HomeMy WebLinkAboutMech Permit 05-1075
i/ ,
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. Pink File PERMIT NO
2. Green City . or _ ~o?r
3. Yellow Applicant .:) , I ,~
(Please type or print and siWl at bottom)
ADDRESS
ZONING (office use)
55 W (J Los1- HoY' /- z'w ~; 'rol p)
LEGAL DESCRJ..t'TlON (office use only) 0 J
WT 13wCK ';<ADDmON ~?/U --ct.a..
g;::;R .WO 11. (1:1 Lo~J - +fu -H-eV'I' V' (Phooe) $;),-~ ~ f/3tl
(Address) r 1',' 0 (' ~rJ.J:( e,/ _/J!.J1J oJ> L;:~.'??~
APPLICANT \ ,11 _ \ Ii ~ J li
(Name) f= \.('~ P-fl(l{'t" ...,ftO~ (Phone) ~!J..--W,-e~~s
(Address) --;< 8) c;cJ lJ;, tlw I' 13 &rJltSll/JJfJ- /lJUIL. 55 =?2?
(Address) ~ (City) I (Zip Code)
(ContaclPerson) ----KL+ fu ~dili, <;' (phone) 9'5)-'1~g -7?~1
-APPLICANT SIGNATURE 'O:cu ~A'.dJ /-j '- DATE _f'YrJ'- ~11flt,hL:;"
, -... -
PID 0l5-/0~-" 03;;).-{)
APPLICANT P EASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATINGORPO~RPLANT
OUTPUT
DWarm Air Plants 0 Steam PLEASE NOTE:
o Gravity 0 Hot Water Air Conditioner Units
o Mechanical 0 Radiation Cannot Encroach into
DAir Conditioning 0 Special Devices Required Side Yard
DVent. System 0 Other Devices Setbacks
FIREPLACE MAKE AND MODEL -It- e~ ~ J.-tJ-I f) hLO~ - r1...JV !1J1S 1')1 ~i? f^ t -
FEE SCHEDULE
Industrial, Commercial & Multi-Family I % of job cost Residential, Gas Fireplace $39.50
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations $39.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3S;. ~o
.50
'10. , tJ
flee Use Only)
This Application Becomes Your Building Permit When Approved Paid ftJ .IJ()
~ ~ --42.~~ Date /
Building Official Da~ II> Je,'-f I 5
24 hour notice for all inspections (952) 447-9850, fax ~52) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
Re@~i9
BY~
,
)
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
#MJ-
/ '
Sj~O L:;;I ~~/~~ C.t-
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~-/6?J-
o FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
[J FINAL
[J SITE INSPECTION
o PLUMBING RI
[J MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
ft'1=IREPLACE RI
..,.2"FIREPLACE FINAL
~L1NE AIR TST
[J
COMMENTS:
~ / >_ I
h~~ /J/4C~ ~S~~ r-
;tiz -~G% ,
, / ~ P:-L-~/Y
~; ,., ~ }'
.A~/6 ft;,t. . TC9 /- a~~p~r
~,<#_ -4. 0=;'", ~/e/"~
~/ I~/v~ .~. ~~~ r- .
~ / /
/~S e/ I O/~
~._..___T"'
~/
Ie /6 Je
~KSATI
o CORRECT ACTION AND PROCEED
o CORRECT WO.)~~J'~ :A~ FO~INSPECTION BEFORE COVERING
Inspector: J~~.L--, Owner/Contr:
----.
/~ A> ~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl