HomeMy WebLinkAboutMech Permit 05-0433
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
S-.I (p .us(
I Pink File PERMIT NO
2. Green City . OC-.(j f'1?
3 . Yellow Applicant
(Please type or print and si~ at bottom)
ADDRESS ~
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LEGAL DESCRlt'uON (office use only)
LOT
ADDITION
BLOCK
OWNER
(Name)
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(Phone) ~ .r~-,4 41- \\{ <10
(Address)
APPLICANT ^ ~
(Name) ("\ ~~ t; , -.. - \ Y") ~
(Address) \ \o~ '2 a \..h.\ lUYW.,. ~ V\...
(Address)
(Contact Person) t\ 0...."'\ \-- d
APPLICANT SIGNATURE .~~ )~
ZONING (office use)
PID
(Phone) '\.s: ~- \.{~J - ~ \ ~'t
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(City) (Zip Code)
(Phone) "-f ~- ~~,.~, ~~
S- i l,- S
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ,esJ REPLACEMENT D AL TERA TIONS
FURNACEMAKEANDMODEL l~.....,..,~ '-""""' s g f"\V f -\o~ -\~ FUEL r:v t&
FLUE SIZE \> V c... RETURN OPENINGS INPUT \.o~ I ~ ~ (\ OUTPUT ~ ~ Q... '\
TYPE OF SYSTEM
~Warm Air Plants
OGravity
o Mechanical
Ii: Air Conditioning
eVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
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
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
'')ffice Use Only)
fhis Application Becomes Your Building Permit When Approved
Paid ~ t /I?J
Date.J./ If,. ; I'
Building Official
Date
24 hour notice for all inspections (952) 447~9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Receipt NOc1" ~ / 'If
By /
V
DATE TIME
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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
~ wieCH FINAL
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
C9MMENTS: 1". r? /
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o CORRECT ACTION AND PROCEED
o CORRECT WORK, C~~ REINSPECTION BEFORE COVERING
Inspector: # t- 'Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!