HomeMy WebLinkAboutMechanical Permit 04-1069
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONING/FIREPLACE PERMIT
ase type or arint and sien at bottom)
.uDRESS
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LEGAL DESCRIPTION (office use only)
LOT Z-BLOCK I ADDITION ~OJOI'JJ'
OWNER
(Name)
(Address)
APPLICANT
(Name) ::\a y--, Q
I . _ \c((\ pp-e- ..c:,
(Address) I 4-::1 ~')o "[-)\...e, c\ '-l ~.Q (1 (
(Address)
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h I.-I NF
(Contact Person)
APPLICANT SIGNATURE ().v~
(~'..c~r7 .b..k- n,",
Date Rec'd
/0. Iff. 04-
:;;:, ~::y I PERMIT NO. 0"". fO (i. f'/
3. Yellow Apphcant ., /
I
ZONING (omce use)
Ie I JO
/J7-
(Phone)
PID z,s; In. () dZ-. (,
(Phone)
q 5:::J.- ~ :':>~~ - <1Q41"
v.. \ oV' Lat..-It..
(City)
":"''S -:~.;")'~
(Zip Code)
(Phone) q '"C::>d - d. ~.~ -~ 4-Q4(,.,
DATE IO-ICt- 04-
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
rURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
DWann Air Plants
DGravity
D Mechanical
( .....-- ir Conditioning
DVe System
S17J lie-
EIII.IOIlI,.'.€E MAK
HEATING OR POWER PLANT
D Sleam
D Hot Water
D Radiation
o Special Devices
o Other Devices
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
TYPE OF SYSTEM
-
Industrial, Commercial & Multi-Family
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Estimated Cost $
Building Permit # d 4-. I 0 ~ .'1.
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$
$
$
3 '1.SV
.50
-to ..IIV
I Paid (/0
+0,
I Date ,A
If) ,1'1- Or
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
, ReceiPt~gq7 I
By ~/dI I
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/rj?s-o
Ji'i L
CONTR. /
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
;a ..""H FINAL
COMMENTS:
/
;;'/6........
DATE nile
r/!~~ -
&'U~( /; /
~~~/tJ6?
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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Jf1NoRKSATI~CEED
/' ~RRECT ACTION AND PROCEED
o CORRECT WOR~~~EINSPECTION BEFORE COVERING
Inspector: /~ Owner/Contr:
,.
CALL 0&47-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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INS/'iOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/