HomeMy WebLinkAboutMechanical Permit 01-0336
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/~IKEPLACE PERMIT
Date Rec'd
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L Pink File
2, Green City
3, Yellow Applicant
PERMI}~.O(~ 1133'
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tlr' ZONING (office use)
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(Please type or print and si~ at bottom)
ADDRESS
c;l, lD 1 L\ Sp(\ (\~ LaJUL \Ld...
LEGAL DESCRIPTION (office use only) r.J \ ~ ^\
~ e. p \-Ci\..L.e... II C_ 13
LOT 33 BLOCK ADDITION f3 !de e..rJ\.Ju+ ~ ~
PID Z5-131- OIa:B
OWNER
(N ame)
St-Clr\ S~hwosz-
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(Phone) q sa -4 L-\ 0 -'5 4. a.~
I (Address)
APPLICANT ~ . \ \ \ <. .....\ H- () q oq'
(Name) 'D \)f (\~ V\ \ lQ. H ~-t-lIY'- '+' '--. (PhOne). 'D ~- ^ Lf,- Ocx.."h
(Address) \aLtC(t ~lsL 'llilliM 'A-\J~ _ S. 3(),X1J\~ 5531$7
(Address) (City) <1 (Zip Code)
(Contact Person) \.--A, \ l.--Yltl~ 1 /J1 '. _ \ (Phone)
APPLICANT SIGNATURE ~y( f ~ DATE .L/17-0 I
APPLICANT PLEAS~__COMPLETE BELOW
A C DNEW CONSTRUCTIONc:rro~PLACEMENT 0 AL TERA TIONS
FlmJACEMAKEANDMODEL t.e.___Yln{'\x (OAc.-~,g.,Y J\O~ FUEL f\J..o+'(1ClS
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
,
,
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
o ~echanical ,
~ir Conditioning
DVent. System
'LANT
10/03/2001
CLOSED DU-E TO
INACTIVITY
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $ (oSD 0 .00 Building Permit #
HEATTNG PERMIT FEE
STATE SURCHARGE
TOTAL PERl\tlll FEE
$ 3'7.'00
$ .50
$ LID .00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid 40 ~O
Date l/-J/J/O./
~~tNo. .,
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BY~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245