HomeMy WebLinkAboutMech Permit 02-0181
CJTY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FlREPLACE PERMIT
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~~~Y, I PERMIT NO.~il. /) /0)
Apphcant c...AIlw {./ 0"
(Please type or print and si2l1 at bottom)
ADDRESS
I. Pink
2. Green
3. Yellow
,/&!dL5 1?,dcro~ !J1()Nf'
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LEGAL DESCRIPTION (office use only)
LoT3 BLOCK ~ ADDITION ~~ ?~
fl- dJG p
Date Rec'd
ZONING (office use)
)215 {)
PID~- /65-COS-o
(Phone) qrJ. -Lf lf7-l.{ s-8 Y
(Phone) Cf,?J.q3d.. {q~~
txAR1()S1' {Iltl S'5'3> ~ 7
(City) (Zip Code) ,
n~ (phone) 9YJ-'f3J...( 1S?....
~. ~ ) DATE ~...(t7-cG-....
~PP~IC~NT PLEA~E COMPLETE BELO;
DNEW CONSTRUCTION ~ REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
OWNER ~ ../J.4., C- _ r
(Name) V"a\, '1 ~ \ ~
(Address) /~ftJOJ ~\~""'~
APPLICA~ r':t
(Name) J O?'l-l{ ~ U!J .
(Address) J~ i it talA f't. II
- (Add/ess
(Contact Person) M It(t()
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It
APPLICANT SIGNATURE
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATINGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
~arm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Penn it #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
'-;'1,50
,50
l{{) ,OQ
Paid t/{J j tJO
Date
t9.,ai, -C>J-
$
$
$
(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
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
ReceiW~~
By
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CITY OF PRIOR LAKE
INSPECTION NOTICE
..
DATE
SCHEDULE!:].
3-".0?.- <!f:tJV
ADDRESS
/su O.s 0.oG.cfo? ON I
OWNER
CONTR.
PHONE NO.
PERMIT NO.
2 -/~ I
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 FIN
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
FIREPLAC~
o GASLlNE AIR TST
FU/U'J h -
5rrf~
COMMENTS:
(1)~ --~
....
~TH
ur'>wl
~~t::. [l.,c..,..-\"l' ul ~-
frfL~ ~
...
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~ALL FOR REINSPECTION BEFORE COVERING
Inspector: d:ij " Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
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HEATING
eQUIPMENT
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! FORM 682 '
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