HomeMy WebLinkAboutMechanical Permit #01-1144
CITY OF PRIOR LAKE
hEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~: ~::n ~!~ PERMIT NOO J - 'J I. '1./
3. Yellow Applicant 'I
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(Address) 14-0-.~ ~'f t3~" I /'..JL
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(Address)l~lf-~r \~~~ .\ -\Sl~ Av-e-. SO.. ~f\\)~ 55318'
.. (Address) (City) (Zip Code)
(Contact Person)
APPLICANT SIGNATURE ~ ~ ~
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APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION ~REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL L~ hD \.X' FUEL I\.J Ov'\
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(Please type or print and sign at bottom)
ADDlf~'+~ ~ 5~ \ V-Z
LEGAL DESCRIPTION (office use only)
LOT ( BLOCK
I ADDITION
(Phone)
Pr \'\ c.>./
(Phone)
DATE
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
--- . .....Tru~ n"Q POWER PLANT
REQUEST FOR INSPECTION
SENT TO HOMEOWNER 2/03
NO RESPONSE. CLOSE FILE'
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
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ ~ - CO Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERlVlll FEE
3 <1..50
LL .50
,0- ex:>
Paid #'I{) / a:)
D/~-II-t11
$
$
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
ZONING (office use)
R\
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to-~~Ol
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Rel?DN~ q 3
_BY~
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