HomeMy WebLinkAboutMECHANICAL PERMIT 16-1400 CYDATE TIME
CITY OF PRIORNOTICE LAKE SCHEDULED ( �
ADDRESS LA \ Z t) lA
OWNER CONTR.
PHONE NO.
PERMIT NO. L o
0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOOTINGN0 MECH RI 0 COMPLAINT
❑ FRAMING
❑ FRAMING 0 WATER HOOKUP 0'FIREPLACE trFIfIREPLACE RI
REPIJ�CE FINAL
❑ INSULATION 0 SEWER HOOKUP ASLINE AIR TST
❑ FINAL 0 PLUMBING FINAL
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS:
❑ WORK SATISFACTORY,PROCEED
! ',CORRECT ACTION AND PROCEED
O CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector:
`i.; Owner/Contra
C• L 447-9850 '•R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD • '% • • ENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
3(076gq 7—m/s
4PRI��
CITY OF PRIOR LAKE Date Recd
� Ah HEATING/AIR CONDITIONING/FIREPLACE PERMIT
�rINN.$Sa�
0 I. ui
Gle Cit PERMIT NO. (1
2. Goren File
j �/�-�(;
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
)L71/
2 8 Cedar ZONING(office use)
w-c>od Col, r-f- Al
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNE(Name)
(/en'l Ste(./ , (Phone) (01Z--7&0-105.21f
(Address) c aGt.A.-e a. f SI// C'
APPLICANT //,,
(Name) t-1 rr5 f jC Ne v-->Lli 4 HOl t4 (Phone) 6SI e33 2-5-&t'
(Address) 2-706 F`-'i i''''''kr l'e t-A-) ,4u-e, At) g05cudHH' 55113
(Address) (City) (Zip Code)
71 �
(Contact Person) (5741/1.4.v"'T- Sep,-f' '�I (Phone) 657—&3g- 33C -
v / I - _ 1 TE —i--i
APPLICANT SIGNATURE L/ _
APPLICAN P I#SE COMPLETE BELOW
• NEW CONSTRUCTION 0 REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
❑ .ravity 0 Hot Water
T:',Mechanical into Required Side Yard Setbacks.
❑Radiation Fireplaces with Box Additions or
■• Conditioning ❑Special Devices
❑Vent.System ❑Other Devices Cantilevers to the Outside of Buildings
_EMT ��� � Require a Building Permit.
FIREPLACE MAKE AND MODEL Y ;a
FEE SCHEDULE
Industrial,Commercial&Multi-Family 1%of job cost Residential,Gas Fireplace $49.50
$49.50 minimum
Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations $49.50
Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50
d'O
Estimated Cost$ Building Permit #
HEATING PERMIT FEE $
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid Z ,C..;(...) R ceipt No.1 c---1._..7
Date
Building Official Date P ( )952 �� t�/, _
•
• 24 hour notice for all inspections 447-9850 1�
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372