HomeMy WebLinkAboutMech Permit 02-1483
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
.J tl-B-OZ-
I. Pink File
2. Green City
3. Yellow Applicant
PERMIT Nt) ~ - / tj rKi
(Please type or print and siJtll at bottom)
ADDRESS " ~ rot "\
a5a.Q Stx"'3 LO-\\~ 1lU-.3. ,
ZONING (office use)
f(JSlJ
LEGAL~ PESCRIPTION (office use only)
Qq ~ /A ,. Ai' ~ / iJ
LOT BLOCK ADDITION ~L-1At1L~a~
PID ~5'''' /31-~tJd-t)
OWNER ~. ~r \.-.
(Name) "X')" r'\ U-~ \ \ (\ qC'.l::j ,
.......,
(Address)o.So.?) ~'\3 Lll~ -r--d ~
APPLICANT
(Name)l.t )"'l\ \~ 0~+hsne)
(AddresskQ.C-{) \ ,\ ~-t-h(~, * !Go
- (Address) ,
(Phone) ~-yL\~ - 34-oY
(Contact Person) CrLr"'\ lL:r~\ers
APPLICANT SIGNATURE l()~} n~072-~-iJ1~
(Phone) ~-431-70qQ
Clop\e.. \I 0. \ \~ 55 \d.Y
cs;Jpj) (Zip Code)
(Phone) CQ3--L.{:)\ ~ ..~
DATE 0- \ \-C9-
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 1KI REPLACEMENT RI AL TERA TIONS
FURNACE MAKE AND MODEL YlLLurl - Ue-L\-\ Cy, EAUc.R. FUEL I~Q-tu-(Cl.l
FLUE SIZE RETURN OPENINGS INPUT;b.~ a:J:::; OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
I:!Warm Air Plants
o Gravity
~ Mechanical
~Air Conditioning
o.Jc OVent. System
. ~f~AeE MAKE AND MODEL
o Steam
o Hot Water
o Radiation
o Special Devices
,. 0 Other Devices
. \I.)..
Ccuner -_~) - ...38i2A 0\0
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
c -
Estimated Cost $ , '":>l ,,,C't'"j ,
. ,;
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
2>q.so
.50
4Cj;.::s.--"j
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid OU
40.
Date
/1- /d-. - d
Recetl~9 S-f?'
BY~
U
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 SCHEDULED
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
7-s-} '7
DATE
TIME
II-If.(
4,,'t1)
S fJ/1l;}~ 1<<1(,,10- Ilrl,
CONTR.
PERMIT NO.
o PLUMBING Rl
o MECHRI ~
o WATER HO KUP
o SEWER HO UP
o PLUMBING FI AL
o MECH FINAL
P(frv\~4. ~
~
) - /-117
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/ / fJS-t
L-1 '-/ 'q,~
r-/
1'-/ L( ,
I .
.a:',*;>
.
, WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:.fVf U -{ ~...-rfl- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTI
.,
.
..
>
~
~
APPLIANCE
PERFORMANCE TEST
Attach to gas line adjacent to regulator
UC/t~
(5
10 - / I-d Z-
Heating Contractor
Name of Tester
Date
Job Address,]J-z. J >P'/,'A-K ~~
Heating Contractor L)dt, (~
Name of Tester L J
/o///IOz,
E(
7
(/
") JO
Date
Percent 0
Percent CO2
Percent CO
Stack Tel11>.
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