HomeMy WebLinkAboutMech Permit 02-1001
CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
8:'-/5 -() 2-
(Please type or print and silVl at bottom)
ADDRESS
SCjq(}
~: ::n ~~~. I PERMIT NO.Oz.--/OO /
3. Yellow Applicant
- v .
_~ /001-11 &-SE4
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER .--r-:. C, 0.,-
(Name) . IOltl-i J Q/ 1J1t!} u;n (Phone) ~~-t.j1/74/fcJ6"
(Address) Sl/ q 0 I~o ,ft S'f.. S~ ~
~;;~~ANT rf'rP~tJLfAJV'~er/tJlj,et~F,leJ/rf~one) 9~-J>t?~-()/4
(Address) 2'?..s-o Lb. !(b/I~ /3 ,~rJf.\j,r'/le..iJl)1J.. GS32?
(Address) -0- (City) (Zip Code)
(Contact Person) (" (Phone) ()t;tJ.,- rfPC-()7S-;;;
APPLICANT SIGNATURE ~ DATE ~ /tjlf ~
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
REA TING OR POWER PLANT
OWarm Air Plants 0 Steam PLEASE NOTE:
OGravity 0 Hot Water Air Conditioner Units
o Mechanical 0 Radiation Cannot Encroach into
OAir Conditioning 0 Special Devices Required Side Yard
OVent. System 0 Other Devices Setbacks
FIREPLACE MAKE AND MODEL ~- N-a-1o f'VJJ~J : 1lf-S<<&DIYII2-""""/J /US~~t.
. .
Estimated Cost $
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Building Permit # d Z- - {O 0 /
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
31. (()
.50
40,~
(Office Use Only)
This Applic1~n Becomes Your Building Permit When Approved
fJ;zAJ- / -- l[ - cJ l-
Buililing Official - Date
Paid tfu, c.rv
Datev- -
O-/)-JZ--
ReceiPt~NO' Z-
4--z, 7
By .~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED ?/dR-1J7 lIS-
$((CjO /€iO ~--
CONTR.
PERMIT NO.
~ - It}::) /
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
~IREPLACE RI
o FIREPLACE FINAL
~GASLINE AIR TST
o
C
FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTl