HomeMy WebLinkAboutMechanical Permit 04-1210
CITY OF PRIOR LAKE
HEATING/AIR CONDlTIONING/FIREPLACE PERMIT
Date Rec'd
~.;;;:~ ~:~ I PERMITNO'/1~/_J'I-1
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ase ~ or print and si2ll at bottom)
.ODRESS
ZONING (office use)
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LEGAL DESCRIPTION (office use only). 'CJr J
LOT ii?BLOCK / ADDITION hud.f\ I CJ.t1J2-'
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OWNER
(Name)
(Phone) 95 ~ - ~jtlll- /73Cj
RI\J!y~TvII
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(Address) J (City) I Clip Code)
(Contact Person) ~Zr:> r,~ \' /1 (Phone) C?5J.-Y9//~cJ7~f{
APPLICANTSIGNAT~-;:E '}).,,~ 2/1l:2 th./ DATE /)pW/J/'~ f)y/
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
r"URNACE MAKE AND MODEL FUEL
FLUE SIZE RETIJRN OPENINGS INPUT OUTPUT
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(Address)
APPLICANT
(Name)
(Address)
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVen!. System
HEATING OR POWER PLANT
o Steam PLEASE NOTE:
o Hot Water Air Conditioner Units
o Radiation Cannot Encroach into
o Special Devices Required Side Yard
o Other Devices Setbacks
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TYPE OF 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
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ~~<?,S-O
$ . .50
$ L/O, -
(Office Use Only)
~his Application Becomes Your Building Permit When Approved
Building Official
Date
Paid '-/0,---
Dat/d_(, -t/
Rec~~o 7)
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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
SCHEOULED ~~
~.-/h." / ,ei; e ~/
ADDRESS
\? j'9
,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
c?J~/.2/0
7
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION /. 0 MECH FINAL
COMMENTS:~er kJ~/
LU~'~Y
rJIC
o EXIGRAD/FILLlNG
o COMPLAINT
..A-t'rREPLACE Rl
o FIREPLACE FINAL
~INEAIR TST
o
N "'"
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~ORKSATISFACTORY, PROCEED
~~RRECT ACTIO WAND PRO ED
o CORRECT WC:>>~~L REINSPECTION BEFORE COVERING
Inspector: P U. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI