HomeMy WebLinkAboutMech Permit 05-0233
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
; ~~n ~!~ I PERMIT NO. /)~_ J ~.-j
J. Yellow Applicant U../ . (?f U .:lj
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ADDRESS
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT ~OCK I ADDITION
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(51-
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OWNER ()
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(Address)
(Contact Person) N fA.. "'" ~
APPLICANT SIGNATURE dr\ v... A ~'*-
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(City) (Zip Code)
(Phone) q{:} - 4 ~ l-~ \ ~ \(
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DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRU. CTIO~ ~,RE.PLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL (o..V"'Y'l '--- ,/ 5'\l-\ _C,\ f) - \ \0 FUEL rv~
FLUE SIZE RETURN OPENINGS INPUT <t ~ . (j ~ OUTPUT" '..l'\ () ()
TYPE OF SYSTEM HEATING OR POWER PLANT
OWann Air Plants
o Gravity
o Mechanical
OAir Conditioning
OVent. 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
( $39;V
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ "5 ~ S~
$ .50
$ '--10 ~
Estimated Cost $
fice Use Only)
Building Official
Date
Paid LlO., _ Ret}?( (J /
Dat3-3/-s BY~
U'
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
OA TE TIME
.:f J. 05-
ADDRESS
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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
~MECH FINAL
COMM~TS~ / __
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
j(D GASLlNE AIR TST
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WORK SATiSFACTORY, PROCEE~-'
o CORRECT ACTION AND PROCEED
o CORRECT/W~'; CVR REINSPECTION BEFORE COVERING
InSpector:Y~ /,/ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
~
1
GAS UNE AND
A~E PfAFOAIoiAHcf TEST
lCoMec:a tD -..-.. " ......)
(AIIIlch tD .. line ..-... tD l'eQlMIorl
"HNIing CoMec:a METRO AIR
"Job~ /t.;cJ" I P.' ,,-,'..., Cj4 s;>-
o _
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., lCOoJ~"'"
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"SlecllTemp .-=;'7('7
"Permiltl (J _r- - ? 3 '"?
"Job Addr_ criP / &~.(..; c.'" )"f",
"HNIing Connctor Me I nO AIR
"TesllllW/Signlllu'. ~
Q!!!
Pounds
Pr.......
Ii!!!!
"0. Line
PresMlrized
Inspeded
PERfORMANCE TEST
"Percenl CO:! -,. ") "Percent CO CJ
"Percent O:! --IJ.+.>1 "Stack Temp. ~ ?: )
FinIIllN . . . .. .
Date