HomeMy WebLinkAboutMechanical 05-0943
t'1RY-17-2005 12: 26 CITY OF PRIOR LRf<E 9524474245
;.:"~ CITY OF PRIOR LAKE
(€(ffi<~ HEATING/AIR CONDlTIONINGIFIREPLACE PERMIT
\ 050 l' :J / 1-- THIS FILE HAS BEEN
.I"'~UO~" 1/ Lf D <'l; CLOSED DUE TO
I ,'- INACTIVITY 4/16/2008
P.0V01
Date Rec'd
() ('-
7 Z&OJ
'. \ PERMIT NO. OS 014- 2 I
hcant ......:J
at bottom)
ZONiNG (Qmc~ u,,:)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITlON
PID Z~). 2. rYJ-. () 73. ()
.
(Phone)
APPLICArx \ \ L:~.tv
(Name) r \ (MI t j10(A('\J n 1 (/
(Address) ~ 1/01; ~'~ \tI,A~;V\/ .h; e. N !
\ (Address)
(Contact Person) \
(Phone) 10'7" >I1J - / { b b
G D l~ \/wLf-?tJ /V1 rJ~5l( ~ =r
r (City) T I . (Zip Code)
(Phone) ~ '1 S'tr; 1 \ \v ~
DATE 0
ONEW CONSTRUCTION FSA REPLACEMENT 0 AL TERA TIONS,
FURNACE MAKE AND MODEL C(AjI('n QN / 09) ~ ~ loG ' \ ' \ " FlJEL'/\\M\I'1{ ~ ~ ~ i,(
FLUE SIZE a" (Jv c RETURN OPENINGS INPUThtth -6oouu OUTPUTk '" . .~ Do D
I HEATINGORP6~R~t~~ (ow - 5--t,ootJ
TYPE OF SYSTEM
~a~ Air Plants o Stearn PLEASE NOTE:
, ,[ ravlty o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
DVent. System o Other Devices Setbacks
fIREPLACE MAKE AND MODEL
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Mlllti-Fa.mily I % of job cost Residential, GllS Fireplace
$39.50 minimum
Residential, Heating & NC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
Estimated Cost $ cl r;) b, ~ Building Pennit #
I
$]9.50
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 7q.~
$
$ lIfO ~
.50
-= -~
\ uffitt: tJ ~t Ollly)
This ^pplitation Becomes Your :Building Permit When Appn~ved
Dill'
Paid Lj () __
Dateq Z U~{/ j-
eceipt NO'9 tj'9 g 3
By-
BuildIng OffiCil11
TOTRL P.Ol
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