HomeMy WebLinkAboutMech Permit 05-0014
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
ase type or print and sign at bottom)
_uDRESS
3.;t.'1J WI'/JtA./UO..{J ~
Date Rec'd
I. Pink
2. Green
3. Yellow
~!:y I PERMIT NO./')~ -0 n/J},
Appltcant (/ oJ U "1 I
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK I ADDITION !t J{){)ch r.~~;Pc:f!a
OWNER
(Name)
131--;-6-.,
C j,rl' ul-~-#f.s--e--"'l
(Address)
JVI J Iv. J J VI h .J .7'J--e.. . '!
APPLICANT A A
(Name) /fIJ y (1 7' i ~~ ~ / ~c -
(Address) /7--7- S J Al, CdJ...J LJ- ~- S.
(Ad;~ ~
(Contact Person) ky ~ ...,., .....,;>J
APPLICANT SIGNATURE
~t/
,
ZONING (office use)
Pt<J)
PIDd$'-3<f3 - t){J3-P
~/d' 1.A-k-
(Phone) 9'$l...- 2/0- ~S.33
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S'S'3?L-
(Phone) 9 S" L- 7 '1'-- S""2.-0\)
/3 U ..... #'IS v. / LA.. P7"; S:s 3 3 7
(City) (Zip Code)
(Phone) t:j S L- 7 t/l.- ~~~
DATE /~~~~
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCIION :;f23'REPLACEMENT 0 AL TERA nONS
,URNACE MAKE AND MODEL ~ Ii, 1-e..il..J - k: ~I(JW- <to FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
TYPE OF SYSTEM
OWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office lJse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
HEATING OR POWER PLANT
o Steam
ZtHot Water
, ::J Radiation
o Special Devices
o Other Devices
Residential, Additions & Alterations
Residential, AC Only
Building Permit #
$ :,\ <j', s-o
$ .50
$ 'to;)
Paid L/ CJ ... ---
Date // 3- os-
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Recet;~661
BYe?
0---
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 3~'tt \~~ J;.
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
)t.MECH FINAL
COMMENTS:
/'
jI/
I-
)
()
..
DATE TIME
!ftJ O~
6-0('-1
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.)i\WORK SATISFACTORY, PROCEED
o CORREC ACTION AND PROCEED
o CORR .~ CALL FOR REINSPECTION BEFORE COVERING
Inspector I Owner/Contr:
'--
44 - 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!