HomeMy WebLinkAboutMechanical 03-0475
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
,SCHEDULED
S'- 22..
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
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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 FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
~I PLACERI
IREPLACE FINAL
ASLlNE AIR TST
o
COMMENTS:
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
,AN) 5-~1--{)'>
Inspector: V Y r Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOn
CITY OF PRIOR .LAKE
HEA TING/ AIR CONDITIONINGlFlREPLACE PERMIT
Date Rec'd
1. Pink
2. Green
3. Yellow
-
~!~ I PERMIT NO. i J ,
Applicant 0 3.- "'11J...../
(Please type or print and si~ at bottom)
ADDRESS
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APPLICANT, \ J / J J L rJ I L.
(Name) (',f~5~/0',o ttl'aUJ! ~//O~.
~8"<7d (A,J{J .If W(j /<
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LEGAL DESCRIPTION (office use only)
LOT If) BLOCK I
ADDITION
OWNER
(Name)
(Address)
(Address)
(Contact Person)
APPLICANT SIGNATURE
ZONING (office use)
Rl
I S+ PIrgS- tJ/13-CJIO-Q
I
(Phone)
9?d -j~~'~,?s
(Phone) t2 t; ~ --P-q/J0 ;7 G Ii
(Jtff/li/l//k;: JJ/JI. 5SJ3;?
, (City) ./ (Zip Code)
(Phone) -2 ?/j. --t!l/1-o.7~61
DATE _4pL/ r9sf1 l:::t?
APPLI NT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
DWarm Air Plants 0 Steam PLEASE NOTE:
DGravity 0 Hot Water Air Conditioner Units
o Mechanical 0 Radiation Cannot Encroach into
DAir Conditioning 0 Special Devices Required Side Yard
DVent. System 0 Other Devices Setbacks
FIREPLACE MAKE AND MODEL J!eaf- ltJ--6-fo I ~ 1. 1llp.t! i'H t? J'...T/nS 1'1" -j. j
FEE SCHEDULE
Industrial, Commercial & Multi-Family I % of job cost Residential, Gas Fireplace $39.50
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations $39.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
lice Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
$
$
$
g 9~ 50
.50
LID.
Paid
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Receipt t:;L/o1~ J
By ~
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372