HomeMy WebLinkAboutMechanical Permit 04-1239
CITY OF PRIOR LAKE
HEATING/AIR CONDITlONINGIFIREPLACE PERMIT
Date Rec'd
;;;:, ~:~ I PERMIT NOA/ ./_j::) 341
). Yellow Applicant (/7- CT I
.ase ~ or print and sUm at bottom)
I ADDRES;S / /? ~
7/JU ~ mrC /,./
I ZONING (officeu") I
. LEGAL DESCRIPTION (office use only) ( ,
LOT<K BLOCK ~ADDITION (f /~ A_ /) UVj-2 4.4
OWNER
(Name)
/5 r PID ;)S- d~ij - OJ )'-6
(Phone)
(Address)
I APPLICANT~~ J ~ '1 _
(Name) < - I r<.-' ~
(Address) ll,2P. l&.-I Jr:--rl.
(Address)
(Contact Person) f~rJ~~II,.J
. APPLICANT SIGNATURE ~
(Phone) I. /2 ~ 7,1../-S:SVh
P10 k, /UN" 1::<;'7~?
(City) (Zip Code)
-
(Phone)
DATE
12.../ zoJDcf
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TrONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVen!. System
HEATING OR POWER PLANT
o Steam
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
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 & Ale (New Construction)
Residential. Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
, TOTAL PERMIT FEE
$
$
$
:?CJ 5D
.50
4()PIJ
(Ollie. Use nly) A J
'his
J
pI" a ' ~mes YOU~g Permit I Paid If (). ----- ReCq pi) if /
\.--::: z.o eJ4 I Date By (
Buildi ~ ----- ....J Dat. /;) - ;;x;-Lf 0......
24 bour notice tor all inspections (952) 447-9850, tax (952) 447.4245 U '
16200 Eagle Creek Avenue, Prior Lake, MN 55372
DATE TIME
CITY OF PRIOR LAKE . -/'_-C.
INSPECTION NOTICE SCHEDULED ~~ ~
ADDRESS /S/;;;yo C;;:'/';99C 4...... c...
v
OWNER CONTR.
PHONE NO.
PERMIT NO.
C)~ - /2- 3q
I
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
--o"1IilEcH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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IWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~~'r:<t~t6R REINSPECTION BEFORE COVERING
Inspector: // VV Owner/Cantr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
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