HomeMy WebLinkAboutMech Permit 05-1077
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
(Please type or print and si~ at bottom)
ADDRESS
)lca\~ ~~)\Q CVCl-~J~ Ave
LEGAL DESCRIPTION (office use only)
LOT BLOC~ "~DDITION
Date Rec'd
~ ~:n ~:~ PERMIT NO. /\C"'_ /))1/7
3. Yellow Applicant ( V . IV .' /
ZONING (office use)
-.S. L .
!i~ (Jodc
"""
OWNER
(Name)
c ~ ~, 'I
J
,~ t) \ ~
~ ~ ",',
C:4)\st
t\"",,- \\c\ ~~r'\
(V-- -t..~Jc J\ V Q J, L .
(Address)
APPLICANT '^ .
(Name) ~_l_ \-"'''' \.3.....'\ - T Y\ l.
(Address) \\0 \ 'i -b vJ ,\ ~v~ rvv l
(Address)
(Contact Person) '-X'\.~)J ~
-'-\PPLICANT SIGNATU~ -,~ ~
PID GlS-tJ9(,'" fJ38.-o
(Phone) ~r~. ~ ~ lo ~ 'J \0 Q
(Phone) q S"::> . ~ '-\.., ~ R \ ~ \,f
P "'1 ~- La tu nN S 5 3 J-~
(City) (Zip Code)
(Phone) '\ S ~-"""'L\ l~ \>
DATE I\). d. \0 -J
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL S ~ S T\\ _Ia -, ~ - \ - D ~ FUEL N ~+
FLUE SIZE RETURN OPENINGS INPUT" \. , ~~~ OUTPUT S '3, ~ ~ <:}
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
$39.50
$39.50
$39.50
Building Penn it #
"'1 1 SO
Paid l{{J :---- Re~e~~lJ /
Date - .~.'BY - 5
/tJ' (;:17-(.)')
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
lice Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$
$
$
.50
'-\ ~ ~/
CITY OF PRIOR LAKE
INSPECTION NOTICE
,/
SCHEDULED
ADDRESS /6' t17CJ
c5:4k
cO\c6'R.
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
o PLUMBING FINAL
..J"MECH FINAL
COM~NTS~ ,,-
/~/(?h.e~d
,
./'
;z,YH"I ~c...,
,j
/f/~l') L4,r/~ 't:~
J/I /-.
/~~("..,,_-A_ r~y~~
..-
~ / /
(' pP~~ (As'" ;?O,tA
~r
DATE TIME
/flk
Crt!-tJ~ ~_
.~'-/077
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
.--:-
_~~c::;C-~
.// /~/
~
O'^'
-------/ /' -../'
~A-4. / C//{
7 ~C'--_._.__.
~. -_._-=-~--.
~ C!6f"C- r ~e-~
~WORK SATISFACTORY, PROCEED
I ~ORRECT ACTION AND PROCEED
o CORRECT WOJR':.;~'7~REINSPECTION BEFORE COVERING
Inspector: Y ~7 ~/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNon
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
"Permit. D <r' - t 0 '7 7
.JobAddr_~1 0 lEA ~/I (~(:
"HMling c. Me I "0- AIR
"TatenlSiplur. ~ , D U
,
Q!!!
!!!!!
Pounds
Pr.......
"G. UN
Pr-.ized
lMpected
PERfORMANCE TEST
*PercentC~ _b- '1-tf~ *PercentCO 0%
*"-"' ~ U Yc "Slack T_p. ;b8. ~
FiMl InIpec:Iion .
08le