HomeMy WebLinkAboutMech Permit 06-0148
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec' d
3/!tJ/oG
1. Pink File
2. Green City
3. Yellow Applicant
PERMIT NO. Dw -0/ Lf%
(Please type or print and si!tn at bottom)
ADDRESS
43 f(s Cht3:!>-fJ1//1 t LIlJ// tJ
!!JG,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
f). 0 11 117 ~'/7<:'
L( :3 L/ ~--- (1J A.~s; f idalia fA ~
~;;~~ANT Fltve,>/cO~ ilfPtV't/A rlloJM'9- (Phone)
/LI ,'5 Of__q (Ad!tSS~ \Jt 'f l~ 9~ /)J;o 'Y!:ty~llfJ~/ )41J{/ef:cor78
(ContactPen;on) }L(+ f! I '.:lP'C -jJli'Lf (P....ho.....n....e) ---9~.. :J- - /~~. (l>' 7?q!
APPLICANT SIGNA TORE IGJu d J J(~,( .. DATE /J1 P f'r f. f/9i},Jj/l;
APPLICANT PLEASE COMPLETE BELOW
~NEW CONSTRUCTION 0 REPLACEMENT- 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
OWNER
(Name)
(Phone)
Cf5;<-~~0...,S-/6/
_ . l
(Address)
i1/ r:; ,
QG~- '/8~ -7/0.1
(Address)
FLUE SIZE
TYPE OF SYSTEM
RETURN OPENINGS
INPUT
OUTPUT
PLEASE NOTE: Air Conditioner
DWarm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
DGravlty 0 Hot Water
. into Required Side Yard Setbacks.
o Mechanical 0 Radiation
DAir Conditioning 0 Special Devices Fireplaces with Box Additions or
DVent. System 0 Other Devices Cantilevers to the Outside of Buildings
tti--t "- r A) ~ I . Require a Building Permit.
FIREPLACE MAKE AND MODEL ~Pal-=-~ ''-(J1() -- IJ/Or/JC)""( )L...g C,1::=rR..
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
HEATING OR POWER PLANT
Industrial, Commercial & Multi-Family
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$ '~'1, ~Q
$ .50
$ '16, {ic)
"flee Use Only)
r
J/lo~"
Date
Date
t{d.OC
111 oloG,
r
Receipt No. c;r I 51
BY~
I I
rh'
pplication Becomes Your Building Permit When Approved
o ,Jl~
Paid
Buildinl!: Official
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS L .3 c..; s
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE
SCHEDULED S/Z;j,~
QW~ -l
TIME
CONTR.
,
/
~-14,.~
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
~ FIREPLACE FINAL
GASLlNE AIR TST
o
I. ~A~ I~
L\~ M~t.e
o WORK SATISFACTORY, PROCEED
If CORRECT I AND PROCEED
o CORR W j CALL FOR REINSPECTION BEFORE COVERING
Inspect r: / Owner/Contr:
CA L ~FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
V
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl