HomeMy WebLinkAboutMech Permit 05-0253
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink File PERMIT NO 1
2~ ~ .(J5-'~
3. Yellow Applicant c;{ .J '
(Please type or print and sign at bottom)
ADDRESS
5665
\ /"
6'~' ( ,p,t..r
ZONING (office use)
(,...ocoJ
'IF' J
,
LEGAL DESCRIPTION (office use only)
. LOT i( BLOCK if ADDITION ~I1AA rI
t-........." --
tP~~ (~ rd
PID rY 5-d/L/-tJ~)~-D
OWNER
(Name)
Sl~lb..
.... J
S-6D~
N~ 156 "'-
C eJ{..r !.vDC>)
(Phone)
'1LfS-- 70 ~ 7
. (Address)
0-(
APPLICANT L
(Name) L 6.. F- e v.' /1 -e
( A f ',/
(Phone)
j/.."r
(City)
4J.7t> ""-J.f'? ~ <f
1... j -e ,;h # 5',J)> 7..1
(Zip Code)
7/~/
/
)i~ / _.-' (Address)
(Contact Person) ~, ",-
APPLICANT SIGNATURE ~
(Address)
L~^.., f/, 'C""""
A~~
(Phone)
DATE
~~tt' "'r? J "
~-6-b >"
c.r
APPLICANT PLEASE COMPLETE BELOW
,
ONEW CONSTRUCTION ~PLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL L 4 r f /' e. C / ,,4 FUEL /l/ "t. f
FLUE SIZE RETURN OPENINGS INPUT ~ ~0t!?e::;::> OUTPUT
,
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
. 0 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 Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 3Cj-S-O
$ .50
$ &/lJ_--
lice Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid
~CJ _ -
Date
1/-& - ~
Rece~1 tJ,
BYV
V
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE l / / c/~
INSPECTION NOTICE SCHEDULED W'K
ADDRESS S/;OS ~J.,Y~~oJ 77/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
rJC;- -,.2.D
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
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~' C:~R REINSPECTION BEFORE COVERING
Inspector: /' Yt/'/ Owner/Contr:
, ,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
Job Address 5&,05 (.e'~~.e: c- ~ I r
Heating ContractorL- Lvt(fL fl.-tl: ~l A \1,.
Name of Tester
Date
Percent 0
Percent CO2
Percent CO
Stack Temp.
~\ w.
~ .A~~L>5
1.Cc.
7.5
o
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