HomeMy WebLinkAboutMechanical Permit #13-1360 DAT TIIAE
CITY OF PRIOR LAKE n� 1�
INSPECTION NOTICE SCHEDULED �'1 )
ADDRESS �� • � 7 j���"
OWNER CONTR. �J - �� I ���' I �� -- -
PHONE NO. PERMIT NO. � � � { � � �
O FOOTING D PLUMBING RI ❑ EX/GRADIFILLING
❑ FOUNDATION ❑ MECH RI 0 COMPLAINT
O FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION �MECH FINAL ❑
COMMENTS:
G �
�
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�110RK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORREC WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. OwnedContr:
CALL 447-9850 FOR THE N�XT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
/NSNOTI
N 1����5�� � 5 y S� �
� pRro CITY OF PRIOR LAKE Date Rec'd
� ° `�-�` '���:-� HEATINGIAIlt CONDITIONING/FIREPLACE PERMIT
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• �f�'NES��P l Pmk Filc pERMIT NO •�
2. Grom C�ty � • /`� _ /�� /�
j 3. Yellow Applicaot (i
! Please e or rint and si n at battom
, ADDRESS ZONING t�es� ��?
' �I��� �r►�v� �o��� S� SC
LEGAL DESCRIPTION (oflice use only)
LOT BLOCK ADI7YTION PID
(Na� 1 � 1 "� � � '�, �� l � � (Phone) l ! �� `1 �`/ — U��,l ,
(Address) �� � � �r I UY�' WQ � �
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ame � 2 " hone
(Address) Z2 W w w'� 1� ► t V �� J S� J
(Address) (Cz (Zip Code)
(Contact Person) �-- � �. (Phone) S 2 " " �V �
APPLICANT SIGNATUR� V I� �� DATE I
APPLICANT PL AS COMPLETE BELOW �
FURNACE MAKE AN�D MODE ONS�R SL _ P � I ���� � V.� � FUE ONS �
�, .xQ
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYYE OF SYSTEM HEATING OR POWER PLANT
� � PLEASE NOTE: Air Conditioner
[]Warm Air Plants ❑ Steam Units and FSreplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
�,'Nlechanical ❑ Radiation
❑Air Conditioning ❑ Special bevices �replaces wi#h Box Additions or
�Vent. System ❑ Other Devices Cantitevers to #he Outside of Buildings
Require a Building Permit.
FIREPI.,ACE MAKE AND MODE[,
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1% of job cost Residential, Gas Fireplace $44.50
$49.50 minimum
Residential, Heating & A/C (New C.crostruction) $149.50 Residential, Additions & Alterations .$49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $43:
Estimated Cost $ Building Permit #
(� C l'he Minnesota St�itutes ` 32613. I�S
HEATING PERMtT FEE $�/ (•`� � "�� i ARGI:" hus heen chun�ed li>r one
ycar eff'rcti� e
STATE SURCHARGE $ U� .50 .1u�, i, �+� t��, �,nr;: ,r���,� 3u, zr�i i.
TOTAL PERMIT FEE $:�j�� • S �►hc rninim�im surc4argc fn►• a"1i�cd fcr" permit
(Office Use Only} ic ��, be};innin�.tuh� 1.2DUI
This AppGcafion Becomes Your Building Permit When Approved Paid ����, Receipt�J ! X �
')U
Date By �',
Buildine Official Dnte �LII / . t, K�'
/
24 hour notice for all iospec4ons (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372