HomeMy WebLinkAboutMechanical Permit 04-0762
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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2. Green
). Yellow
~:~ I PERMIT NO. I
AppU'm< () Iff . 01(P z.
:ase type or print and sign at bottom)
I. .DDRESS 'Y)r;:;. 'A
QM'fJ Terrate
ClrcJe
SV0
, LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
kr\~n Lmd'2X>€-
~C\t:)~ I~Vrote CIV'c,le
S\0
Date Rec'd
{, ~. 04-
I ZONING(oflkeu"'l I
PIDZ5: I~. 01.,.., I
(Phone) C)5'l- L/ Lj~ - 45'2.L/
APPLICANT.-;). , ^. . \
(Name) I'On 5 1'1 lecl"(1V\ I Ca \ I'X: .
D \d ~\(''\C. ~()Yd Rt'lCld
_ (Address)
(Contact Person) L\ VYh , (Phone)
APPLICANT SIGNATURE H1~ (\p N'VO r{1Jv DATE
APPLICANT~EAS~ COMPLETE BELOW
DNEW CONSTRUCTION ~PLACEMENT 0 AL TERA nONS
rURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(Phone) Ot;8- 4L./S-~~
S raJ:Dpe~ Ch6391
(City)
(Address)
(Address)
\10 \f)
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Sleam
o Hot Water
o Radiation
D Special Devices
o Other Devices
OWarm Air Plants
OGravity
j;eChaniCal
ir Conditioning
OVent. System
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)
(Zip Code)
1-dD-Ot/
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39,50
$39.50
Estimated Cost $
Building Permit # 0+, 0 7 (, Z-
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
-:f1, q)
. ...sO
4-0. aU
(Office Use Only)
"his Application Becomes Your Building Permit When Approved
I Paid +a tV
I Date 1. 2-.U f-
Building Official
Date
24 hour notice for all inspections (952) 447.9850, fax (952) 447.4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
. ReceiPtN'4-7S5.f-
B~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ? 153
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
fl.. INSULA TI9/'l
~ FINAL 1t C
0. SITE INSPECTION
COMMENTS:
C/ {AI
SCHEDULED
DATE Tille
I (uJ ,,';--
T€.rr~ Q.1..
CONTR.
PERMIT NO.
<./-7"'-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
p~PLUMBING FINAL
)!l. MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
I " """- I
t"l-l T' ( ~
;f WORK SATISFACTORY, PROCEED
o CORRECT C 10 ND PROCEED
o CORREC W R ALL FOR REINSPECTION BEFORE COVERING
Inspector: _
Owner/Contr:
FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
1/EMENTS A1/E FOR YOUR PERSONAL HEALTH & SAFETY!
IIaNOTI