HomeMy WebLinkAboutMech Permit 04-1036
CITY OF PRIOR LAKE
ltEA TINGI AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
10.. (f.. G ~
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.DDRESS
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3. Yellow Apphcant V-r-.
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LEGAL DESCRIPTION (office use only)
...
LOT 1 BLOCK I ADDITION (')J~/\V I~f-
OWNER
(Name)
(Phone)
(Address)
APPLICAWi) /
(Name)lr\ Or- tJoC. ~ ~ (
. ~ "
(Address) 1'~l.J ~bl2/~ fv-oo~
(Address) -
(Contact Person) ~ tJ.rc4~
APPLICANT SIGNATURE? .
ZONING (office use)
PID r,.I: 10 i 010.. 0
(Phone) 9&':>-'1'1 /-<;tJ Jt)
(City)
(Phone)
DATE
(Zip Code)
10., d. 04--
APPLICANT PLEASE COMPLETE BELOW
,,..--...-- 'W~NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
",URNAC.:9KE AND MODEL FUEL
FLUb MZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Building Permit # 01-- ./O;j> "
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New ConstructiOn)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
1 'tflJ
.50
4O"K)
.
(Office Use Only)
.r--l'his Application Becomes Your Building Permit When Approved
Paid fo. W
Date I () ./ /, , f-
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Receipt No. 41/7 t
By (tV
o~r lp
o "11TY OF PRIOR LAKE
l INSPECTION NOTICE
ADDRESS
..?6j~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
Cl SITE INSPECTION
COJIIIIEN"J:$: ..~
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DATE nME
SCHEDULED ~~~~~
u/, //~~geA-C~7/-/
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ECH FINAL
.-
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L?r~ Go ;L-
A
o </-/dZL
Cl EXIGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~ORK SATISFACTORY, PROCEED
~~'ORRECT ACTION AND PROCEED
Cl CORRECT WORK, C~L 7'...IREINSPECTION BEFORE COVERING
Inspector: K~ Owner/Contr:
CALL 447-9850 FO~ THE NEXT INSPECTION 24 HOl,RS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
IlYSNOTJ
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PERFOAMANCE TEST
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