HomeMy WebLinkAboutMech Permit 02-1576
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
/7 -II - 0 2-
(Plc;ase type Or orint and sign at bottom)
Ao.DRESS ZONING (office use)
\ 1.\ 3 ~ \ ~C~~\J ()~4 \.~\ \' r'~~ l
~. ~::n ~:~, I PERMIT NO.j\? -/57/-
). Y.II~w Applicant U t- cp
L~GAL DESCRIPTION (office use only)
LpT
BLOCK
ADDITION
PID
OWNER
(Nj:1me)
LG..v-..-'1. S '-' '-\ '-J\\ L Q......
\'\ ~ ~ \ S \" ~ <.\" C)Q~\\"~ T0V1: (
(Phone) ~ ~ )- '-\ ~ ~ ~Q \ ()
(A{ldress)
/
APPLICANT '^ \ ~
(1){ame) \i\", ~~) T'<; '\ r- --L YI l:
(A~dress) \ ~ C\ )S CJ \.j ~ \ L (j~ (-\. V "-
(Address)
(C(,Intact Person) N "\ V\ L-- \/ ~ LJ~ ~ "- \ ~
APPLICANT SIGNATURE ._ ~~p L./~^~
(Phone) C\ S :), -. \.1 \\ l- ~ \ d-l{
~ C\ (J- \.t.. \tl 0~ s S -~'I d.
(City) (Zip Code)
(Phone) <1';';1,-"\,--,\,. ~ \Q.",\
DATE ~ \ d-,- \ G- ~
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION ~ REPLACEMENT 0 ALTERATIONS
FU~NACE MAKE AND MODEL C,--V'r~ ".v- ~\I fl-. \ ~~. 'd ~ FUEL ~)c\i-
FLUE SIZE V "{ C RETURN OPENINGS INPUT OUTPUT
.
TYPE OF SYSTEM HEATING OR POWER PLANT
. ,J2lWarm Air Plants
OGravity
o Mechanical
;:gAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FlI\EPLACE MAKE AND MODEL.___
Ind\lstrial, 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
Re~lderitial, Hea(ing & AIC (New Construction)
Re~jdential, Heating Only (New Construction)
$39.50
$39,50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Penn it #
$ S '1 s)}'
$
$ ") ~~.
tJZ-/570
Estimated Cost $
.50
(Oftiee lIse Only)
es Your Building Permit When Approved
I Z. II. o-z.--
Date
paid~O. (/{)
Date
Il.((.fJ~
Receipt ~o:>4-
~-:> SO
By '/
.......
Gj'
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTI6N NOncE
ADDRESS --'..!d .12- t
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED t / ~ tf;:5
~~~qyl
CONTR.
PERMIT NO.
(92-" I~?~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
A
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
? -is ~G<..
-4L
-' e--
~-i
~ORK 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 YO{lR PERSONAL HEALTH cl SAFETY!
.J.wl."
~~~~---_____~-.--...r-~_
.Permil' -1::t2- - l $" , ~
.JobAdck_\Ll"3~ ~~L;~-~""'\
.Heong Conlr_ Me I 1'10 AIR
.TestersJSignatur~gJ;) -'
.Gas Une
Pressurizlld
Inspected
.Percent c~
.Percent 02
Finallnapection
Q!!!
Pounds
PrllSSUre
Time
PERFORMANCE TEST
~ .1 "to
(;,tq c:r I')
.Percent CO
D~
I21CP
.Stack Temp.
Date