HomeMy WebLinkAboutHeating 06-0298
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
Date Rec'd
4. 2/. () ~
]
ZONING (office use)
OWNE~ (L
(Name) -.D SLt)O()S~ l--VI'b-r.
PIDZ5.lIfR. 003.0
(Address)
(Phone) _____________________
APPL CANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
APPLIC~
(Name) \ fll/}al;(~
(Address) jblJl ( .fty-rd<<n S-rtJ6
(Address)
ftt9(nW
(Contact Person)
TYPE OF SYSTEM
(Phone) '11{l~ - L/3Lf - 7 74-1
((n !; s..W
(City) (Zip Code)
DATE
HEATING OR POWER PLANT
OWarm Air Plants
I OGravity
o Mechanical
nAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
I,'
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential. Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
#30~
Building Permit #
"'e Use Only)
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
.s Application Becomes Your Building Permit When Approved
Building Official
Date
$39.50
$39.50
$39.50
$
$
$
3Q.{;O
dJO
'-10
Paid 40. 0 0
Dat~. 21, 0&
Receipt NO'512.-5.3
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245