HomeMy WebLinkAboutMech Permit 05-0164
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
3, Z , oS-
I. Pink
2. Green
J. Yellow
~!~. I PERMIT NO. ()5', c /(,~ I
ApplIcant
(Please type or print and sign at bottom)
I ADDRESS
30'-11
K I'lQ j/ '(' I'~ 9 e.- 0 r /v Q.,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z-S'. 3'-0, 00 z. ()
OWNER
(Name)
(Phone)
(Address)
(Address)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
CJ5J.-fl9~'- 3 09/
APPLIC NT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
HEATINGORPO~RPLANT
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
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
()S. '1(, ~
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
J'f.SD
.50
ftJ.t..U
lice Use Only)
This Application Becomes Your Building Permit When Approved
Paid J1.Jl
-,- . &.11
Date J 'Z. -
. ,CI ~
Building Official
Date
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
.e
$39.50
$39.50
$39.50
Receipt No.
~~IU-
DATE TIME
CITY OF PRIOR LAKE 3JZr(oy
INSPECTION NOTICE SCHEDULED
ADDRESS 9:>4/ KIAO I ( ~
OWNER CONTR.
PHONE NO. PERMIT NO. S-J~'i
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP A:1FIREPLACE FINAL
o FINAL o PLUMBING FINAL ,J;rC~ AIR TST
o SITE INSPECTION o MECH FINAL o .--
COMMENTS:
/
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE RK, CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
QUlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI