HomeMy WebLinkAboutMech Permit 05-0323
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. Pink File PERMIT NO. 05
2. Green City
3. Yellow Applicant -V?? _ 't
(Please type or orint and sign at b_~_~)
. ADDRESS
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 25: 12 ':;>. 0 UZ. . ()
APPLICANl) l-
(Name)-Tf" \ C r-
(Address) / &,sg <J
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OWNER I) J/ I 1 ...
(Name) t1rrll.A J( "" /-J...DNe,J
(Address) /sD1'J . ~reeA/ tJt::...Ks J~L
~ ~dJc (Phone) 9...$:::2- L[1.J7-f?LL1)
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(Address) (City) (Zip Code)
(Contact Person) .\ )eo... rV .Ar.. i/"\.~ (Phone)9,C:-...2 ~Lj_7--J?J J t)
(Phone) 25J- lJ'I/-tJ.lXJ
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APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ..aREPLACEMENT 0 AL TERA TIONS
FURNACEMAKEANDMODEL IImericdA-l S:f~~~r-cj FUEL AJllr
o .,H ' -,
FLUESIZE r \Ie. ~ RETURN OPENINGS INPUT &1>lJOQ OUTPUT 7~ ~~('J
TYPE OF SYSTEM HEATING OR POWER PLANT
~arm Air Plants
o Gravity
o Mechanical
DAir 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
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$-
$
$
,32~
.50
/lIJ,{)O
(Office Use Only)
~~BUildingp#2-w;it;~nVed ::: ~,~
. Building Official ' Date - 1./(~ ~ c;-
24 hour notice for all inspections (952) 447-9850, fax (9~2) 447:4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
Re4~ p:? (p
By 19- '
DATE TillE
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
[J FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
[J FINAL
[J SITE INSPECTION
[J PLUMBING RI
[J MECH RI
[J WATER HOOKUP
[J SEWER HOOKUP
[J PLUMBING FINAL
~CH FINAL
c:::;S - J2 <.
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
[J GASLlNE AIR TST
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~ORK SATISFACTORY, PROCEED
/ [J'-eoRRECT ACTION AND PROCEED
[J CORRECT WO~~~L~EINSPECTION BEFORE COVERING
Inspector: /' ~ ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!