HomeMy WebLinkAboutMech Permit 02-0243
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
fh EtfJ !r_ (IN
LEGAL DESCRIPTION (office use only)
LOT /OBLOCK I ADDITION (}lUl~&~
~=R ben0 HZJ~s~:
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(Please type or print and si~ at bu.""~)
ADDRESi 47 3 C('
1. Pink File
2. Green City
3, Yellow Applicant
PERMIT NO.e~-O,Jlf3
ZONING (office use)
1.71 Sf)
Sc
PID a 5- /a;. 0/0-0
(Phone) 9.5~ :l-~ - b3 3<'1
. (Address)
APPLICANT
(Name)
~iANDARD MiAl~ '~ llltll:nmmtONlJG Cu,
410WES" L",~f' 'STREET
(Address) MIJI[APOU$ii'\I'll\l5-~
^/ ~2-~
(Contact Person) ----W" Ue.:, (7' (Phone) .i
APPLICANT SIGNATURE ~~ f._ _2Lnv/\-- DATE .~ 1,)~O1.-
- APPLI~T PLEASE COM~LETE BELOW ,
DNEW CONSTRUCTION ~ REPLACEMENT 0 AL TERA TION1t.~ r. I
FURNACE MAKE AND MODEL fJ r"14y, '-f ~ 55 FUEL ~ ~
FLUE SIZE RETURN O~~UNGS INPUT ~ , 'f:JE)t::::J. OUTPUT
(Phone)
(City)
(Zip Code)
TYPE OF SYSTEM
'-
iZfWarm Air Plants
.. JGravity
o Mechanical
lliAir Conditioning
[jv ent. System
HEATrnGORPO~RPLANT
n Steam
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
REQUEST FOR INSPECTION
SENT TO HOMEOWNER. NO'
RESPONSE - CLOSE FlLE
4/2003
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
,,~( S
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~.~
_ .50
i..fO . {)O
.
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Pa~t/t1&
Dat~_/S_~
- "
Receipt Nt; ISO '1
By ~
/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
. ," GASWaR~+OR'E)ER
.STANCARC
-- ~ HEATING 0'"
& AIR CONDITIONING
A Blue Doc. Service Co. EQUIPMENT INFORMATION
LAST JJ (}~C1~O~ FIRST (, ~^ 0 TYPE
ADDRESS , '-\1 ?., t./ fY\ tH\ If.' "1 t L :MAKE t3 f:. 'I J
CITY ~("\ Dll L.. o,~ ZIP -5.. ') .~?~ .MODEL355 /'I14t/Ot:!J-Q5i:){ifY,4
HM PH q.5'Z..- 1.:2 ~ -11331 WK PH \ .SERIAL ~l)OS' I
TECH ~'N'\ "- DATE~ ~D fa? .INPUT ~( .'
ORSAT TEST RECORD
METERED INPUT P Df:Il> cfh CHIMNEY TYPE V U C-
LIMIT SETTING ! ~d 0 FLUE SIZE
PILOT OUTAG~A ~ see CONNECTOR SIZE
o TOTAL CHIMNEY INPUT ~O
02-D24-.3
1082 Payne Ave.
St. Paul, MN 55101
651/772-2449
tio.
. .
410 W. Lake,St.
Minneapolis, MN ~ 554-08
612/824-2656
'2 in. ·
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