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HomeMy WebLinkAboutMech Permit 05-0880 fif!!OA (~~1 .'NIIIESO't'- CITY OF PRIOR LAKE ilEA TING/AIR C,-,.1 ~DIT~,-,.1 ",~NGlF~RE~LAC~ "'E.k..1~'\~ 1. Pink 2. Green 3. Yellow Date Rec'd 9-)~-i>~ ~:;y I PERMIT NO. 05 (J8 80 Apphcant (Please type or print and sign at bottom) ADDRESS 320/ L-/NOGN UK- LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION OWNER (Name) (Phone) (Address) ZONING (office use) PIDZ.S:- 1+-1. 03/. 0 ~~~~~ANT_<) m I S' ~ J{ tf? 6- If (Phone) _~t77 - 7 Y y - -? 3 /' 3 (Address) .:-2 ().R... 56 v rlJ /444/N' 5'/ Lo'? ~ ~ ~ ~5'cP{ b (Address) ~ (City) (Zip Code) (Contact Person) (?e./e.4-/ L~ <) ffl { r..e tE:.., . _ (Phone) ~(I?,?Y Y - ..:?.3 ~ ~PPLICANTSIGNATURE ~. /?/ ~c;;::? DATE q-/~- 0 ~ /- /-.--- -,. ~- - I APPLICANT PLEASE COMPLETE BELOW DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS ~NACE ~AKE AND MODEL FUEL - .---' FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT o Steam o Hot Water o Radiation o Special Devices o Other Devices DWarm Air Plants OGravity o Mechanical OAir Conditioning OVent. System FIREPLACE MAKE AND MODEL Industrial, Commercial & Multi-Family FEE SCHEDULE I % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 $64.50 Residential, Heating & AIC (New Construction) Residential. Heating Only (New Construction) Residential, Additions & Alterations Residential, AC Only Estimated Cost $ Building Permit # HEATING PERMIT FEE STATE SURCHARGE TOT AL PERMIT FEE $ 39. 50 $ .50 $ 4-0. VV .ice Use Only) Building Official Paid W 40~ Date Date'f./~ ' .f- 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue, Prior Lake, MN 55372 This Application Becomes Your Building Permit When Approved PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks $39.50 $39.50 $39.50 Receipt No. H9~f-t By /ff CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS ..?,20/ ~'~~h OWNER CONTR, PHONE NO, PERMIT NO, 0... TE TIME %~- /"?;.-- ~S--J:po D FOOTING [] PLUMBING RI o FOUNDATION 0 MECH RI [] FRAMING [] WATER HOOKUP [] INSULATION [] SEWER HOOKUP [] FINAL [] PLUMBING FINAL [] SITE INSPECTION ~ECH FINAL COMIJFNTS: 1 ___ /~~ tl4t"'eA ,h/r-,YLe::;, (. ~ I) J, / _ /14l.A.-/ ~roH~c,./ _ I / 8 -:2 //J~ ~.~/ '~;,..., ~~(?5~ ../ /') / /,//1q / [] EXlGRADIFILLlNG o COMPLAINT [] FIREPLACE RI [] FIREPLACE FINAL o GAS LINE AIR TST [] ~/ t'7/c " ----------- ~/ -_...~ r"-.. ~. /t9S' -e ,/-; /' e ~ --- .. roRK SATISFACTORY, PROCEED [] CORRECT ACTION AND PROCEED REINSPECTION BEFORE COVERING Inspector: ~ Owner/Contr: r CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNOTI CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!