HomeMy WebLinkAboutMechanical Permit 04-1005
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. =, ~:~ I PERMIT NO. .A J J ---rr "k:""'"'
3. Yellow Applicant ( .I '-f If LJ+J
ase ~ or orint and sien at bottom)
. .DDRESS
/~S35
() m ~ I'JC(. Yra; /
.J
I ZONING (office use) I
LEGAL DESCRIPTION (office use only)
LOT / BLOCK I ADDITION ,:)l.J2.
0w/~
fh,.J Y' e.o sf ~ po V'
(Address) / /7t; ~.~ 111 ~ /)11'1 ~a / I
. J
. APPLICANT It; , A II ~. "f. N d~J e.
(Name) f'1Y'e.SI(X..J' f.l-(:::J2L1-:':-!J::.t 'r ~(Phone)
(AddreSs)_~'S("';-() lIJ, If-W.}J /3 8~1tJ1S'/// ~,/)JIjI/,
(Address) (CIty) (Zip Code)
(Contact Person) X,'f J2(n 2€JL; _11..111/ f' (Phone) 3_C;:4. -t!lIJ- (]7~{1
APPLICANT SIGNATURE y~~' DATE OCt- 11 !;'fh, '{}~
t/
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
fURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
PID,..J5-J01- nO 1-0
(Phonj5l. -Y1/./1 - /jrJ {/t:,
OWNER
(Name)
Cl5;t - N'!!-c;J 7;8'
~~33?
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVent System
HEATING OR POWER PLANT
o Steam
o Hot Water
D Radiation
D Special Devices
o Other Devices
a {J o/lYfJ f:r'f..e IlUfJ)).p j: P. ?9,/JQI'J
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
TYPE OF SYSTEM
FIREPLACE MAKE AND MODEL
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 3q..'":J0
$ .50
$ L/(,).-
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid L/ {J,e;---
I Date{{J -5-0L/
Recetl1J!J tjf{',h
By VI
U
24 hour notice for all iuspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
DATE TillE
/Clft'/oy
/S-S?~ GJ~~q4- fr'/
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CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED
PERMIT NO.
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
t:) .y - /Ot.7\--
o EXIGRADIFILLING
o COMPLAINT
[J FIREPLACE Rl
..,...a-FIREPLACE FINAL
[J GASLlNE AIR TST
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COMMENTS:
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pORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~';:;i WREINSPECTION BEFORE COVERING
Inspector: ,r~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY/
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