HomeMy WebLinkAboutMech Permit 04-1099
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o ~'TY OF PRIOR LAKE
\ 0 INSPECTION NOTICE
DATE TIME
ADDRESS
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SCHEDULED ~~~~~
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
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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
~CH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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40RK SATISFACTORY, PROCEED
~'~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
/0, 1.,S. 6+-
~: ~:n ~!~ PERMIT NO. ()4'. 10 qq
3. Yellow Applicant I
ase type or print and sign at bottom)
JDRESS
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,
LEGAL DESCRIPTION (office use only)
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ZONING (office use)
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LOT S- BLOCK I ADDITION
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5~ PID 25". 6 Z!:>-. (JOS. /
OWNER
(Name)
(Phone)
(Address)
(J~_t~Ja1 e
(Address)
(Contact Person) ~""/1. t1 r-er. .~. t-. (Phone)
APPLICANT SIGNATU~...M "'1 /Iu~t< DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~PLACEMENT D AL TERA TIONS
. LJRNACE MAKE AND MODEL /) W1 s- ~ FUEL fl:J&:..J'
r "
FLUE SIZE --0 RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
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(Phone) 9S-.1-'-IY7-GJlln
{JC' ~O r t.-J<r 117A/553 7 ~
(City) (Zip Code)
l}{; 2 ~-'-ll{7-f{)I()
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~Warm Air Plants
UGravity
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
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERl\'Ul FEE
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Building Permit # () ~ . 1079
$ 39. S2
$ .50
$ '10100
$39.50
$39.50
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
(Office Use Only)
,I
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Date
+0. 00
10. 'L6:o4-
Receipt No.
This Application Becomes Your Building Permit When Approved
Paid
Building Official
Date
By ffif
I
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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