HomeMy WebLinkAboutMech Permit 02-0400
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
(Please type or print and sign at bottom)
ADDRESS
39/s- Crt::eAJ )/~+~
IrL
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER ~
(Name) ~ 0 rJ
(Address) 39 JS
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,
tree,.) JI~+-'S Tr L
1~;~~~ANT ~T'\ b \ L~ K e. ht+~ ~ If / L
~6)~ 8rDoR C f-
(Address)
(Contact person)~42..o....tJ ~eV\ci\.
APPLICANT SIGNATURE ft)~ _~
(Address) ) ~S'i?!l
Date Rec'd
1. Pink File PERMIT NO
2. Green City . 6'Z.~~
3. Yellow Applicant
. ZONING (office use)
PID
(Phone) tj-SJ -'llIlJ - 58&3
(Phone) 9S.l-'JIJ)-&,} 10
fJr;aT tAte... mA/ SS~'/,J
(City) (Zip Code) .
(Phone) i.ji/7-!?J/t)
DATE l../-J. J. -/J ';).
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION BREPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL IJmem4-.J S~nti?c-A.t" J /JIlVlJRtJR 9 V s U FUEL Ai .111
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
~Warm Air Plants
o Gravity
o Mechanical
~ir Conditioning
OVent. System
REA TING OR POWER PLANT
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
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
TYPE OF SYSTEM
FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential. Heating Only (New Construction)
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
es Y our BUildi~1 Permit When Approved
L{ - ~:>.. - cr:;L.
Date
$39.50
$39.50
$39.50
Building Permit #
$
$
$
3((.575
.50
lfO . O~
Paid
Receipt No.
.
Date
By tf:l)
c(-22.02
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION' NOTICE
DATE TIME
5/ (P !tJJ, q,' tM
3c!J / S ~ 1J;t; T/2,
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION@)
o FRAMING
o INSULATION
I)a:lFINAL
o SITE INSPECTION
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ~
(lf~
~~
-~
I
Y WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
t)'L -~"O
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~/
-1 (
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Inspector:
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
II'/SI'/OTl
"Permit # () d ~ DO
" Job Address .....:s "} IS:- Cr~.-'...6S f <; trL
"Heating Contractor P"';l>r ).l..l:e ~./!r#/<-
"Testers/Signature ~~
. Gas Line
Pressurized
Inspected
" Percent CO2
" Percent O2
Final Inspection
Date
Pounds
Presssure
Time
PERFORMANCE TEST
Lj, 7 " Percent co
1;;119
o o/()
" Stack Temp. tl)"7 If
. ,
Date 'I~'1._{)~