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HomeMy WebLinkAboutMech Permit 04-0550 DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCH~DULED ~-q~ ADDRESS (f.{Q7 .~ ft,.: / '~ER CONTR. . . .ONE NO. PERMIT NO. q-s:Jb 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 EXIGRADIFILLING o COMPLAINT o FIREPLACE RI o ..!IREPLACE FINAL , GASLlNE AIR TST o COMMENTS: rj:" 1 ~51- OIC ~ WORK SATISFACTORY. PROCEED o CORRECT ACTION AND PROCEED o CORRECT 7n~OR REINSPECTION BEFORE COVERING Inspector: -lY /" Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTI CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/lflKEPLALE PERMIT J/j/trJ Rec'd :~'{.~"~""'. ~: ~~ ~:~ . PERMIt NOe64-. 0550 3. Yellow Applicant . e type or print and sign at bottom) . .~D31q1mt -!ill j()). (luJ LEGAL DESCRIPTION (office use only) LOT q BLOCK (:J. ADDITION W LIVe; /f){lII/;1/ Is-r . ZONING (office use) PID zb: 31cP. 0/3.0 (phone) qrj;{ fIWJ-U,;;3 mn ~r:.;~~ANTf!J(J1l/ IOJal1J (phone) UPf/- 4;J.3-/t1-<J- (Address) 11716 J RJhf;eJ TId. RoJ(jJ71JvAl mn qJI)///cP () 1 (A~qress) L' ,. (City) (Zip Code) (Contact Person) {:h Jet'J 17 m/(<s. (Phone) (6;--4;;<'3-,1/11-1-- APPLICANTSIG~ATURE ---f{,LJ~) *~~ DATE IO,/L!/IJ<-I APPU~ANTPLEASECOMPLETEBEL9W/iftSM,/( qat /jl11!- iv ONEWCONS1RUCTION o REPLACEMENT .# ):LlhKATIONg--' j~, FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT rg.V;:R UJ II fr& JDt1t(J~ (Address) J' ~ . (J/2{p}2 fA/!L TYPE OF SYSTEM HEATINGORPO~RPLANT o Steam o Hot Water o Radiation o Special Devices o Other Devices DWarm Air Plants DGravity o Mechanical DAir Conditioning DVent. System 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 & NC (New Construction) Residential, Heating'-Only (New Construction) Estimated Cost $ Building Permit # ()4.o5tJO HEATING PERMIT FEE STATE SURCHARGE TOTAL PERlVul FEE $ ~.5D $ .. .50 $ LI(). fX) ~()ffice Use Only) s Application Becomes Your Building Permit When Approved Paid 40.00 Date (p. /0 .O~ Building Official Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 PLEASE NOTE: Air Conditioner Units Cannot Encro.ach into Required Side Yard Setbacks $39.50 $39.50 $39.50 Receipt NCZI~9f}tJ By i . u