HomeMy WebLinkAboutMechanical 04-1222
CITY OF PRIOR LAKE
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THIS FILE HAS BEEN
CLOSED DUE TO
INACTIVITY 4/16/2008
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I ~ ~DDRESS .
IS) Cj()
REQUEST FOR FINAL
INSPECTION SENT TO
.. HOMEOWNER 10-06 ~icant I PERMITNOlJtl/lo-d-~
,ase type or pnnt and Sign at bottom)
witch". (1tJ"" fltJJ~Rdct.Q I
ZONING (office use)
/'
LEGAL DESCIfPTION (office use only)
LOT.:21BLO~K ~ ADDITION
f
PID 5-37/p-- /03 ()
OWNE~
(Name) . 0 US
(Address) '5
(j/J. - 581 -' ~Of22~
APPLICANT
(Name)
(Address)
UJ, E{luy ):3
(Address) .
(Contact Person)
(Phone)
APPLICANT SIGNATURE
~-
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
....URNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
FIREPLACE MAKE AND MODEL
INPUT
REA TING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OUTPUT
OWarm Air Plants
o Gravity
o Mechanical
OAir Conditioning
OVent. System
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(Office Use Only)
~his Application Becomes Your Building Permit When Approved
Building Official
Date
Paid !It) ,----
Date
/d -/0-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372