HomeMy WebLinkAboutMech Permit 05-0935
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
1. Pink File
2. Green City
3. Ye\low Applicant
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ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
OWNER
(Name)
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(Address)
APPLICANT . ~ \_. -(\ \ \'
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(Address)
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'-"'PPLICANT SIGNATURE ~)) U-
Date Rec'd
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PERMIT NO. Os.. OCf35"
ZONING (office use)
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PID 25. 0 17. 001 0
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(City) (Zip Code)
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DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL ~ ~-,.~ ,- ~V f - ~ Q-' ~ FUEL t\J '-\..\--
FLUE SIZE ~\l L RETURN OPENINGS INPUT ~~. d 00 OUTPUT -,s J~
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OWarm Air Plants
o Gravity
o Mechanical
~ir Conditioning 1'< A - ~ "3()
- [j\i ent. System
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 & A/C (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit # ~O 93S-
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.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
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lice Use Only)
, Application Becomes Your Building Permit When Approved
Paid #_
Da~ Z,? 05"
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Receipt No. + 9977
By ./f/ltt-
I
DATE TIME
SCHEDULED L'/ //~,-
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/6'5-77
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
~CH FINAL
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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&~ORRECT ACTION AND PROCEED
o CORRECT WO'~ ;.A~R REINSPECTION BEFORE COVERING
Inspector: /P--- ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!