HomeMy WebLinkAboutMech Permit 03-0962
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
"I . . .. . . -
,REQUEST FORF~AL
iNSPECTION 'SENT TO
HOMEOWNER 8/03
(Please type or print and siscn at botton , ." ' , ,
ADDRESS
IS3<?b
f'\~l,.. ~ 0'\ ^ +
~d
Date Rec'd
L Pink File
2, Green City
3, Vellow Applicant
PERMIT NOot13 - 9~:} ,/
ZONING (office use)
I K/SO
LEGAL DESCRIPTION (office use only)
LOT /OBLOCK I ADDITION /J1~ ;::; AJd ~ lfo/dJJ
OWNER
(Name) Deo,^
(Address)
APPLICA~T
(Name) ~ v s e..
(Address) 73 'J. 'D
k: ; s SoD"
fV1 <: C '^ 0. V'\: c. 0\, ,
C '<for d S-(-
(Address)
(Contact Person) GO~ V"'
APPLICANT SIGNATURE
('
Rou :>-e.
r1 "\
~ fl- - Q
PID;! 5-()Llf- ~I O-~)
(Phone) b I ). - 7 47 - 10. 7 -;
(Phone) q S ~ - ~} :r - :)"} 0 D
~'f".L....,,\~ P~rK -:554;>~
(City) (Zip Code)
(Phone) CJS';) - '1 :J 3 - S '3 '0 C>
DATE -p..- /7 - 0 3
APPLICANT PLEASE COMPLETE BELOW
-
DNEW CONSTRUCTION B'REPLACEMENT
FURNACE MAKE AND MODEL B',Vti.-1 t- S 5 5" f'f) A \J
FLUE SIZE -S ',012. luctl( V'Q.nf-RETURN OPENINGS INPUT
o Steam PLEASE NOTE:
o Hot Water Air Conditioner Units
o Radiation ~ ' 'lcroach into
o Spec; REQUEST FOR FINAL Side Yard
o Othe: TO
INSPECTION SENT
HOMEOWNER 11/03
FEE SCHEDt
1 % of job cost Rt... ____, u-a;> r Ireplace
$39.50 minimum
$99.50
$64.50
TYPE OF SYSTEM
~arm Air Plants
DGravity
o Mechanical ,
air Conditioning;;1. 5 'To;') rstV(v-.1-
~ ent. System S S D A l"l )c;
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
('lice Use Only)
i
Estimated Cost $ ~
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT .Il J!.J!.
e:J AL TERA TIONS
FUEL tI C\ S
<6""0, 0 &7 0 OU~PUT
HEATINGORPO~RPLANT
$39.50
Residential, Additions & Alterations
Residential, AC Only
$39,50
$39.50
Building Pennit #
$ 3. 1. 5" 0
$ .50
$ If-O. to 0
Pai~tJ, --
Date"1_;;';-- ;;
RelJ~rh 0
B~
.-1his Application Becomes Your Building Permit When Approved
Building Omcial
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
OA TE TIME
SCHEDULED tJ ;;1-01-(;'"
/5SS-0 FshjJo/',u+ Rei
f
CONTR.
PERMIT NO,
1) 3- 9& d-..
o PLUMBING Rl
o MECH Rf
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLfNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
SENT ESTS~~
INSYEL'llON LETIERS uU1
RECF.IVl?D NfiBESPflNSFl
CLOSE-FILE DYE-+O
lNAC1JVlIY
o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
IHS/'tOTl