HomeMy WebLinkAboutMechanical Permit 13. 1020 J
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o � ? R ro� CITY OF PRIOR LAKE Date Rec'd
r t" HEATING /AIR CONDITIONING/FIREPLACE PERMIT
U
t o�P 1. Pink File PERMIT NO.
LANES 2. Green City
3. Yellow Applicant / �G
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
422— 64 ea I I,Q.. ® r .. k A L
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER Q ,,..... ,...,
k (Name) / ` t e) -.5� (Phone)
(Address) /CeZ 4 6/- C C.t -eL ,4(/
APPLICANT f
(Name) k Q tit'? Itettil fi . ` ° i.
(Phone) 0 3 � "-
(Address) 3e6-2- 4 b4 54 i d? q � k-' / 7» ,4 EZs /hi
(Contact Person) /3 j�^�► . e J (Phone) 6 %) —3 &" ,'" 4
to
APPLICANT SIGNATURE i� A , DATE V77//0
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ,REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL 1 o r e ., Fur Accac Q iL /4' e._ FUEL
FLUE SIZE RETURNINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner
El Warm Air Plants El Steam Units and Fireplaces Cannot Encroach
El Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation Fireplaces with Box Additions or
❑ Air Conditioning ❑ Special Devices Cantilevers to the Outside of Buildings
❑ Vent. System ❑ Other Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only • $49.50
Cost $ Building Permit#
HEATING PERMIT FEE $ 47 . 50
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ cTf— -..-'
This App! j 1 i 1 n Becomes Four Building Pe Whe (3 / Approved Paid _ � Receipt No. 7 � 7 L/A0 P (7 Date "" By
I ding Officia D /a(e
24 hour notice for all inspections (952) 447 -9850
4646 Dakota Street S.E., Prior Lake, Minnesota 55372