HomeMy WebLinkAboutMechanical 05-0708
"I~~S "F~LE "RA.Q;. nRRN
I CLOSED DUE TO
INACTIVITY 4/16/2008
II LAKE
'G/FIREPLACE PERMIT
Date Rec'd
I. Pink
2. Green
3. Yellow
~!~. I PERMIT NOoO t:._ 70~
Apphcant ..J
I ~;;S~~q5;_m~~ fey
ZONING (office use)
KI.5 D
~
SlAJ
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID /33-
-oL..
OWNER I
(Name) l M
ML- ~ ~ ~
(Phone) CJj- -
(Address)
APPLICANT. ~] A . 1 ~ ~/) Q'3' ~
(Name)=nt1t t>f f) '. f(,lCt\r t1.J{JIt{Phone) T.Jd--- )3. /g&
(Address)~3<1?-16 ~,tU ~1h,J,VLt1 553<1::-
(Addr 55) (City) (Zip Code)
b
"PPLICANT SIGNATURE
(Phone)
DATE 1"'1~ ~
(Contact Person)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
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
OUTPUT
OWarm Air Plants
o Gravity
o Mechanical
~ir Conditioning
OVent. System
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
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 & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3 c/_ Su
.50
(10'-
:ice Use Only)
Building Official
Date
Receipt No'qtl; g
B~?
.~ Application Becomes Your Building Permit When Approved
Paid
L-/O.-
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372