HomeMy WebLinkAboutMechanical Permit #01-0958
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
\Lnqs ~-tQ~\e__ \r ~ \
1. Pink File PERMIT NO
2. Green City e/11_ (JuS' D...
3. Yellow Applicant U,. I ()
ZONING (office use)
~/SD
LEGAL DESCRIPTION (office use only)
LOT~, BLOCK ~ ADDITION (QCULPflAtJ
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.
PID 25 /3 ~ D)b-q?
OWNER
(Name)
~y~ L\\'U&.
(Phone) 9'5~A141-~311
(Address)
APPLICANT
(Name) ~.)'(f\<;V" \\.2... ~~.rl_..h~~ +- l+\C-
(Address) \~l\<i l \L\\cAa., \~\r~~ A \. ~.
(Address)
(Contact Person)
- ....--.......
WfMl/;J
(Phone)
~59AJQ oJ; -
(City) r
~.
3~ 3J-O J
C;S;;"--5f7(j-oOO ~
5""53 f 8'
(Zip Code)
(Phone)
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION
FURNACE MAKE AND MODEL LP n f\() '")(
FLUE SIZE & (I RETURN OPEN~GS
TYPE OF SYSTEM
.-WEPLACEMENT
CJ;+-IM~1~
INPUT 7~()OO
HEATING OR POWER PLANT
o AL TERA TIONS
FUEL jJ 4.t. ~CS
OUTPUT
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
OVent. System
n Steam
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
REQUEST FOR INSPECTION
SENT TO HOMEOWNER. NO
RESPONSE - CLOSE FILE
4/2003
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
(~
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ -IJ.DCD.r;D
Building P~l1uit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PEAAlll FEE
$ ~Cf,SD
$ .50
$ ,U rLDO
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
~ Llo JOb
Date
q.. tf-tJ I
ReceirJDs 33
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24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245