HomeMy WebLinkAboutMech Permit 05-1215
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CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FIREPLACE PERMIT
(Please m>e or print and si2ll at bottom)
ADDRESS
I'-4LSt4 ~p\e. YI.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNE~
(Name) ~ \ C)i (L t\'v'l \.r n'l ~
(Address) IY-L, e>-\ I"Y'CLp\-e. -,v-I.
APPLIC~N1:.....1 _
(Name) l.LLX\\e:s ~ttbiO~~'
(Address)c.oQ~ ~. 14<..o~":'t. 4F Ci.~
(Address) -'
(Contact Person) 0G..\ ,-=e
APPLICANT SIGNATURE Q,hCtd cilib
Date Rec'd
/Z~/3.6S
~. ~~n ~~~. I PERMIT NO. ~rI21' r-'
J. YclIlow Applicant c..c.J . .:::/
ZONING (office use)
telSO
PID25./38. CJ/~.O
(Phone)Cl5:b\-yy'7 -I 7r:J..,
(Phone) ~42!- <<7rQQ
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(City) J (Zip Code)
. (Phone) q&-L\3\- '7ctlq
DATE ~-z;--()~
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION f2l-REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL ~ '. BLo\ rnP ~5_~~6In FUEL ~
FLUE SIZE 5" RETURN OPENINGS INPUTlrLD/'('() OUTPUT (;:;;>-~an
TYPE OF SYSTEM
DWarm Air Plants
DGravity
~echanical
gAir Conditioning
DVent. System
FI~'i:ACL MAKE AND MODEL Le.f'\r\O'L ~
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
~c..1 ~-~4
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 $ 5175-:
,
c~ 1L:r\ ')
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
'lice lIse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$
$
$
~.,~
.5.0
~,c:...L..J
Paid 4-0. 00
Da'z'/~J05
24 hour notice for all 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.5?)~ z.s-
BY~
/716S </ ~LJk
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CONTR.
PERMIT NO. ~~/L/S-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PHONE NO.
DATE TIME
/~~6
t' -
7//
o EXlGRADlFllLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE 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 ~H FINAL
COM!"'INTS: ...., /~___
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~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~;;// c;FOR REINSPECTION BEFORE COVERING
Inspector: /' ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl