HomeMy WebLinkAboutMech Permit 05-0170
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
3. :1 ~ as
~
I. Pink File PERMIT NO
2. Green City VlC::-, 017 0
3. Yellow Applicant L.t<-' .
(Please type or print and siJm at bottom)
ADDRESS
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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OWNER
(Name)
OIY'k. ()1 p~ aY'0j
)5008 l11{}hl-fOtl
(Phone) 9 S)... - tjt;IJ.- 7947
fJ 0 rud If) G:
(Address)
APPLICANT J..
(Name) r:: tf e -s t ()
~ 9,~-r)
~;+
(Address)
1It?C' vfA ~ IIam e.... (Phone) Y r;-,~ - 82/) - 0 ?S8-
1// r tiWjA J? !3lAr(l\!/,/!/2 J 1iJJJJ. ~S3J?
(Address) -;;; . . (City) / . (Zip Code) ,
P lVl L (> ~ ~ rIA r (Phone) y,t;::J. - 92(J-(J? ~L
(!1!A4~jJ /l_2(.~.. f DATE (Ylarch ;1~h(';;-
. y - tJ - - .
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
(Contact Person)
APPLICANT SIGNATURE
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
DWann Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
INPUT
HEATING OR POWER PLANT
OUTPUT
FIREPLACE MAKE AND MODEL
o Steam PLEASE NOTE:
o Hot Water Air Conditioner Units
o Radiation Cannot Encroach into
o Special Devices Required Side Yard
o Other Devices Setbacks
H-eo i -n/-G-In , /MOJ /<(J'/;oacJ '-r/l:t-4P-t
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 & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Penn it # 05.0/7()
$ :J'i. ~()
$ .50
$ 4o.rAJ
Estimated Cost $
lice lJse Only)
Building Official
Date
pai~ <f ()
Date,? -;> .-
.,)...)..O,}
Receipt No. ~9d3()
BYF
This Application Becomes Your Building Permit When Approved
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
ADDRESS / s:- OoB
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED '3 /;l~
~AI)~<tU
TIME
CONTR.
PERMIT NO.
S-/7r-1
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o j:OMPLAINT
..c("" FIREPLACE RI
o jilREPLACE FINAL
$ GASLINE AIR TST
o
~J(rl~_~. reLt>
~ORK SATISFACTORY, PROCEED
o CORR~~~~ltN AND PROCEED
o CORR(' ., :K. CALL FOR REINSPECTION BEFORE COVERING
Inspector: -J. _/ Owner/Contr:
CAL vi,^-sJ FQR Tl-(E N~XT IN~PECnON 24 HOURS IN ADVANCE.
CO~REMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
/NSNOTI
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