HomeMy WebLinkAboutMech Permit 05-1210
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
12. ; I Z , 05
~. S:w ~J~icanl I PERMIT NO. 05"-1 Zl 0
(Please type or print and si~ at bottom)
ADDRESS
144 -S ~ 'N I~ ~ti,)j A-k Ci tl:ck.. I t--l G : YJtt 0(. l/r Ice
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER -T:' 1 \ _ ..i'
(Name) JII1 ~~
(Phone)
(Address)
APPLICANT
(Name)
(Phone)
ZONING (office use) I
PID 25. 04-re, () 02- JJ
9~- ~33 -d) llS
(Address)
(AddreSS)L
(Contact Person) . _~d (Phone)
APPLICANT SIGNATURE ~~ . -poP DATE ])ec€)-(be~ j~1 ~OlJS
( APPLICANT PLEASE CO~PLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(City)
TYPE OF SYSTEM
HEATINGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL l1AJe.stiG VUJ1ccl- ~h,J,\~ - J)\I~T 4t
\I
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1 % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
Estimated Cost $
Building Penn it #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 51. s-o
$ .50
$ Lfd.{)tJ
flee Use Only)
fhis Application Becomes Your Building Permit When Approved
~ ~ /2.//2_/0)
{ Building Official I Date -
Paid U
{ 0,00
Date / (
/2 (~ o~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 5i5372
(Zip Code)
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Receipt No,
0J ~!?'
.BY~.
I
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~
OWNER
PHONE NO.
D FOOTING
D FOUNDATION
D FRAMING
D INSULATION
D FINAL
D SITE INSPECTION
SCHEDULED
l}~d"JJ ~ t\
C~TR.
PERMIT NO.
D PLUMBING RI
D MECH RI
D WATER HOOKUP
D SEWER HOOKUP
D PLUMBING FINAL
D MECH FINAL
DATE TIME
I~
~ - tZlD
D EXIGRADIFILLlNG
D COMPLAINT
D FIREPLACE RI
%FIREPLACE FINAL
;1il GASLlNE AIR TST
D
COMMENTS:
I. Q~Mrk~--- ~ (~t- ~c-uk.~,~
t'P(' nth' '^^~~
~.Juf D,/
l 'X VU y ( \..0
~ ~ v ~I '
o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORRECT ,ALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CAL ~7 850 F~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
--!-/ .
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1NSNOT/