HomeMy WebLinkAboutMech Permit 05-1025
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
(]/t;sed tul-tlt- L 1- 05- 1103
Date Rec'd
10. /3. oS-
2q/8
1f(/~&I1r ~/L-
~. ~:~n ~:~. I PERMIT NO.As: IOZ.~
3. Yellow Applicant V . V
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
ADDITION
(Phone) ft;(;; 1do CJ,9t){)
BLOCK
OWNER
(Name)
J7Jb f U)K/f K;;e,Uo/
(Address)
PID~.3'8z.. O/~. 0
(Address)
(Contact Person) rV\
APPLICANT SIGNATURE
(Phone) -39 .-lf~1 (". 3iCo ~
(City)
(Zip Code)
(Phone)
DATE
~o)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM REA TING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
OAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
$39.50
Estimated Cost $
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
lice Use Only)
This Application Becomes Your Building Permit When Approved
Date
Building Official
$
$
$
:Jt:f.5V
.50
40. rU
paid~O.OO
Date
/tJ. 13j 05
Receipt No. 50/3/(,
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372