HomeMy WebLinkAboutMech Permit 05-0261
04/13/2006 THU 15:36 FAX 6514606276
CONTROLLED AIR
~OOl
A -( -(r-,): L \ 1'\ d -A
Date Ree'd
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGfFIREPLACE PERMIT
~: ~~ ~~. I PERMIT NO. A ~ A -2 L./
3. v.n..... Apphc..' ~ . fJ~
(PI~sc type or priDe and si~ at bottom)
ADDRESS
~YN ~(}^TA-\ \ \ r--(',,\ \ N'vJ
ZONING (ol&e
\!$C)
LIIGAL DESCR.1.r 110N (office use cmly)
LOT BLOCK
ADU1110N
PIDZ-$. ~O
OWNER \/
(Name) rf\n. V'" \L
~~~)h(\&)n
(phone)QES@. L-.lLfl- ~OO ~
(Address) 2aL-la ~))(. \ 0.1 \ \ rc..l \ ",)\.,,)
APPLICAl)Pl\ .L _ . \ \ t
(Name)-1..J'YYT( y) Pt1
A-\r'""'
(Phone) J..c6\ - W 100-:- (oCA~
(A~SPi\() ~A1m Pi)e-J Fo('m\~)(} ~y
(Addre3'l (c:ft;j (Zip Code)
(ContactPerson) (' .\(\~ L.l u~..r~..1 (Phone) J()f)I'~/.r;frJn~(\V)3
APPLICANT SlGNATIJR.E( Y ~ ~ u ~"Dn::blo,f . DATE '-I - 13. to
. - A.PptJc,l PLEASE COMPLETE BELOW
[]NEWCONSTRUCf]:ON 0 REPLACEMENT !3':ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE REnJRN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWIml Air Plants 0 Steam
OGravity 0 Hol Waler
o Mechllllica1 0 Radiation
IQ1Gr Conditioning 0 Special Devices
OVcnL System 0 Other Devices
PLEASE NOTE:
Air Conditioner Units .
Cannot EncroaCh into
Required Si<ko Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commerci31 &. Multi-Family 1% of job cotlt Residential, Gas Fileplacc
S39.50 minimum
Residential, Heating'" Ale (New Constnic:tiOll) $99.50 Residential, Additions &: Alterations
Residential, Heating Only (New Consauctian) $64.50 Residential, AC Only
$39.50
$39.50
$39.50
Estimated Cost S
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT fEE
Building Pennit #
$
$
5
.50
(Office Use o.ly)
This Appllc.atlon Becomes Your Building Permit When Approved
Bulldlllf. Official
Dllte
Paid' H. DO Receipt No. .
Datif, 1-. () 5" By
24 hOllr notice for all in8pel!tion~ (952) 447-'850, fn ('52) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~~
~
ADDRESS
OWNER
.32~ ~ 1;...1
PHONE NO.
CONTR. ~
o ",,--::,00. ;~G
C MECH RI C COMPLAINT
C WATER HOOKUP C FIREPLACE RI
C SEWER HOOKUP 0 FIREPLACE FINAL
C PLUMBING FINAL 0 G.Af4fjEAIR TST
C MECH FINAL ')l ~ T
It-(L -
C FOOTING
C FOUNDATION
o FRAMING
o INSULATION
II FINAL
C SITE INSPECTION
COMMENTS:
ck -6C6~ lR f G
o WORK SATISFACTORY, PROCEED
C CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTJON BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT ',;.eCnON U HOURS IN ADVANCE.,
I
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH. SAFETYI
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