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CITY OF PRIOR LA~ THIS FILE HAS BEEN
HEATING/AIR CONDITIONING/FIR CLOSED DUE TO
INACTIVITY 4/16/2008
REQUEST FOR FINAL
INSPECTION SENT TO
IPI=!lT<OCprin'm~~ HOMEO,WNER 10-06
I ADDRESS .
~\Ul - A4)i)rj Sf- VC_
~ Rec'd
(J5'
~!~ I PERMIT NO.li..s- / J C;/
<\pphcant L- ' -/
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone) (/i) ~ C(C((g lilt
(Address)
(Address)
(Contact Person) Q.
APPLICANT SIGNATURE
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
! 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
$39.50
Residential, Heating & NC (New Construction)
Residential. Heating Only (N(:w Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~q. -sD
D .50
L/ .cJD
'lice Use Only)
This Application Becomes Your Building Permit When Approved
Date
Paid 41.) t/U
Date y 'e t. e-
/. / . J '.)
,/ .
Receipt NO'S7)39.,J
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245