HomeMy WebLinkAboutMech Permit 05-1097
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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LEGAL DESCRlr llON (office use only)
LOT
BLOCK
ADDITION
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APPLICANT tv"'\. \
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(Address)
(Contact Person) N~" ~~ ~ '-" l ~\L
APPLICANT SIGNATURE ~ ~ h~
OWNER .
(Name) (_~ t' \ \
(Address) '-\ ~ '\1\
Date Rec'd
" .,. 0 J-
~. ~ ~~~ PERMIT NO. ()J-. III 47
], Vellow Applicant f
ZONING (office use)
PID
. (Phone) C\S" ~.",u.s--S,a"
(Phone) q~ ~~44, -~ \ ~ '-i
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(City) (Zip Code)
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DATE fa - ::1, - ",.......
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT 0 AL TERA TIONS
FURNACEMAKEANDMODELC,",,""'~\~ <::,& '<'-\\19 -\~-dO FUELV~
FLUE SIZE ~ \lc RETURN OPENINGS INPUT' 0 ~. (J~ OUTPUT .ct"\ a~~
TYPE OF SYSTEM HEATING OR POWER PLANT
OWann Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL
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
1 % 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 & NC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$39.50
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$39.50
Building Permit #
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$
$
$
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Paid 11;--
Date, ( ~ ~
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Receipt N~ J t' 4--'
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
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DATE TIME
CITY OF PRIOR LAKE '>I' A-./
INSPECTION NOTICE SCHEDULED .-1'/boS-
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ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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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
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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/ b CORRECT ACTION AND PROCEED
o CORRECT WO'.:J.~~EINSPECTION BEFORE COVERING
Inspector: F ~ / ) Owner/Contr:
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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