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P CITY OF PR LAKE V Date Rec'd
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,, HEATING /AIR CONDITIONING /FIRE PERM k
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jA'NEsd * 2 1. Pink n City File PERMIT NO /J /� O
. Gree / D
3. Yellow Applicant `
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
5932 Hidden Oaks Circle SE
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) Bob Giles (Phone) 612 - 875 -4339
(Address) 5932 Hidden Oaks Circle SE Prior Lake 55372
APPLICANT
(Name) Rons Mechanical Inc (Phone) 952 445 - 8585
(Address) 12010 Old Brick Yard Road Shakopee MN 55379
(Address) (City) (Zip Code)
(Contact Person) Linda D_ (Phone) 952-303-3049
APPLICANT SIGNATURE Del DATE ti - 3 1 t
APPLICANT PLEASE COMPLETE BELOW
['NEW CONSTRUCTION Q REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL {C u AA 1) U, - P moat-1 a +On FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
['Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity El Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation
[V]'Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
['Vent. System El Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi- Family 1% of job cost Residential, Gas Fireplace
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations �4
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $'•
STATE SURCHARGE $ ,50
TOTAL PERMIT FEE $ 50.00
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid so co Re t No. e
Date / b i v B
Buildine Official Date CO •
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372