HomeMy WebLinkAboutMechanical Permiot 14. 0634 CD J i_
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CPR/04, Date Recd
CITY OF PRIOR LAKE•
HEATIN /AIR CONDITIONING/FIREPLACE PERMIT `7, �, lCLile
� T E S......:::,..p,
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1. Pink File PERMIT NO. /V p►JL/
2. Geen City
3. Yellow Applicant
(Please j$a or .rint and si ji at bottom)
ADDRESSZONING(office use)
IL 151 R,41-ceir SY k(f icor L? pi/5B
LEGAL DESCRIPTION(office use only) J ,� /
LOT 3 BLOCK / ADDITIpN e /, J/E.. PID Ol /f0/I-dO.3"0
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OWNER710 .rt J(1 J�/C01 J (Phbrre) 240 l,' lJ'
(Name) C
(I P.11-01 J( Nf I I l C)1 6'L'�: 1..3 Z
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APPLICANT T l� 1 ' ,r--k(, ,' i I N (Phone)i/� �G L L f � �T �:
(Name) i r- C '.)3-7--,5` _
5
(Address, `_"' 2 CO t4f G./' 7�Pr,l.J . ....; M•u f o )
7
(Address) 1 (City) _ (ZipCode)
(Contact Person)(1 101 x'1 — (Phone)
J \--1,_/
APPLICANT SIGNATURE ..ifyyetIrOlikOV DATE
APPLICANT PL S COMPLETE BELOW
:NEW CONSTRUCTION [REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL I FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
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.
D Mechanical 0 Radiation Fireplaces with Box Additions or
RiAir Conditioning 0 Special Devices Cantilevers to the Outside of Buildings
['Vent. System 0 Other Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial,Commercial&Multi-Family 1%ofjob 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 $49.50
Estimated Cost$ Building Permit #
HEATING PERMIT FEE $
STATE SURCHARGE $ ��-- 5.00
TOTAL PERMIT FEE $ �.l r'Jv
(Office Use Only)
This Application Becomes Your Building Permit When Approved P lag yj3 Receipt No-7' rtc
DateBy
Building Official Date I'—1r t . � .
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 Z