HomeMy WebLinkAboutMech Permit 05-0883
CITY OF PRIOR LAKE
l1EA TING/ AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
f- If. ~j
~.::;.:n ~~~ PERMIT NO. ()S-,OC~ 3
3. YeUow Applicant
(Please type or print and si2l1 at bottom)
ADDRESS ZONING (office use)
15112 APPALOOSA TRAIL ~
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
OWNER
(Name) P~'l'lH("T ~ ()~'l''RF.M
PID~3O+-. ()OS. 0
(Phone) Ql'\?-44n-4n4n
(Address) 15..ll2 ~ PP ~ T.()()~~ 'l'R ~ TT. NF.
APPLICANT
(Name) RQ.N' ~ ~NT('a-TN(,,-
(Phone) Ql'\?_44n_4n4n
(Address) 12010 OLD BRICK YARD RD
. (Address)
(Contact Person) L\Ylb...... ~~ (Phone)
~'l'PLICANTSIGNATURE ~~IL ~~ DATE
APPLICANT ~EA]E COMPLETE BELO)Y
DNEW CONSTRUCTION ~REPLACEMENT r:r AL TERA TIONS
PU~TACPMA~,A'l\TnHODEl L\..fe..'O~ \55 ~ ~.\J FUEL
OUTPUT
~H~K()PF.F.
(City)
FLUE SIZE
RETURN OPENINGS
INPUT
TYPE OF SYSTEM
HEATINGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
~nt. System_ ~\J
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 & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
Estimated Cost $
Building Permit # {)5. 0 f3!} '3
31.~
.50
L\O.oo
REA TING PERMIT FEE
SI A IE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.lice Use Only)
'lis Application Becomes Your Building Permit When Approved
paid1't'. trz}
Date ~ /~ ,r'
r
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
MN
55379
(Zip Code)
q.. \t~
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Receipt No. tJf?;/--7
BY~
{j
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
IS-Ill
d:Pjl~~N
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
..,aMECH FINAL
COMMENTS:
A-rr
.,
+,... 4,;,.
.
DATE TIME
&(-5<)
7>-1
S--8"'"8':>
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
--- -~ ~
/~I r I )
l QC:;~//
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
[] CORRECT WORK, CpR REINSPECTION BEFORE COVERING
Inspector: /IV OWner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/II$NOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!