HomeMy WebLinkAboutMechanical Permit 03-1449
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
(P1ease'!yp< or print and sion at bottom) HOMEOWNER 01-05
ADDRESS
Date Rec'd
Pink
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Yellow
~!~;~, I PERMIT NO, &2- / tN?1
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I ZONlNG(officeuse) I
LEGAL DESCRIPTION (office use only)
LOT/ BLOCK ,~DDITION J)yj/yJd~-
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(Address) \~O ~\~
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PID d5~/fr,5- 6~"-()
(Phone~-Y40- 1S40
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APPLIc.;ANT .
(Name)Ll"l~\e.6 ~,,-fuS\rip l ~_
(Address)bQSO l.,J. Iyln-ID-esr. -::l:t= lei"
(Address) 'I
(Contact Person) D(').r..
l.. "Y':t'\ \eK0
tC'Jeu-:. 1 12-. ~
,-\PPLICANT SIGNATURE
(Phone) q~-t.\3I-/cqq
Gcpelb-\\~A ,Sc:.,I~
(City) D (Zip Code)
(Phone) C\6~4~ 1- 7cA q
DATE \Q-IF\-ci)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~PLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL 1h.u 11 r\ '. \ I &P ,""en FUEL t-J ct\u_ru. I
FLUE SIZE RETURN OPENINGS INPUT -, ~"r:J OUTPUT
HEATING OR POWER PLANT
TYPE OF SYSTEM
'fil!.w arm Air Plants
TIGravity
[3,M.echanical
&-ir Conditioning
OVen!. 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
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
ut..-
!- u'u:.o...l....J"l.'-'.L. MAKE AND MODEL
~LUJ.d. " LlCl\T)LD~
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ ~()O
.,
L;),,~J
$39.50
$39.50
$39.50
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
flee Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$
$
$
oq.5D
,50
LlO--ro
I paidL(O,--
I Date . ?
I O~ :31- ::.>
. Rec~/9
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED ~~~
/-5-CJ..2CJ ~)-J,tvk JL/'L-.S
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
O...5-/~~
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
~H FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMEN/o/~I'.e /' /?;/c
KVU cf .
~4V' i//!$L-O-2-/ah'L
//L ?/.~ krl
,
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1'7tC.-
,,"WORK SATISFACTORY, PROCEED
/0' CORRECT ACTION AND P CEED
o CORRECT WORK, CALL R REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
C:ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
IN$1iOTJ