HomeMy WebLinkAboutMech Permit 05-0208
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
I. Pink File I PERMIT NO -- _ ~ /1 c;,...
2 Green City .,." ~o
J. Yellow Applicant '
(Please type or print and si~ at bottom)
ADDRESS
S- L!:L/)
&~)t'~
C, rLll
ZONING (office use)
APPLICANT ()
(Name) ,,' '^ <""
LEGAL DESCRIPTION (office use only)
LOT if BLOCK I ADDITION i31tJO~~i')o,f. j.jJJh c;(tu:1
, IvU
OWNER R tJ \'
(Name) t)a.P, t\\',~ 6-
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--.Jk- ~~ ~IJ/L (Phone) ;JC::;J- l/'1)- f?)J{)
(AddreSS)~'~,/ &h)~ ~rDDk Cf fJr)L>r Le::..Kc- ,~AJ~~3'7 J.
(Address)A (City) (Zip Code)
(Contact Person) ~p I"';..~ J....lt'e..fi'~~./., (Phone) LfLf7-RIJ ()
'PPLICANTSIGNATUREmAA-'? ~ DATE ~-).:?-dS
,
PIDd5"'- O/t:,-{J6LJ-Q
(Phone)
9LC; :J-4'L/-~?5!I~
(Address)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~PLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
REA TING OR POWER PLANT
.awarm Air Plants
DGravity
o Mechanical
&ir 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
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
Estimated Cost $
Building Permit #
REA TING PERMIT FEE
ST ATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~9cS.O
.50
l/lJtDCJ
/lice lJse Only)
Building Official
Date
Paid LID: Rti'tZtq d--'/
Date ;3 r d ~-) B~?
0--"
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
SCHEDULED
ADDRESS
.f71{ D fl""k(
OWNER
CONTR,
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: Fwn (('-c-
~
/' /1 I ,.-1 ~
/ / / /)C~ f-!/ A )
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DATE TIME
~).S-c&-
-:-; - ,) 6?
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK~ C~OR REINSPECTION BEFORE COVERING
Inspector: fir Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI