HomeMy WebLinkAboutMechanical Permit 04-0120
M ~ 40-00
CITY OF PRIOR LAKE 10"6'6 b Date Rec'd
HEA TING/ AIR CONDITIONING/FIREPLACE PERMIT
REQUEST FOR FINAL
INSPECTION SENT TO
.asel'lpeororinrandsimatbottoml HOMEOWNER 01-05
ADDRESS
, 11",()t{j k.J.o(.\\.'u~\n~ Q~
S:w E:,;~, I PERMITNO.O;t.o/zol
LEGAL ~~SCRlPTION (office use only)
LOT \,0 BLOCK ADDITION
17 aid lJ /(Y()~
OWNER
(Name)
Pr~\7
} (At) 49-
tJor~t.Jnci L
\(~.
O;VV"-
(phone)
1 ...X~.
(Address)
ZONING (ollie,",,)
PID2.5 14-1. 073.0
APPLICANT I '\ r I C /I 9 0
(Name) lAJe", '7 10:. \}. \J }.,. L (phone) (0) - g ~ ~.. ?5 / F
(Address) t-I It, \ ()\} 5.).-1... t/\ ____;,J \'>t.~ f C6-ff ~ M...., ,<::~ JJ.1..
. ~. 'ltity) (Zip Code)
(Contact Person) R\ <:..~ (Phone)
APPLICANTSIGNATllP~\ l (' "'(\/\','0_ DATE' 3-.~ (J 4
'''') VV
id'PLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION QJREPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL ~ ~,\!I.'~TLJVJ()r)~9V- 'FUEL W~
FLUE SIZE ,<," RETURN OPENINGS INPUT /00., (lO G OUTPUT .2l, ()O ()
TYPE OF SYSTEM
[iJJIV arm 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
$64.50
Residential, Heating & Ale (New Construction)
Residential. Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
Estimated Cost $
Building Permit # 0 if- . 0 1 'Z- D
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ~ q ,SO
$ - .50
$ uD,tY>
.-iOffice lIse Only)
:his Application Becomes Your Building Permit When Approved
I pai~.O 0
I D~. g,04-
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 4474245
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
ADDRESS
/bOUq
DATE nMe
SCHEDULED , C/d-fl-if
>t~
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
1/ -I ;::;-0
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 EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
,
(! / .
Ij~'
nC/.aAJ P.1VvYlu "
- .fJ.
W~L.
-J-)-
..-
~--
()':5 -; '5 '1 ~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
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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