HomeMy WebLinkAboutMech Permit 05-0043
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
ase type or print and sign at bottom)
. ..DDRESS
30",'1
,
Date Rec'd
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~. ~e:n ~!~ I PERMIT NO. 05.. () CY/:.::J I
3. Yellow Apphcant ~
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Jk 11r? Vi
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT II BLOCK / ADDITION /lIO~dl)P 6~:J.l!J2
/feb 1'0
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APPLICANT G ^ Ll ~I f1 l' p..
(Name) 'T'~Y' l'-S i'OLe Ll P---eA V' / t\. '+-NOIM L-- (Phone) 95-"- 0 flf)-117S-g
'30'S[) (Al{ f14J.?' &tJLrzi!(e;I1I1/ _-S;~~~':,?
(Contact Person) t< / '+- JJ/U 2.ev i/'A oS' (Phone) ,
A~'1I KooO I DATE :;JaM. uffl-- {;(~
APPLICA PLEASE C~MPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
OWNER
(Name)
lJ1av- Th
3d?'!;
(Address)
(Address)
APPLICANT SIGNATURE
PID Z-J-:' .3 71. () // ()
(Phone) t:(5"; -/A 33 -1039
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TYPE OF SYSTEM
HEATING OR POWER PLANT
DWarm Air Plants 0 Steam PLEASE NOTE:
DGravity 0 Hot Water Air Conditioner Units
o Mechanical 0 Radiation Cannot Encroach into
DAir Conditioning 0 Special Devices Required Side Yard
DVent. System 0 Other Devices Setbacks
FIREPLACE MAKE AND MODEL ~)-('-/..f'J ' Jt'toJ~ I." (/JOO() f"4-rfa)c;:tpr::t
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Industrial, Commercial & Multi-Family
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
Building Permit # 0 r~ () Of J
$39.50
$39.50
Estimated Cost $
(Office Use Only)
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 3~ s"b
$ .50
$ 4t)~ W
Date
PaidA",
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Date I {I (/\-
~ .
Receipt No. efft J?
By ~
T-- '--
~his Application Becomes Your Building Permit When Approved
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
DATE TIME
-?~t,b-
~07/ hLe ~~~ cl-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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: _
,/; /
T-/rek? /,yC c--
;'
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
~EPLACE FINAL
o GASLlNE AIR TST
o
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~RKSATISFAC~
.. /0 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!