HomeMy WebLinkAboutMech Permit 05-0901
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or orint and silitll at bottom)
ADDRESS
~. ~~n ~!~ PERMIT NO,!), c_ 9 A J
3. Yellow Applicant J - V /
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LEGAL DESCRIPTION (office use only) j). _ /J
LOT bBLOCK ,S-ADDITION~~d
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OWNER ( ( . '13
(Name) .~ '* (-'..Efi,.) , ~lAjt\ER
(Address) 1~1T7 SKY'-INJ: Jil/.G: Ai.W.
ZONING (office use)
PID 1113 - Ob 1
(Phone)~:; i{!jf) /f)e:J~
(Contact Person) .-P _ LJ
,~-. PPLICANT SIGNATU~ / l1i~f C7'J.;..{jA,Illf/l, J
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APPLICANT PLEASE COMPLETE BELOW
__ ~DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
( FURNACE MAKE A D MODEL FUEL
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'rLut; ~IZt; RETURN OPENINGS
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Phone)
DATE
INPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
HEATING OR POWER PLANT
o Stearn
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-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 & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ~~_e&
$ .50
$ '-10-
,lice Use Only)
Building Official
Paid / I
..., ()
Date
Date tjj je, I ~
24 hour notice for all inspections (952) 447-9850, fax~7-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
This Application Becomes Your Building Permit When Approved
(Zip Code)
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OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
ReceiPt~ tJO '3 L/
~~ /
DATE TIME
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CON,.,(
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/S-77?
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION ~CH FINAL
COMM~TS: I "...-
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~ORK SATISFACTORY. PROCEED
/d-'~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR EINSPECTION BEFORE COVERING
Inspector:
Bwner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI