HomeMy WebLinkAboutMech Permit 02-0348
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
(Please type or print and sign at bottom)
ADDRESS
M/ f [-D.S p~- t'V/ L(
/505/
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK I ADDITION #tV I L- ().5
'/ /v!.O
L--
OWNER
(Name)
(Address)
APPLICANT..-:::;; \'l
(Name) -LJlJ..i?_~~iO $dP '+ t-~ fU>~to.(.J"
. -
(Address) /17 ~ c2D 8-1. '"" 1. /).j
(Address)
(Contact Pe"on) A!o flJAAa ;(j:f::;::::!':!_ '.
APPLICANT SIGNATURE . _ _ ~_b:f1j~
Date Rec'd
I. Pink
2. Green
3. Yellow
/f-/I-aL.
02.- 0311
PERMIT NO.('~ -.P~
~ .
File
City
Applicant
ZONING (office use)
PUD
pm 2_5"- J 2.3 - tJO"$- ()
(Phone)
(Phone) q ~.2 ' 1?8.2 - II 74
(City)
(Zip Code)
(Phone)
DATE
~/-{/-t12
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Building Permit # 02 -6,74-6
FLUE SIZE
RETUl REQUEST FOR INSPECTION
TYPE OF SYSTa SENT TO CONTRACTOR. NO
RESPONSE - CLOSE FILE
OWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
OVent. System
(~PL~KE AND MODEL
o Radiation
o Special Devices
o Other Devices
~p)(
3~ f~II'~
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
comes Your Building Permit When Approved
if'II.-o1-
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
OUTPUT
ER PLANT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
~\R.. \4.V i ~
$39.50
$39.50
$39.50
$
$
$
.3 '1. ,IT:>
.50
4-0..tIV
Paid I-P. V?J
Date 4- ,.( (..-() v
Receip)/l5fo
By ff I
?--
----