HomeMy WebLinkAboutMechanical Permit 04-0143
CITY OF PRIOR LAKE
HEATING/AIR CONDII10~lNG/~1.KEPLACE PERMIT
Date Rec'd
7:~r
I. Pink
2. Green
3. Yellow
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File
City
Applicant
..;e type or print and sign at bottom)
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LEGAL DESCRIPTION (office ose ooly) , if}?,? A., II , ~ /}/',/) ~ ~
LOT 1 BLOCK ( ADDITION vl.Y~t.-~ ex.
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~=R flt(lJrJCIfitJ IAl/ f&... " .' (Phone) .tfi~ ~44D-I(PsS_
(Address) ! 1 fil/) (p, /lflJeft e(d, . fJ J?-llt:.- ) fJ!2/PfL fU:f, /!In l35310?
-^J:~~~~-fJ~Z::~ -.\~aj/ll-'.~ -. '.,'. (Phone) -'('(;t;-/~L/~!- IIL(Lf
(Address) J f-. ll..,) \~ ~ y~() /QLfQ;f .MJ ('/(l ~cmD1t/lti l nil i l t~ ~JRf3
(Address) (City) (Zip Code)
(Contact Person) C.1l YU;ti~ -fl;r. /(s _ _ D~. II . . (phone) (PC) I -4 ~3- / I L/t.!
APPLICANTSIGNATURE (1 ~) ~/\ DATE?---[ -04
(' APPLICANT PLEASE COMPLETE BELOW ~d 1 a.s U Yt., --fo
ONEWCONSTRUCTION o REPLACEMENT ~ALTERATIONS ~'"
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
ZONING (o~ce use)
f/I Sf! ',.
PIDd5-37d.--{XJ1-O
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE 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
$39.50
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERl\tJ.IJ. FEE
re Only)
, ...pplication Becomes Your Building Permit When Approved
$
$
$
~5q.~
I .50
</O.OU
Building Official
Paid t/{) ---
Date3...-. ( r
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Date
Receipt NOLI ~ t:(;;z. L(
BY~
O"~
~
DATE TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS
/ 7kSC> a~6-e/<!-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'-1-/43
(] FOOTING
(] FOUNDATION
(] FRAMING
(] INSULATION
(] FINAL
(] SITE INSPECTION
(] PLUMBING RI
(] MECH RI
(] WATER HOOKUP
(] SEWER HOOKUP
(] PLUMBING FINAL
(] MECH FINAL
(] EXlGRADIFILLlNG
(] COMPLAINT
(] FIREPLACE RI
(] FIREPLACE FINAL
.. GASLlNE AIR TST
(]
COMMENTS:
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~K SATISFACTORY. PROCEED
(] CORRECT ACTION AND PROCEED
(] CORRECT WORK. CALL R REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI
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