HomeMy WebLinkAboutMech Permit 05-0262
. OF PRIOR LAKE
ASPECT'ON NOTICE
SCHEDULED
DATE
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ADDRESS
/6J"'L/,J tV/ /~~ .LP---
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OWNER
CONTR.
PHONE NO.
PERMIT NO,
o FOOTING
o FOUNDA liON
[J FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
[J WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
/ MECH FINAL
05 ~ /6..2
o EXIGRADIFILLlNG
o COMPLAINT
.......I!!I . ..,...r~CE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
CO~ENTS: /? / /'
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~ WORK SATISFACTORY, PROCEED
/ d ~ORRECT ACTION AND PROCEED
o CORRECT ~O~K~L FOR REINSPECTION BEFORE COVERING
Inspector: ?r Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/NSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1-- I. () S-
~. ::n ~!~ I PERMIT NO. 05. () 2hZ.
3 . Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
/lj~ 4-3
Wlvl/OW U1#~
ZONING (office use)
~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID ;:?5": 24-8. 0/3,0
OWNER
(Name)
(Phone)
(Address)
APPLICANt' r- r n
(Name) "- ') f ~ f<:;.\ c:. .:ro...", 'I
(Address) , ~{)d-\ t\"O",,-,~ ~
(Address)
(Contact Person) _ 'V\. \~
APPLICANT SIGNATURE
~hone) CJ~~ ~lflf7" 31<Od.-
~(~ (~ ~/'~
(City) (Zip Code)
(Phone) 'lb--c- ?>Co6J.- rs ~7
.LJ DATE ~((\...-tJ S- I
A~L~CANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION
<f~~.~'ACE M~AND MODEL Yon rL
FLUE SIZE ---- RETdrn OPENINGS
TYPE OF SYSTEM
o REPLACEMENT 0 AL TERA TIONS
htt fl-Id--.W u ttt t/ FUEL NG &->
INPUT (jio"roO OUTPUT
HEATING OR POWER PLANT
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. ~ystem
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 # oS": 0 Zfp Z-
HEATING PERMIT FEE
ST A IE SURCHARGE
TOTAL PERMIT FEE
$
$
$
:3 9. 57)
,50
40 ,(..0
fice lIse Only)
Building Official
Date
Paid (-0, {/V
Date 4-. 7. tI s-
Receipt No, '18 eo iJ
By /0//
r- - - --
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
APPLIANCE
PERFORMANCE TEST
(ORSA T)
Heatine: Contractor
GE.rNJ~SlLS
-;-Allt CONDtTlONI~
NamYf(er ;}4 d-
Percent 0
Percent C02
I Percent CO
I Stack Temp.
Job Address
l~ft(3 vJ,lIou [Ai
Date 7 i
i-//7/0<)
~%
q
?J
3000