HomeMy WebLinkAboutMech Permit 02-0427
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
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3. Yellow Applicant U
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(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT 5 BLOCK I ADDITION
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OWNER
(Name)
(Address)
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(Address) Q ?;:;O (JjJa ~/Ol ~ vf ~.
(Address) I
(Contact Person) Qr! 11 n ;~. () t:r J~ ~
APPLICANT SIGNATURE fJ.r/h.~,. O,~1'.//L...
(Phone)
(Phone) C) 5~ '"' Rq 0 - ~I It
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'J(City) Ct)! If (Zip Code)
(Phone) 0};;2. -t) /0 - J ~rJ 7
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DATE
APPLICANT PLE.AS): COMPLETE BELOW
____ ~TRUCTION
< f.URNACE MAKE AND MODEL ;J G {;(Jd fYJ~ I\.
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FLUE SIZE i.f RETURN OPENINGS
MREPLACEMENT D AL TERA TIONS
/""J G'/l] N J ,1;1 FUEL
I~PUT Jd4t2tJc2 OUTPUT
REA TING OR POWER PLANT
REQUEST FOR INSPECTION
SENT TO HOMEOWNER. NO
RESPONSE - CLOSE FILE
4/2003
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Building Permit # 0 Z- -0 4z. 7
$ 39.50
~. 4'fl QP.50
TYPE OF SYSTEM
OWarm Air Plants
o Gravity
o Mechanical
OAir Conditioning
OVent. System
n Steam
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
Th;, Applka,.,,,,,,',, Your Buildiug Pennit Wheu Approved
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Building Official Date
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PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
Paid 4- -
70.(/V
Date~_ '?'i, d'1.--
Receipt N~ /'14&
BY~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245