HomeMy WebLinkAboutMechanical 04-0680
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CITY OF PRIOR LAKE ~
THIS FILE H -_T-"'IT'~O"TING/FIREP~~\n~E IT
AS BEEN ~~~~
CLOSED DUE / o~ :f"-r
INAC TO \ 0'-"1 ~o r//,-6 "J :#04-_ 0341
TIVITY 4/16/2008 C" ,~. "', I PERMIT NO I
2 Green CIty . , 0+ 0 b ~()
3 Yellow Applicant _ -
lease e or rint and si at bottom
ADDRESS
Date Rec'd
1. t. 04-
ZONING (office use)
v-L
Ie I $"()
LEGAL DESCRIPTION (office use only)
LOT I ~ BLOCK ( ADDITION Is (... VIGIV /C7
OWNER
(Name)
(Address)
(Phone)
APPLICANT ffi 1\ ~ ~ \
(Name)~i:J..j y ~ f\ (
(AddreSS)~0eic(XY\o f-h)-Q
(AddresS)
(Contact Person) n Q
(Phone) ~Ul- 8\~4
\)YlGY tCA tQ ~C;~ld
(City) (Zip Co )
\.. -\ "--llKJ d \..\
(Phone)
APPLICANT SIGNATURE
"~
\
..
,.
DATE
APPLIC T PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 0 REPLACEMENT . ""gAL TERA TIONS
FURNACE MAKE AND MODEL M (. /\ \...} 0 '" \ ~ (ill It ( / FUEL Nu -hl'''- (,,, j
FLUE SIZE ~I' PVC RETURN OPENINGS ~ INPUT '-40.000 OUTPUT 3<,0:x....)
J
HEATING OR POWER PLANT
TYPE OF SYSTEM
~arm Air Plants
DGravity
D Mechanical
~ir Conditioning
~ent. System
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & AlC (N~:w Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Residential, Additions & Alterations
Residential, AC Only
Hr(i. ;'\ A.. a
2liilaiftg Permit # U 'T, d(' (/0
$39.50
$39.50
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$)~-S\J
$ t .50
$ \0 ~/
. "flice Use Only)
A'ls:Application Becomes Your Building Permit When Approved
Building Official
Date
Paid ftJ , 0 (;
Date A-- -
7,7,0 T
Receipt N..'f7 1-- 5' 4-
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372