HomeMy WebLinkAboutMechanical Permit 14. 0284 p ppp 1O 1 $ TI O
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o* "I CITY OF PRIOR LAKE Date Rec'd
HEATING /AIR CONDITIONING/FIREPLACE PERMIT
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tiro 1. Pink File PERMIT NO. , `
NxES o 2. Green City /�z&
3. Yellow Applicant /
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
i� r1 1 V—. p cS
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) 3 \ I , (Phone) Ct5,2, " Cic--10'-. 50/ 4--
(Address)31f ed Pa s 1 Prior r (za bL i r ,f .5
APPLICANT
(Name) I . ' / t _ 1 1 iii_ . I (Phone) q 5'a _ L 4 - 9�
(Address) rf �r J_ _ e >• _ i 1�
(Contact Person) , „., �` (Phone) 2-^-T[ -0-7 c
APPLICANT SIGNATURE Il' - DATE d i
/
APPLIC • T PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑REPLACEMENT ALTERATIONS
FURNACE MAKE AND MODEL 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 ❑ 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 1• ,: _ _, _ r 1 1 — _ _ I Q 1
FE SCHEDULE
Industrial, Commercial & Multi Family 1% of job cost Residentia as 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 $ 9 fs
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ 5 C _ 0
This Application Becomes Your Building Permit When Approved Paid L37J Receipt No. 7//74
Building Official Date L/49/19_ By
fficial Date
24 hour notice for all inspections (952) 447 - 9850
4646 Dakota Street S.E., Prior Lake, Minnesota 55372