HomeMy WebLinkAboutMech Permit 02-1524
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
(Please type or print and sign at bottom)
ADDRESS
3440 Wi ,lOt,) ~ T("~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
K(Lrl
~44D
(Address)
APPLICANT
(N ame)
1
(Address)
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
OWarm Air Plants
o Gravity
o Mechanical
OAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL
#eM-N (1/0
Date Rec'd
I. Pink
2. Green
3. Yellow
'11/
~:~ IPERMITNO./):)_ /SCAt'J
Apphcant U~ ~ 7
ZOp!-7G (office use)
PID&l:J-IOb-OI%l
(Phone) ~2; 441-- 14,2.,\
(Phone)
(City)
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
~rr'H'L~ y,
(Zip Code)
/JbJ 102-
.
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
1?L-S ~3
t,~~
Wi' \QU.) f;e.a.cn -r ~ai;...
FIRESIDE CORNER
J~ii " HftY 13
BURNSV I LLE MN 55337
II c fIZ~~~)1 I
. :HONE 952-890-0758
(Contact Person) fttl "!~ / mc.4f~ (Phone)
APPLICANT SIGNATURE _?//(/.., /J1.~~ DATE
( I <-./
APPLICANT PLEASE COMPLETE BELOW
~
DNEW CONSTRUCTION D REPLACEMENT EJ.AL TERA nONS
FURNACE MAKE AND MODEL FUEL
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
0/1.60
.50
4O.tJl)
Paid )Ie? OJ
Date,
/l- ,:J::l-oo
(Office lJse Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
$39.50
$39.50
$39.50
Recei~ 911
BY~
U
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
J2-~
.J 440 Vvl/ltt1./ ~qc,h
SCHEDULED
l'>~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
/ SJ- {;(
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
o MECH FINAL
o EX/GRAD/FILLING
~ 0 COMPLAINT
. .....a'1=IREPLACE RI
r.A 0 FIREPLACE FINAL
~ ~SLlNE AIR TST
COMMENTS:
1:!-~ Qfr O'L
I
/. I ~.Q" _
L/\.V~
r~1
.;....-,U
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: rrf / L- ,- 02-... Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI