HomeMy WebLinkAboutMechanical Permit 03-0790
CITY OF PRIOR LAKE Date Rec'd
HEATING/fTU C'ONI\TTTONTNl;/FTRF,PLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 11/03 :w ~!~;'~l I PERMIT NO. tJ 3-/ltJ{J
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(Phone)/<J'5~ ) L 33'/f6l"
(Please ~ or mint and si... at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT '1BLOCK / ADDITION KA)I"J h
1-1/ II
OWNER 1/.4/4
(Name) ~/r (1 ft?tt..Y
(Addtess)
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APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Contact Person)
(Phone)
DATE
APPLICANT SIGNATURE
~-
/------
(Zip Code)
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APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
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 & Ale (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Penn it #
~-
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3q.W
.50
LI /) ,----
1ice Use Only)
}Ids Application Becomes Your Building Permit When Approved
I Paid t'.J
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I Date0 "/(., - '3
Building Official
Date
24 hour notice for all Inspections (952) 447-9850, fax (9S2) 447-4245
16200 Eagle Creek Avenue, Prior Lake. MN 55372
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
ReL7li* 0 (
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEOULED
ADDRESS
/ '1S{t-( &//t ilZ."J
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
I [ft-.
/1 I." )
( ~'U
DATE
{;-N
"":,,,,:'.'
TIME
3-. 70,0
o EXIGRADIFILLING
o COMPLAINT
~FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o~1
, l- I
()
~
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~ WORK SATISFACTORY. PROCEED
b CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. r1;(? Co - J f{ -6? Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
-,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4 SAFETY!