HomeMy WebLinkAboutMech Permit 05-0432
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
.--
j-: Ift.oJ
I. Pink File PERMIT NO
2. Green City . /1C'"". ().A...:>Z-
3. Yellow Applicant V...J y-~
(Please type or print and silm at bottom)
ADDRESS
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ZONING (office use)
LEGAL DESCR1.t' nON (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Address)
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(Phone)
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APPLICAN;t ^., __ "'. \'
(Name)~IT) ~--1'\" l'C"
(Address) J1D99C> \DQ\( t'lffiP ~
(Address)
(Contact Person) ~_"f ^~
APPLICANT SIGNATURE
(Phone) (C153) t{ Lt ,-)? \ a 4
tfurlf~ ~ 55C)l~
(City) (Zip Code)
(Phone) 44,-s<\a ~
DATE Ii;;, J 1 ~LO 1 os-
. -
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT 0 AL TERA TIONS ~
FURNACE MAKE AND MODEL { ~ or t'"~ '- ~ S ~ (., \J 1\ - ~ ~- \ ~ FUEL t\J L_
FLUE SIZE RETURN OPENINGS INPUT q", , ~~~ OUTPUT ~
TYPE OF SYSTEM HEATING OR POWER PLANT ..., \: ~~~
'Pr(1Warm Air Plants 0 Steam PLEASE NOTE:
OGravity 0 Hot Water Air Conditioner Units
o Mechanical 0 Radiation Cannot Encroach into
OAir Conditioning 0 Special Devices Required Side Yard
OVent. System 0 Other Devices Setbacks
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
$39.50
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ ~ '"\ SO
$ .50
$ "4<) ~
Estimated Cost $
"mee Use Only)
fhis Application Becomes Your Building Permit When Approved
Building Official
Date
pai~~. ~
Dat:r./6. ,.r-
Receipt No. .{4ft f f
By L.
{/
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
DATE TIME
~~-
ib?'9,2 $kr<:sl- 6~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
.DDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~CH FINAL
COMMENT~ / /'
Ze/J /t:?tC" d
/
CJJ - ~d2.
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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(('~(cse ~/ /e- )
~RKSAT~Y.PROCEED ~
/6 ~~RRECT ACTION AND PROCEED
o CORRECT W~:5~ REINSPECTlON BEFORE COVERING
Inspector: /~...,. r Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/II$/iOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
"P.rrnilllf
oJob Addr_ (;, o,";).. 1-1'"/ I C/~+
"HMIing Connctot Me I nO AIR
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"a. Line
Pr......nad
Inspected
~
PoundI
Pr......
PERFORMANCE TEST
.Percenl CO:! ~ ~,-") .Percent CO O~
.PercenlO:! 7. ';)."7~ .SteckTemp.;;;1 J"
Final Inapeclion
Dale