HomeMy WebLinkAboutMech Permit 02-1351
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or orint and sign at bottom)
ADDRESS
IS-JS 0 6f1~~tl)b~ C f?-
~. ~~n ~!~ PERMIT NO. /) , _ /25/
3. Yellow Applicant UrI- ~}
. ZONING (office use) I
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LEGAL DESCRIPTION (office use only) )"
LOT fl(BLOCK I ADDITION ((oiL tR'~e, (lj- /:if
OWNER > to .
(Name) LLJ~ ~~ R1Jt> 1'-1
(Address) t ~-I ",~b () fJ /f:...;~1 t1~ ~ ~ f2-
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APPUCANT,/ .
(Name) V/Gf>-L~ 11 ~J}LA~
(Address) t~/SI /JJJ9) '" /lln-- <?~~ <J
(Address)
(Contact Person)
(Phone) '2Sl.--lf'/o oJ srdJ.-O
1R.wp- L~~ ~5S3:7"2-
(City) (Zip Code)
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APPUCANT SIGNATURE
(Phone)
DATE --L4/L~/tJ"L-
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AP LICANT PLEASE COMPLETE B~OW
A4Pu4 DNEW CONS~UCTION D REPLACEMENT 'lS\.AL TERA TIONS
P.fi"~ ~KE ANSXDEL ~iSt...tG'( - · FUEL /Vt1-;;""/
~ / JIM VIERE -
FLUE SIZE 7..6 / RETURN OPENINGS _ HOMEOW-:;J- NOTIFIED mTPUT
TYPE OF SYSTEM C~OSEFILE ~2~g RESPONSE
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
FIREPLACE MAKE AND MODEL
, 'U .~.- ,
o Radiation
o Special Devices
o Other Devices
~ P-J':t 7
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % 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 PERMIT FEE
$ :39,.50
$ .50
$ qt), --
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paid.?/o._____
Date It> -; t -- Ol
,
ReC~c,ogq 4
BY~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245