HomeMy WebLinkAboutMech Permit 05-1107
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
440
~. ~:~n ~!~. I PERMIT NO. Os-. /107
3 . Yellow Applicant
OWNER .
(Name) ]lliJLt'--~ 6ak-baAr4, D Wc.eYl-:!
(Address) 34D J lttJJJlo LV f!Jr;tYJ! 11 .
APPLICANT . . d I'l-//>
(Name) ~ t' nsv J I / C Id.c.Ar-l-I n tJ~ IT ~ (Phone) ~ q L/ - OtJ/6
(Address) .?;L/.5) ~r) t3JAA?7L<i VI.I / r; VeJsd,uLl Bu-yns v17/~ 56.~37
(Address) J (City) (Zip Code)
(Phone) fq 1-. ~
DATE If) /oIJIJS
J
(Please type or print and sign at bottom)
ADDRESS
3:if2J ItA) II , 0 /A)
~aoh Lv,
I
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
(Phone)
(Contact Person) 16 ~
APPLICANT SIGNATURE P>t./41
N I (!,,- uv:S"~n
-
ZONING (office use)
PID Z5 110. 032-.0
Lftf/}.67L{q
APPLICANT PLEASJ COMPLETE BELOW
ONEW CONSTRUCTION ZREPLACEMENJ 0 AL TERA TIONS
FURNACEMAKEANDMODEL Un nDtI.... I~ f., I mpv 3/' (6-010 FUEL N~~~I
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
~vity
~ Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Stearn
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % 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 #
-'oe Use Only)
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ t~q.5()
$ . , .50
$ .LlO.OI)
.is Application Becomes Your Building Permit When Approved
Paid 10.00
Date /1. 3.05
Building Official
Date
24 hour notice for aU 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. 503 C0
/1
BY!.
DATE TIME
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
PHONE NO.
CONTR.
PERMIT NO. S --//1)7
OWNER
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION ~CH FINAL
COM~TS:/ c:.!/ ./
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~RK SATIS;ACTORV, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~.;A:/ 7/ R:INSPECTION BEFORE COVERING
Inspector: j/ t/~r Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
INSIiOTl