HomeMy WebLinkAboutMech Permit 02-0635
CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FIREPLACE PERMIT
(Please type or print and si~ at bULMU)
ADDRESS
/'1 ~itJ if - (!,lLltd I~Wd(}J
Date Rec'd
~. ~:'n ~~~. I PERMIT NO. .k) '1-0 62q-
3. Yellow ApplIcant (./0"'-:;,
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT JLIBLOCK ~ ADDITIO~kd 17 ~ LfO--
OWNER
(Name)
W/lli LLlYtlffllt~A
I if A I, l./~ CILA-J L{!.;W()(JJ.. L~hP,..
. (Address)
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PIIB-5- 8/5.-0 f>>l/-(?
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(Phone) qS-;l- S/9{g-/()9(,
APPLICANT J,J/; IL I~
(Name) s:, (.v il, S.i"P~ 1'7 '7 Y /'f..J.J- I ltc.,
(Address) J /) ~ I) lJ - N tJ r In IL ILJd e, 6/i/ rL
(Address)
(Contact Person) f( 6 ~11- -t- S /e.,. (e..,;-r t
APPLICANTSIGNATVRE /l.d~_.A!~
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(Phone) !l.r:J--Y8'~ oz..~S..3
!JIb'; nlUttJ_ n,.,. Mil s:rY.3 7
(1:.ity) . (Zip Code)
(Phone) _ ttr;)..... B'~i/- a '15....3
DATE b -~'T--o ~
TYPE OF SYSTEM
OWarm Air Plants
o Gravity
o Mechanical
llJAir Conditioning
OVent. System
REA TING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices _
FIREPLACE MAKE AND MODEL
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1 % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AIC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
d"
Estimated Cost $ ,;l;, 73'- Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use 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
$ 3 9, S7J
$ 50
$ ~)) .. bib
Paid L/o 100
Dat~ -31-tJ ;3--
$39.50
$39.50
$39.50
ReceiPtj(/i-1 J-I
BY~/
V --
CITY OF PRiOR LAKE
iNSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FiNAL
'O'st-TE INSPECTION
COMMENTS:
'~-"'""
(f L/ ;l. t, L/ c~~c:d Uv
CONTR.
~-~ 3S-
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
If / c!./
I
L;-o~
~.~
~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InspeelO< -i If l1-w r[?'leontr
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl