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THIS FILE HAS BEEN
CITY OF ] CLOSED DUE TO
HEATING/AIR CONDITI' INACTIVITY 4/16/2008
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 10-06
Date Rec'd
~i~ I PERMIT NO. /is- I / ~5t
ApplIcant ~ J
h3X
~AJIf J
AI- l,0 I
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Jr. :)fi? oc J. L-t
OWNER
(Name) fJ--:;7 L^-....... \
(Phone)
CEjl/v~(')^)
(Address)
APPLICA~~ ~
(Name) \ d/h
Qi/l
(Phone) ~ Go :;;2 ?-
(Address)
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,
(
Ilue
(
Cora tV
(Address)
MAJ.'
(City)
(Phone)
(Contact Person)
->;'7(1 ::2 ..y
(Zip Code)
I APPLICANT SIGNATURE DATES-
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT L TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
a ('~ 00<
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$ -5f 5V
$ .50
$ ~tJ . tf2)
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid 4tJ" i/l/
Date II. 2tJ / (!J"'-
Buildinl! 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. 50 ;)- Z 7
By