HomeMy WebLinkAboutMechanical Permit #01-0514
CITY OF PRIOR LAKE
HEATING/AIR CONDITIO~~ING/FIREPLACE PERMIT
Date Rec'd
~: ~~:w JJ~icant PERMIT NO.()/~':571/
(Please type or print and sign at bottom)
- ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT y BLOC~ ADDITION ~+ OJ j}. --~ ~ PID.25 -'" 15 7- O/r-t.?
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OWNER
(Name) JeJ.re ("Y\.\/~ ~'\(~r\..~ , (Phone) Y Yc- Oq(p ~
(Address)
APPLICA~ ,.... , .1 -- V~\-
(Name) c ~) 11\5) \A \ \ ~ ~\..JU'A..L.f\('^ ~ c..,
(Address) \ 2\.~8 \ \LnD~ \ ~ \-c~ ~;:+-J, ~ -.
(Address)
(Contact Person) ~ f 'rc1:1cll e.. /J ___
APPLICANT SIGNATURE ~~
(Phone)
(Phone)
Sa..va a (L
(City) Y
96>;2 - ~q Lf-(X:J:::>)'
S-dL(-OI
~S3(8
(Zip Code)
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION
FURNACEMAKEANDMODEL ~ f\DV
FLUE SIZE lr>' , RETURN OPENINGS
TYPE OF SYSTE' I
[XWarm Air Plants REQUEST FOR INSPECTION
CGravity SENT TO HOMEOWl~ER. NO
o Mechanical E
li:IAir Conditioning RESPONSE - CLOSE FIL
OVent. System 4/2003
jEfREPLACEMENT 0 ALTERATIONS
Cl3 ~ 'iQ 3="JS FUEL N tA.,.t: - q a S
INPUT "75, o:::x;> OUTPUT
VER PLANT
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
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$31J.:>U
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ 4'3oo.0D
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PElU'JJ J FEE
$ 3Cf..b{)
$ .50
$ ~tO.OO
(Office Use Only)
Building Official
Paid Jfl) ~ tJ ()
Data;~/ /) I
,
24 hour notice for all inspections (9152) 447-9850, fax (952) 447-4245
Date
Receipt No. / /tr?
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This Application Becomes Your Building Permit When Approved