HomeMy WebLinkAboutMechanical Permit 04-1223
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
/2,/7. 09-
I,Pink
2. Green
3. Yellow
~:~ I PERMIT NO.O"f 1z.z.3
Apphcant '
'Me ~e ~Ml md s; albo~m~
. ,DDRESS
I LIS I OSeIlJ(jo~ f)J, /!/# b.
ZONING (offi" use)
LEGAL DESCRIPTION (olliee use ooly)
LOT
BLOCK
ADDITION
PID25,3/0. 030.0
I OWNER
(Name)
(Address)
""~) Q'i;;1-;133- 2& 1
f)J i 1!)6',
APPLIC~, ~
(Name) It P ~ ," 0,
(Address)
:5 r;c;o
(Contact Person) .J " i
APPLICANT SIGNATURE
(Phone)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
fURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
OUTPUT
oWarm Air Plmts
oGravity
o Meehmical
DAir Conditioning
oVent. System
o Stearn
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
· Sf /5tJ7)
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Building Penn it #
of-./~z-]
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
31. )V
.50
1tJ, tll)
(Office Use Only)
"his Application Becomes Your Building Permit When Approved
Building Official
Date
Paid ,fv. W
Date
{7. ./7.0
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
SCHEDULED
ADDRESS , (.js-"t I
Rl):>40Iol.,.,J. Q,,~ ~ 0
,
OWNER
CONTR.
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
,~
<-{ - 12),""
o EXIGRADIFILLING
o COMPLAINT
.l1f.f:IREPLACE RI
o FIREPLACE FINAL
..k: G~~ AIR TST
o r-
8\0~ ~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT LL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Conlr:
E NEXT INSPECTION 24 HOURS IN ADVANCE.
CAL
INSNOTI
TS ARE FOR YOUR PERSONAL HEALTH & SAFETY/