HomeMy WebLinkAboutMech Permit 04-1123
CITY OF PRIOR LAKE
HEATIN AIR CONDITIONINGIFIREPLACE PERMIT-A
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~ase type or orint and si2J1 at lx>ttom)
ADDRESS .
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LEGAL DESCRl.t'UON(office use 0 y)
LoTdOBLOCK L/lADDITI JCt/JtJ
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Date Rec'd
ZONING (office use)
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OWNER C-J f
(Name) ~ If,,S
(Address)/'!/7 {, ~J, ov~
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(Phone) !15:;J- YY~--/tol-L
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PPLICANT PLEASE COMPLETE BELOW
UCTION D REPLACEMENT D AL TERA TIONS
FUEL
APPLICANT
(Name)
(Phone)
(Address)
( !\ddress)
(City)
(Contact Person)
i
APPLICANT SIGNATIfE
~
DNEW CON
I
FURNACE MAKE AND N1:0DEL
FLUE SIZE RE JRN OPENINGS
TYPE bF SYST M
INPUT
HEATINGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
DWan 1 Air Plants
DGrav ty
o Mec lanical
OAir qonditioning
D; reL-T .~st.TJ /J ~
FKtBfLA~ MAKE ANDi Moblf
Industrial, Commercial & Mul ti-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 Cl'lew Constru tion)
Residential, Heating Only (New Construct on)
Estimated ost $
Building Permit #
/
HEATING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
(Office Use Only) .j
~ fhis Application Beco..-es Your Btilding Permit When Approved Paid 1 filII ~
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Building Official il. Date Date / /) .- p4 -t/
24 our notice for all inspections (952) 447-9850, fwf (952) 447-4245'
16200 Eagle Creek Avenue, Prior Lake, MN 55372
(Zip Code)
/tJ-l}&j-O'-t- .
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
. ~
ReceiPtNO~tJ/~
By V
ADORE'
OWNER II
PHONE 10.
[] FooTIllIG
[] FOUN.IA TION
[] FRAMI IIG
[] INSUt.: ~ TION
[] FINAL I
[] SITE I~SPECTION
COMMENTS:
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VWORK ~A TIS FACTORY, PROCEED
A ~RRE' T AcnON AND PROCEED
[] CORRE.. T WORK, CALL F REINSPECTION BEFORE COVERING
CITY OI9IPRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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CONTR.
PERMIT NO.
[] PLUMBING RI
o MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
[] MECH FINAL
DATE TIME
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[] EXIGRADlFILLING
o COMPLAINT
[] FIREPLACE RI
~EPLACE FINAL
~SLlNE AIR TST
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Inspector: ;
Owner/Contr:
J;C~,
~L
CALLil447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE JlEQUlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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