HomeMy WebLinkAboutMechanical Permit #01-0523
CITY OF PRIlOR LAKE
HEA TING/ AIR CONDITION][NGIFIREPLACE PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS ~
s1ot./1 ~~ooJ I ~J
I. Pink File PERMIT NO
2. Green City · tJ - L' ., 3
3. Yellow Applicant _ J c7-
ZONING (office use)
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LEGAL DESCRIPTION (office use only) .' _ _ /) .
LOT I BLOCK J-f ADDITION S~ I- f?,~ .8 td
PlndS/;:lI'/- 0 3S-D
&=e~~J'\aJ ct- .~ d-~YL-/ (Phone)gS-~ 'd.33SV/1
(Address) ~t.{ I ~ ~d J:Jt..~
APPLICX1~.it-> ,., _ . _ 'I f J I n C' 11 / CI CA
(Name) ~~~l ~ ~CL~L~ ct:- 1t-,1c;,(PhOne) _~SJ---ot'i- Q?O~
(Address) l ;}-\{ft ~<k ~ ~~ It r G.~...v a-S"'37cf
(Address) (City) (:) (Zip Code)
(Contact Person) ~ r-; (Phon~ ~ l/ -000 r
APPLICANTSIGNATURE _ ~.5._ ~) DATE ~d--ri{Jl
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APPLICANT PLE~S.J: COMPLETE BELOW
DNEW CONSTRUCTION ~PLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
DWann Air Plants
o Gravity
~echanical
. Conditioning
Vent. System
INPUT
HEATING OR POWER PLANT
OUTPUT
10/03/2001
CLOSED DUE TO
INACTIVITY
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
$39.50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERl\'lll FEE
$ 3.C}, ~()
$ .50
$ ,-!(JL&:)
(Office Use Only)
This Application Becomes Your Building Permit When Approl'ed
Building Official
Date
paidl/tJ / tJ ()
Date
.. ~- ~~I?-O!
ReCe~~Nqt,S\3
BOG
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245