HomeMy WebLinkAboutMech Permit 02-1216
CITY OF PRIOR LAKE
ltEA TINGI AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
9. 25" () 2--
~. E:w ~l~icanl I PERMIT NO. t/d-.-/d-/b I
#I/L ,d~ dJ ~
ZONING (office use)
RJS'D
LEGAL DESCRIPTION (office use only) /)
LOT ~ BLOCK I ADDITION c1~ Ui~{~-f-
PID..;2S- /l./3-tJOf'-P
&':~R {J ~ ~dl ~t7 ~
(Address) Isb'73- .tJj'~ ~J rAI/C_;U ~
APPLICANT IJ /'. j~. 1./ ?1.
(Name) L-~"'L~ ILJ::::::f I:t:.. ~
(Address) _ 7 if 0;) ~ <? )!}~ St). E Jl.-AJ hn-/;" ;,; AI SS3 ~ '/
, - (Address) (City) (Zip Code)
(Contact Person) ~ ~~" ;A-........_J-- ../ (Phone) 9S)'-'7yl-/dJ J!~
APPLICANT SIGNATURE -1.)/~ ~" DATE 9 .tL/O;::L
/ APP~IC~NT PLli(A~ COMPLETE BELOW
DNEW CONSTRUCTION riREPLACEMENT 0 AL TERA TIONS _1
FURNACE MAKE AND MODEL ~.J.#-~?S-~ FUEL AJ,.,I-~
, ,
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
~Warm Air Plants 0 Steam
OGravity
o Mechanical . SPECTION
OAir Conditionin' REQUEST FOR IN
OVent. System I SENT TO HOMEOWNER. NO
RESPONSE - CLOSE FILE
FIREPLACE MAKE AND MODEL 4/2003
(Pjo:e) qS)-i/Y)- SJ /~.
("'/UY tcvk< H1NSSJl)~
(phone)
q <5.)- '7 C/I-/ dY V
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1 % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 bill. Residential, AC Only
Estimated Cost $ ti/)t/ Building Pennit #
$39.50
$39.50
$39.50
BUilding Offidal
Date
$ .~ 9"S1.} .
$. _ .50
$~
Paid~ J ____
-I().
Dateq_ dkr ~
Recefl~~o
BY~
U
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4145