HomeMy WebLinkAboutMech Permit 02-0493
05/06/02 MON 10:41 FAX 6124474245
CITY OF PRIOR LAKE
~
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date J
(Please tVDe or tltint and sil!Jl at bottom)
ADDRESS
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ZONING (office use)
PaSO
LEGAL DESCRIPTION (office use only)
LOT 7 BLOCK I ,ADDITION 1/~~rJ:!~(:)-ll<- Oiyehj ,
PIDr25?40- QC)?-(J
OWNER", '
(Name) 1,)\ (~~ C.\y\()\~~rf''5
, (Address)f oC,\ rl.- H()x h\y ? V\ r ~ N, E .
(PhOn~~ \ LjLr~. &.J I.~
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(AddressLy'),n, aJ)( L--fm'lD Ccr't;) +?nninl'\ ~-f.--lLjf3L
(Address) (City~ (Zip Code)
(Contact Person) . K..o , -\- h ~t2re PC' h F ( (Phone) (I to ~ ) ''-T~-- )r CD) 0 l 0
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~ REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODE~,,-/r\J>~--A mAA(\-\l OO<r('\ FUEL (\(} -+ , qQC\.,
FLUE SIZE ~ II RETURN OPENINGS. fNPUT fX:\ I (YJ) OUTPUT 'E:t IrQ
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants
OGravil)'
o Mechanical
OAir Conditioning
OVent. System
o Steam
o Hot Wilter
o Radialion
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial. Comml:rcial & Multi-Family t% of job cost Residential. Gas Firl:place
$39.50 minim\Hll
Residential. Heating & Ale (New Construction) $99.50 Residential, Additions & Alterations
ReSilJential., Heating Only (New Construction) $64.50 Residential, AC Only
$39.50
$39.50
$39.50
Estimated Cost $
Building pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
t
$
$
(~q.5o
.50
1-/0, {}U
(OffiCI! U ~~ Only)
This Application Becomes Your Building Permit When Approved
Building Officilll
Dlltl!
Paid aU
J-/tJ.
Date a - 7 ~ ;)....
Receipt No. () L
, ~/dO lD
BY~
24 hour notice for all inspedions (952) 447-9850, fax (952) 447-4245
DATE TIME
ADDRESS
(E
CE SCHEDULED b -i/ - ~ C.?:- ~
~~/;;Z j}~L-h6L/PL
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~ L/9~
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~ FINAL 0 PLUMBING FINAL
16 SITE INSPECTION 0 MECH FINAL
COMMENTS: r ~CiLQ./
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
_ A
(~.~
.
~~
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~/ ( Owner/Contr:
CALL 447-98~O -:bR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl