HomeMy WebLinkAboutMech Permit 05-0626
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REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 11/05
Lf () . f}J
CITY OF PRIOR LAKE
HE) 'T'n.u" I A m r"n~nTTTnl\TnT"""~l.KEPLACE PERMIT
Date Rec'd
6.s0.0S
(Please type or lnint and sill;l1 a
ADDRESS
103UQ -=retiers po;rs NW.
~.~ Eicmtt I PERMIT NO. 05. O~2101
ZONING (office
use)
(Phone) qll~ -iLfli ~ 1000
B IlYnsvillt: ?J53~~7
(Address) (City) (Zip Code)
(Contact Person) -KIm Rr lJ01/ U (phone) Cf5d. -7&7 - { fu (
APPLICANT SIGNATURE (~. R(fUJrJiJ DATE [;;J--.!JLf--! OS-
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT ftAL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWann Air Plants D Steam
DGravity D Hot Water
D Mechanical D Radiation
DAir Conditioning . . . D Special Devices
,mYent. System o...r;,n I CLI re.- IJJr e1trllwltJ D Other Devices
5lf St-err.
FIREPLACE MAKE AND MODEL
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
OWNER I rt Ir(
(Name) uv (A
"
(Address) JP>2LILl
-kvLUlL1[j) b1/fhf<
I
CfCHf/r\5 PctSS NllJ
(phone)
APPLICANT r Q
(Name) u--errl. - <-U (1 Yl
J
(Address)~dL:O W.HWl/113
-
Industrial, Commercial & Multi-Family
FEE SCHEDULE
] % 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 $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ 5q.5D
$ .50
$ L/-o . oJ
(omce Use Only)
This Application Becomes Your Building Permit When Approved
Paid 40 vV
I Date ('.30 ,OJ
Buildinl! Omcial
Date
24 bour notice for all inspections (952) 447-9850, fax (952) 447-4245
PID'G-5" . 3 no . 6~L i)
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39,50
$39.50
$39,50
Receipt No. 10/12- l-
By $<-
/~
DATE
#'l~
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/'
CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/oJ~9
OWNER
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
~MBING FINAL
~MECH FINAL
TIME
S-6.2'
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
/ ~t' ~
/1/....elA ) ~4~1 ./q/J.-~
~~/~ WJ- ~hr4~P-
~~~ / __<<7? <2L:J
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~'SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR INSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI