HomeMy WebLinkAboutMechanical Permit 04-0295
CIl i OF PRIOR LAKE
REA TING/ AIR CONDI 110NINGIFIREPLACE PERMI."
Date Rec'd
I. Pink File PERMI NO ~~
2. Green City 1 e../l.J_ I . _
3. Yellow Applicant f / ~
(Please type or print and sign at bo~~...~)
ADDRESS )
\ 5'<0 I u, h S\t . Of ~ I
~
LEGAL DESCRL.I:'TION (office use only)
LOT 8'BLOCK ( ADDmON vk.C1 ~
OWNER . I",
(Name) rY\ ~.
(Address) \ 5Co.., <t,
FePn.\~n-
.) 1\_
r:tJ '"' · O,~ f<j..J
(Phone) q ~~ d :).\0" ~ '\ ~l.a
ZONING (office use)
Ie)
Prr);?S - ~ 1- t>o~-d
~;~~.p~.p SlS U,a-L4 (phone) ~~l{'f,~"3.7~?-
(Address)lS'DC1-l rV\lU\~~U. ~f) )L~ tY\.V '55~1~
(Address) (City) (Zip Code)
(Contact Person) tV\ \.~ J _~ ~ (Phone) 9 Q..- 4. 'f 7r ~ 7 Co ~
".--APPLICANTSIGNATURE L{14YI t;~. DATE If-lq -oc{- .
· XPPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL 1 bAA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OU It"uT
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
HEATINGORPO~RPLANT
o Steam
o Hot Water C
o Radiation ,I _,
o Special Devices fP.~ ~ tCr-
o Other Devices U
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
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
,-...
,/
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERl\tu. ~ FEE
$
$
$
3~'!Jd
.50
~ /-
"10-
lee Use Only)
Building Official
Paid Lto"'----
Date Dall-/9-04
24 hour notice for all inspections (952) ~7-9850, fax (952) 447~5
This Application Becomes Your Building Permit When Approved
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
:eceiPl/~ If ~ 1
y fV
(J
CITY OF PRIOR LAKE
INSPECTION NonCE
ADDRESS
/r/(;JC?
OWNER
PHONE NO.
[J FOOTING
[J FOUNDATION
o FRAMING
[J INSULATION
[J FINAL
o SITE INSPECTION
COMMENTS:
DATE nilE
SCHEDULED LI-},J. .o'{
/-- ,:S?( v;&,vd- /C d
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
f-r~ /-e-
--::::~~
~.~
/' /.' /
I ( .-(. OSe
t
~.---
---..
L(-)1S
o EXlGRADIFILUNG
[J COMPLAINT
o FIREPLACE RI
[J FIREPLACE FINAL
~GASUNE AIR TST@
.~
r=1 .'\ )
17'e:
/
~
~ WORK SATISFACTORY. PROCEED
D CORRECT ACTION AND PROCEED
:.=CT 7YPLL FOR REINS::::::'FORE CO~NG
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI