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HomeMy WebLinkAboutMechanical 04-1201 CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd /2//.,,)4-- :ase type or print and sign at bottom) " ~DRESS /43L1q ~/{.J;)-M5Pd'~~. NC. REQUEST FOR FINAL INSPECTION SENT TO HOMEOWNER 11/05 ~~n ~!~, I PERMIT NO. ()4'-, IZ 0 I Yellow Applicant . /' ZONING (office use) )e/JO LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID ~ /I f 0 ') r. "G &=e~R an.z:tt0 -bt.lf!&~ (Address) LI: W t~mJd-C'~ 1R. N--~ ~~;~~AN~I ~/ ;1Yl~N#L/4 (Address) 1/~9 C:~ C/I(f Jf~ (Adi1ress) , (Contact Person) l?, (;//1 JiV~ / J-ey , (Phone) (phone) ~?-~ -~ ~/I7S1/l j iL ?67 (City) (Zip Code) APPLICANT SIGNATURE' (Phone) APPLICANT PLEASE COMPLETE BELOW DNEW CONSTRUCTION PLACEMENT D AL TERA TIONS FURNACE MAKE AND MODEL FUEL ---/J/If::t- FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM REA TING OR POWER PLANT o Steam o Hot Water o Radiation o Special Devices o Other Devices ANDMODEL ~k~_kU~~ REQUEST FOR FINAL Industrial, Commercial & Multi-Family INSPECTION SENT TO SI ential, e' & NC (New Construction: OMEOWNER 10-06 Residentf,a!...JI\at1 g Only (New Construction) H - ~,{~." R l- j-\ <-t ~ c,., , Estimated Cost $ Building Permit # 0 '" JZ (I / (Zl((, f) $ "'? a, .5--71 HEATING PERMIT FEE ~ v STATE SURCHARGE $ .50 TOTAL PERMIT FEE $ 4D .00 OWarm Air Plants o Gravity o Mechanical OAir Conditioning OVent. System PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks :place $39,50 IS & Alterations $39.50 $39.50 I (Office Use Only) ~his Application Becomes Your Building Permit When Approved Building Official Date Paid 40. d7J Dat,)- ./. 11 +- Receipt NO'4I"J 7 S- By 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue, Prior Lake, MN 55372 ".~~-..._,..."._..".~..,_.__._..~-,._----~-_.._~_.,-.,.~~'.~.,--"-~..,--;-"..._._....~"._,.,"~,,,~~^,,,,