HomeMy WebLinkAboutMech Permit 05-1096
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
".I.V~
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3. Yellow Applicant V J. 7 W
(Please type or print and siltll at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
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APPLICANT I"i\. L ^, _____
(Name) , . ~ \. ~ ~,..-. \ Y\l
(Address) \ l.o '\ I.;( D ~ " \. L-U~ ~ ~ 'L
(Address)
(Contact Person) ~ ~ l"\ ~J S '-- ~ ~~ ~
APPLICANT SIGNATURE ~ ~
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(Address)
ZONING (office use)
PID
(Phone) <\ s: d - '" '" 0.. \ ~ G S-
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(Phone) ~ s: ~ -'A ~ 1- ~,~ \.{
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(City) (Zip Code)
(Phone) q ~ ).-~~ {- ~ \ ~ '\
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DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL ("... ~ ~"... c.. V A - c -, ()- \ ~ FUEL N ~ t-
FLUE SIZE RETURN OPENINGS INPUT ~.} ~ OUTPUT' ~3" ~
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent System
FIREPLACE MAKE AND MODEL
HEATING OR POWER PLANT
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
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 $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Building Permit #
$ ~~~
$ l. - .50
$ ,~
Paid
~()--
Date I (
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$39.50
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ReceiPA NO.9] r4--
By ,
1./ .
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 /
16200 Eagle Creek Avenue, Prior Lake, MN 55372 G
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIllE
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ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
-
.!:> -(tJf c
o PLUMBING RI 0 EXIGRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND P- OCEED
o CORRECT WO OR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 0447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH Ii SAFETYI
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