HomeMy WebLinkAboutMechanical Permit 04-0379
CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FlREPLACE PERMIT
Date Rec'd
~: =0 ~:~. I PERMIT NO. /:/ I." Q/lQ I
3. Yellow Apphcant ~ ;:;;J - /7 .
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I J'I 3 S ~ B"'A~J.,
ZONING (office use)
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PID cYSJ (jtJ{P-(j1 -6
OWNER "'n
(Name)---3 ,,~rc.s e
(Address) I
l=d\ Jl~ c:'(.. rJ
(Phone) ~... '//)1- 9/SD
APPLIC':J1 L
(Name) lor LL~~ ~ A G
(Address) 1l..~1../ P~bb'e- BrooK ~ t-
(Address)
(Contact Person)
(Phone) 9~1-44 7-8, J D
{)f'\l)\" We.- f(\iJ s.s3J:l.
(City) (Zip Code)
(Phone) 4~ :1-44 7.... ~, , D
DATE S-V~4
APPLICANT SIGNATURE
,..--.
I
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~PLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL AU'/D8D /JJ?1~"';l.d1V ~y FUEL bl/r
FLUE SIZE ;I" pUC- RETURN OPENINGS INPUT ~DOCij OUTPUT 7'1~')
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
o Gravity
a.Mechanical
~ir 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
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
391 SD
.50
l../ D, /) ()
;"'--"'4Jice Use Only)
Chis Application Becomes Your Building Permit When Approved
By
Building Official
Date
Paid L/(J, ~
Dates_ 3
Receipt
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
TillE
DATE
~
ADDRESS /j/J37 o;t..+ ~e-d 7r I
~- <L-~7P
CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDULED
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~LUMBING FINAL
~MECH FINAL
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~RK SATISFACTORY, PROCEEO
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL OR REINSPECTION BEFORE COVERING
Inspector: ·
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTl
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rEAFORMAHc:E TEST Y.
-Percent COz ~$'; () -hfcenI co lJ 7~
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