HomeMy WebLinkAboutMech Permit 05-0180
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink
2. Green
3. Yellow
~:~ I PERMIT NO. /1<- I ()j)
Applicant UJ - () I"
(Please type or print and siltD at bottom)
ADDRESS
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(lj; ~ /4. I/€---
ZONING (office use)
LEGAL DESCRiyuON (office use only)
LOTL/BLOCK ADDITION k/Vea I',<;e LI...5 eou~ PID,::;:()"- ///:;,-()(JI./-O
/
OWNER ( 1. -,
(Name) (Phone) q ~ -., I Lf 1....1~
(Address)
APPLICAN1/-- } (I 1\ \" J\ f\ ~() I I HOt J1
(Name) \...T~~. n~""K\.0~r-\-\r' (Phone) {,,5 (- ~~ r-L L 2-..,
(Address) t\ 0 \ ).... 'N ~ .<, ~ tV \..V N ~ @)~~A ~Y\ r111A_ <('~ 1I 2
(Address) (City) . U' - - . (zip Code)
(Contact Person) Vv\ l'c~ ~ c")~ ~ (Phone) CS( - ":2-)/ --.J../ C( ~.4
APPLICANTSIGNATURE~ J)~ DATE 2>/14 fOf
f/
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 ~LACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL L\, '{Gt..~ U FUEL ~A...~ Of'Lf
Ir .ILI -
FLUE SIZE .A RETURN OPENINGS INPUT lC)C),OC:>t.PVOUTPUT
TYPE OF SYSTEM REA TING OR POWER PLANT
[g'\V arm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
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
I % 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
Estimated Cost $
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
,3Q S-O
.50
-
Llo/'
lice llse Only)
Building Official
Date
Paid LjtJ...----
Date . 3 C-
<3- / --J
ReceiVPO~b
By C'
~
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
DATE TIME
SCHEDULED ~~-'
Cu e due...
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/Y7t?;L
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
~H FINAL
CO~ENT$: ( ./"
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C1S--/~O
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~ORK SATISFACTORY. PROCEED
~'~RRECT ACTION AND PROCEED
o CORRECT 7~.7~OR REINSPECTION BEFORE COVERING
Inspector: Y ~""'/' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
I/iSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!