HomeMy WebLinkAboutMechanical Permit 04-1222
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
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l [~;w J!i'MI I PERMIT NO'04. Izz z..1
lease or riDt and s. at bottom
ADDRESS
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ZONING (officeu,e)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
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(Phone) r 6:J.. ~q l/(J- (j;, ?O
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(Address)
APPLIC~ 'rQ
(Name) {' e, ~ I e.
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(Address)
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(Phone) 9~~ - (Jq()~()?58
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(City)' (Zip Code)
(Phone) f(s~ - :tfo -IJ? fit
DATE J:"ph, /sf~ OS
(Address)
(Contact Person)
. APPLICANT SIGNATURE
APPLICAN
DNEW CONSTRUCTION
FURNACE MAKE AND MODEL
FLUE SIZE RETURN OPENINGS
PLEASE COMPLETE BELOW
o REPLACEMENT 0 AL TERA TIONS
FUEL
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
INPUT
HEATlNGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
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)
$39.50
$39.50
$39.50
Estimated Cost $ Building Permit # ()~,f 2- z., 2-
REA TING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
lice Use Only)
This Application Becomes Your Building Permit When Approved
Paid
4O-ov
z,. p', Or-
Date
Building Official
Date
24 hour notice for all inspections (952) 447-98S0, fax (952) 447-4245
16200 Eagle Creek Avenne, Prior Lake, MN 5S372
Receipt No.
1f'tJ3 ~
By
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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CONTR.
OWNER
PHONE NO.
PERMIT NO.
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
COMMENTS:
DATE TIME
).'].4'-c'.>
-
4-(2).).,
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
/!'FIREPLACE FINAL
o GASLINE AIR TST
o
-"'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~OR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI