HomeMy WebLinkAboutMech Permit 06-0251
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
4--. JO, ufo
~. ~i~~~w ~i~icant I PERMIT NO. 00. (I Z5 /1
(Please type or print and sign at bottom)
ADDRESS
ZONING (office use)
5535
~v-.~\~ S ~
~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID "25-. Un IJ> -~.F 0
OWNER
(Name)
f(\o...t"" \ " ,J
PJ Dv 6...~
. -
(Phone)
~~) - V.I./ b-'I7SS
, (Address)
APPLICANT .0 }
(Name) T~\ t)r la...k \\\e,~t1 L
(Address) / &'.581 Peh~Dt-
(Address)
(ContactPerson)~ ~~1-
APPLICANT SIGN~URFfij~~ ~~:/--
"-
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~EPLACEMENT 0 AL TERA TlONS
FURNACE MAKE AND MODEL J1Jn ~W FUEL JU Jl j
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(Phone)
IhDI'L~~ JIl/U
(City)
Sc;37d
(Zip Code)
(Phone)
DATE
L/-llJ "- 2D /)~
TYPE OF SYSTEM
HEATING OR POWER PLANT
~nn Air Plants
DGravity
D Mechanical
~ir Conditioning
DVent. System
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
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.
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$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 #
HEATING PERMIT FEE
ST A TE SURCHARGE
TOTAL PERMIT FEE
$
$
$
. =?9 SO
.50
'101 t1D
'flee Use Only)
BuiIdin!! Official
Date
Paid 40, i./LJ
Date 4- . (0. tHy
Receipt No.
11
/'
Slzz7
. This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue. Prior Lake, MN 55372
C~~ENlS: /- ~ J ~-
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.IF PRIOR LAKE
..:iPECTION NOTICE
SCHEDULED
ADDRESS
SS3~ ~U~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ECH FINAL
/;!p'
rl~,
~<.C- c5?L
/
TIME
t<. - .2S-/
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.,~
./
O/C
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~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK,;A~L :~EINSPECTION BEFORE COVERING
Inspector: #~....-- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
~
GAS LINE AND
APPLIANCE PERFORMANCE TEST
(ConlrIll:tOf to complele . ....)
(AIl8ch 10 g-. line ~ to NgUlIIIor)
.HNting ConlrIll:tOf ~ I? L ~
"Job Addr_ .s ~ 35 Bt'"lLA '^ ~ ~ ~+-
ApprCMld .Permit tI 0&-. ~<::;j
.Percent C~ ~ .Percent CO D 2"~
"Percent~ ~8. 9 .SlaCkTemp. 3:;2c;t:l
.Permit..
Ofa.. n;)S/
:::.-=-~~
"TesleI'l/S;gnature ( JA.." ~ -, ~
Pounds
Data Time Pressure
"Gas Une
Pressurized
Inspected
PERFORMANCE TEST
.Percent C~ ~, L/ .Percent CO fi 0/ D
.Percenl02 'fi'.. 9 .Stack TempJd, <\ 0
F.nallnspection Dale ~/ ~