." ~s i(}fJ. ,U- fJ~r/ 11 r lLU-'" ~ _ (Phone) Jl~?^ - nC{(/-(J~?2:8
(Address) 3K"G If.:m..~ ~ S'i/IP /JlUJi. 6fz;~?
(Contact Person) j,(Jf- . OJ 11 (phone) !J5;J.-~-tJ<).5"fI I
/ ~PLICANTSIGNATURE ~_ Z'!l1J..a./.b1' DATE I1J(JJrDh _dld
. APPLI~T PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL 1 bAA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
n.l:"~OFSYSTEM HEATING OR POWER PLANT
PIDdS...i.b4l- ~-()
(Phone) 95A-W-57,c;-
(Address)
DWann Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
o Steam PLEASE NOTE:
o Hot Water Air Conditioner Units
o Radiation Cannot Encroach into
o Special Devices Required Side Yard
o Other Devices Setbacks
/le~f-nJ' GkllJl'ldRt ~ roOOC) 7f). o,,*-
1'1KEPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PE~llJ. FEE
$
$
$
39 S-D
.50
W 0,---
Building Official
Date
Paid i(tJ/~-
Date 3-- /5 "1
Receipt NO.,---:z..
~C/,.')~
'8y C--
7 ) -......{.
C/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
3';).~-ot/
ADDRESS
OWNER
I'::J-O~?. lioc1c ~
CONTR.
PHONE NO.
PERMIT NO.
4 - l't(
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 EXlGRADIFILUNG
o COMPLAINT
2!tFIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
J ~
l iJ"",Lv.~qA-())
// ~~~ .
,C, ~:;...tl f , ). ~_: (
~ C~~CS~ ~ ~
Of- ~
~RK SATISFACTORY, PROCEED
o CORRECT ACT AND PROCEED
o CORRECT 0 , CALL FOR REINSPECTION BEFORE COVERING
)
Inspector:
Owner/Contr:
THE NEXT INSPECTION 24 HOURS IN A6VANCE.
'MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl