HomeMy WebLinkAboutMechanical 05-0096
TH ~~""''''T ~V DDIOR LAKE Date Rec'd
IS FILE HAS BEEN NGIFIREPLACE PERMIT z. .3 05
CL?SED DUE TO Clo>e \U+k~-#- 4": J/12-
INAC fIVITY 4/16/2008
~. ~n ~:~. I PERMIT NO. ~,- 0 oClt"
3. Yellow Apphcant . v~ . Lit'
ZONING (office use)
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Please
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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(Address)
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(Phone)
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OWNER
(Name)
(Contact Person)
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(Address)
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DATE
APPLICANT
(Name)
(Address)
(Phone)
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT L TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM REA TING OR POWER PLANT
OWann Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
:11, f7)
$
$
$
.50
4'010/
Office llse Only)
Date
Paid LhJ . u)
Date J 0--
z.. . . J
Receipt No~ 1
By
This Application Becomes Your Building Permit When Approved
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372