HomeMy WebLinkAboutMech Permit 05-0100
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
..dease type or print and si~ at bottom)
ADDRESS
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LEGAL DESCRl.t'uON (office use only)
LOT
BLOCK
ADDITION
Date Rec'd
z.. 4-. ~S
1. Pink File PERMIT NO
2. Green City . 05. 0 {1"l0
3. Yellow Applicant V
OWNER. . \ V . I \. ' r \.-.
(Name) Q\d-reo... <::f f"\'f"\<-'. +i1\lr\Lll~
(Address) [.p~ ~ +-\ o.r \::::orl il {I .} CLi. ,j S
APPLICANT
(Name)~\e0:>~'"""i L"it-S,de; .+\~.
(Address)(oqc:o LV. 14Lt> -tb.~i . ~ lCl.o"r
(Address)
(Contact Person) ~ )uJ \p
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APPLICANT SIGNATURE
ZONING (office use)
PID 25: 203. 00 I. <1
(Phone) ~~t.r~
(Phone) Q~\- '1CRo..
(l~ LJOI\~ s5~4
(City) (Zip Code)
(Phone) ~IT".f:-
DATE \- ~t--C6
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION \:1.REPLACEMENT q AL TERA TION~ ,
FURNACE MAKE AND MODEL QQyy' \ cr g \. S8 \\\\1 P O~ I t...J. FUEL tJQ I Ur(L!
FLUE SIZE RETURN OPENINGS INPUT 801 ('V 'y) OUTPUT
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
~ l.:",chanical
DAir Conditioning
DVent. System
FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential. Heating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
'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
REA TING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
....-Residential. Additions & Alterations
Residential, AC Only
Building Permit # 05 0/00
$
$
$
3q~
.50
Ll()~
Paid 10, W
DateZ. 1. () S
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Receipt No. -I!6!L
By ~
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6S6r dlo, d~'V
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
~FINAL
COMMENTS:
DATE TIME
/?ti "/00
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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rlORK SA TISFA Y, PROCEED
,/' cl---cORRECT ACTION AND PROCEED
o CORRECT WORK; ~'; WEINSPECTION BEFORE COVERING
Inspector: /~~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSliOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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