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HomeMy WebLinkAboutMech Permit 05-0393 CITY OF PRIOR LAKE HEA TING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd (Please type or print and sign at bottom) ADDRESS ~. ~e:n ~!~y PERMIT NO. /) c:. _ ':xl~ 3, Yellow Applicant if'.J 0 'f' /67'...;<S- wJA.)DSof.? LA-/V~ S~ ZONING (office use) LEGAL DESCRIPTION (office use only) LOT tXLOCK 3 ADDITION I ! ,e;/~~ hnvlX ~-j-:-'ff- 0 "31-cJ .co.- . ..,_ - OWNER (Name) 3'// 6/rn. b/hl-')L~' (Phone) r9sQl} <=-/ ~ 0-"3 ~ 4 9' (Phone) 196~) <./Cw/O- o(P..;2~ ;j?,iOY L~~t:.. 5:?3+~ (City) (Zip Code) (Address) /,,::;J~ ~DS{)I L.A-IUL SE. APPLICANT (Name) O.I"Lr e-clc ~ 'N.. ~ \.a..c.E... . ~,\~ (Address) /(o/S"I mh-x..~ A-vL (Address) (Contact Person) fT~ v~ ~ 1/ 4- LLA (Phone) APPLICANTSIGNATIJRE C;;-~ /L DATE APPLICANT PLEASE COMPLETE BELOW '="'>\' 1VI'IQEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS 'F-.:reL..... I" r c: ~ . FURN:.CE MAKE AND MODEL 3(d1. rn~ L~-\-~c.... ~W,- FUEL -.A,J.I\-r FLUE SIZE \..\)( =1 RETURN OPENINGS INPUT I g _ (XX) ~MJTPUT 9.5~ 4'YO !;;~O ~.s- /OS- /2. Oos- TYPE OF SYSTEM , ..-::z. · ~-rn:10RPOWE~ r I ~Q, &11:r tv I C;; 'I Ot.flRad~' 'n~ 7 ':rSpeci e.v' ~Oth I s DWarm Air Plants OGravity o Mechanical DAir Conditioning OVent. System 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 & A/C (New Construction) Residential. Heating Only (New Construction) Estimated Cost $ Jf \ ~ J Building Pennit # HEA TING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ 39.sC> $ .50 $ t/i" ~O' OQ 'lffice Use Only) fhis Application Becomes Your Building Permit When Approved :~q~ 'i ' C; ... 04' Building Official Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue, Prior Lake, MN 55372 GAs PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks $39.50 $39.50 $39.50 Rti~/~~ By Q 0-