HomeMy WebLinkAboutBuilding 05-0978
THIS FILE HAS BEEN
CITY OF PRIOR L, CLOSED DUE TO
HEATING/AIR CONDITIONINGIF INACTIVITY 4/16/2008
late Rec'd
REQUEST FOR FINAL
INSPECTION SENT TO
HOMEOWNER 10-06
(j) if CAS rtlft02t1"J' jJ, W '
Pink
Green
Yellow
~:~ I PERMIT NO. 05 OQ7:~
Applicant .. .. , C,J
ZONING (office use)
I
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
, PID zG: 3 . 003 .0
OWNER R/1 17 I{' ~ n 11 S' \' " 11
_::L_:l~~fl,~ ,/ '~;i~"
APPLICANT LA'\ r,ll f)/' tv! () /1 j, (CI l/ ,C[r::-./') \) C ) ( [' /1-.
c:::S) \ \~~ tLS-. ~rl rt('l~DA tB~o:;)nivn ~ ~ 111;/ ~:;iz;
(Address) (City) /) (Zip Code)
(Contact person)R \ (;/h l/00J -k r . (Phone) tJ. 'S }. - ~ "1'0. - / (} q ),
l\PPLlCANTSIGNATlJRll /2.;r~ftJL!z= DATE L1- ;;..Cf05
APPLICANT PLEASE COMPLETE BE.LO:W
tAJ\ \ ().: ) vDNEW CONSTRUCTION 0 REPLA~EMENT AL TERA nONS " .'
,UKNALE MAKE AND MODEL .\Jc*'Cf~l-\CO DS- -l-\S FUEL ll1. t
FLUE SIZE RETURN OPENINGS INPUT OUTPUT 1.-\-0 , CJ (:) c..,
TYPE OF SYSTEM HEATING OR POWER PLANT
(Phone)
L/-C./r!-(j 3"10
PLEAst NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
OWarm Air Plants 0 Steam
o Gravity 0 Hot Water
~echanical 0 Radiation
OAir Conditioning 0 Special Devices
C-{").....'''- (~, ,... ~V ent System , ' . 0 Other Devices -
I ~)~iE AND MODEL B\-[) \ \ \ V\tA~~.\-GV V '?--J 01\j\..-\ '
+ \~\., \..v\. e,\~>... ~ \ \'v\~S A1iESCH~~~CL,,- ~
Industrial, Commercial & Mufti-Family I % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50
Residential, Heating Only (New Construction) $64.50
C 6C-tlJ
$39.50
cjfe~id;~ti~l: Additions & Alterations $39.50 >
Residenttal, A-conly _~___n ---,------'$39.50 -'
(y
Estimated Cost $ '!l j 00 -
f
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ Jfl0CJ
$ .50
$---qO ,nCJ
\Office Use Only)
Date
Paid +0. 0 cJ
Date 0 "3 0 ~
I . ' .::/.
Receipt No. SO 003
By
This Application Becomes Your Building Permit When Approved
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245