HomeMy WebLinkAboutMech Permit 06-0225
~'~
'I"'NESO'\~
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
APPLICAN'h /
(Name) *,\~r J-a..l(- \.l~ ~AL,
(Address) ;G,S'6'1 R--tble.. A~ C~
(Address)
(Contact Person) ~ ~~,^.-q"
APPLICANT SIGNA;URE . _ _~41~/
.
APPLICANT PLEASE COMPLETE BELOW
~ DNEWCONSTRUC1'ION DREPLACEMENT DALTERATIONS
( FURNACE M AND MODEL 'It' k ,..,., FUEL
..... '- . /
t'LUt :sILb RETURN OPENINGS
(Please type or print and si~n at bottom)
ADDRESS
/ " 7 0 ~ ~ uGlv' tJ ~ /'IVt3
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
TYPE OF SYSTEM
Date Rec'd
1.3.tJb
~. ~i~:n ~~;y I PERMIT NO. /-. 2 ZS
3. Yellow Applicant CP
ZONING (office use)
PID
(Phone)
9~) -1./11 ) - [s) F/)
/H A-/ ,<:;'53>/)..
(zip Code)
(Phone)
/J r &...,
~rl (}r", l~~
(City)
q..~ ).- 'Iii )-~I , 0
DATE .._S'-3p-O(,..
(Phone)
INPUT
OUTPUT
HEATING OR POWER PLANT
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
DWann Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent. System
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
"flee Use Only)
fhis Application Becomes Your Building Permit When Approved
Buildinl! Official
Date
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
$39.50
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Building Permit #
$
$
$
~91'5b
.50
4'!)...tr'
Paid {rO-
DatSf ) 0 '"
Receipt No, S-I J tj 1
i
a
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
IIIIr
JF PRIOR LAKE
~PECTION NOTICE
DATE TIME
SCHEDULED ~
~~'l~h
ADDRESS /~70S
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
~/
/
/kVV
I/L
CONTR.
PERMIT NO.
b -:,7,?S
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
.JJ--MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/
/
/
z,// ~7 ~
~/ L /L
#,k, ~e~'/ 2 ~- u~,ctz///
~/,', p/ tI
d
....- /
~./ /'-
~6RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL 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 & SAFETY!
IltSItOTI
~..
GAS LINE AND
APPLIANCE PERFORMANCE TEST
IC , ..' to ClCII'ftPlMe " ..".,
IAIl8ch to .. line ,... I to NgUIIIIorI
--. f?/..}j J "if
"HNlingConlr_~ ~
"Job Addr_ / <I 7 tl3 t.V,dN~~ a\l e-
"Pennil. &;;Z~ s-
"Percent co. () 0/ GL-
"Slack Temp., -:s Lf~
Appro\Ied
"Percent CO;?
"Percent ~
~
7.-;)
~5"
.~~--~--------~---
"Permit. t., ~~ 6- . .
"JobAddr_ /17123 C.YeA"kfk/.,r;J all P ~
.He.lingConlr8CtOr ~ J?J.~k.
.Test..../Sign.,ur. --fl-h~, ~~
.Gu Une
Pressurized
Inspected
.Perc.nt C02
. P.rcenl 02
F on.llnspection
0.,.
Ii!!!!
Pounds
Pressure
PERFORMANCE TEST cy.
7~ ~ .P.rcenICO D D D
<) ,5 .Steck T.mp. ~ ~
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