HomeMy WebLinkAboutMechanical Permit 14. 0273 < co
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°ov ro CITY OF PRIOR LAKE Date Rec'd
8'40nrHEATING/AIR CONDITIONING/FIREPLACE PERMIT
V s' •k:4 trt
"' I.Pink File PERMIT NO. /
AONNEsoiP 2.Green City / ���
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
1 3 M D ne 0 sbv-e s .
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
]–C20c
(Name) ��(i(,+r y- �-e-}"IG�,�/I,6, (phone)952_ U
— '' , `��'
l (�idaress)I��VC( �e-�'�' ,-cx' 1,��-• � �G� � ��,'-7'Z
APPLICANT
(Name) T eS P`oliym V, u-.✓l cl_ 0-et/4--1. 119 (Phone) USI-2.72.-q 071
(Address)95 geLvldDi fih `Ne- S. QCLV1` MC' SSID2
(Contact Person)SaA(Y1-4N\V` Las so v\ (Phone) LQSL-ZZ 8-ct(Xi f
APPLICANT SIGNATURE ) 3C'.� ( v C� 'l
/`® , DATE 41 /14
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL CO-(r i 5 BCT A C)10-0 E3 FUEL
FLUE SIZE RETURN OPENINGS INPUT 1L cco 8iV OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
❑Warne Air Plants ❑Steam Units and Fireplaces Cannot Encroach
❑Gravity DHot Water into Required Side Yard Setbacks.
❑Mechanical El Radiation Fireplaces with Box Additions or
DAir 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 I%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 $49 • d
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ {-.50
This Application Becomes Your Building Permit When Approved Paid/ S� Rece' No. 7((Q 4.____
Date¢, 2....s-, /,.// By
Building Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372