HomeMy WebLinkAboutMechanical Permit 14. 0050 I- Ilk
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PRI CITY OF PRIOR LAKE" Date Rec'd
04 �4' HEATING/AIR CONDITIONING/FIREPLACE PERMIT
1.Pins{ File PERMIT NO.) ` thsz9/
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
( 361 Z71e/k7' ‘--/./e. 4P-
LEGAL
-LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 075-go...0 ex-C
OWNER
(Name) (Phone)
(Address)
APPLICAN
(Name) /� " r V eco- r (Phone) 76 5 2 t 15-1
(Address) /?s7 'rid i i'"t / �5 �- -..4 E(2 `LQV
(Contact Person) /714,7/(--- //s ar, (Phone) 74? 2242 5—/57
APPLICANT SIGNATURE c-J71 U5---- DATE /-2- (V
APPLICANT PLEASE COMPLETE BELOW
:NEW CONSTRUCTIONgREPLACEMENT ❑ALTERATIONS •
FURNACE MAKE AND MODEL CONSTRUCTION," /
FUEL,IgJ4c✓.-I 64-S
FLUE SIZE Zn (�V C RETURN OPENINGS INPUT OroQ OUTPUT b017
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water into Required Side Yard Setbacks.
0 Mechanical ❑Radiation Fireplaces with Box Additions or
❑Air Conditioning 0 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 $ 46/,5D
STATE SURCHARGE $ 5 00
TOTAL PERMIT FEE $ 1.
This Application Becomes Your Building Permit When Approved Paid 5q,so Receipt No.ek 7/?...
Date /. (4, ' By ,
Building Official Date
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372