HomeMy WebLinkAboutMechanical Permit 14. 0698 0
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of I'R o4, CITY OF PRIOR LAKE Date Reed
ti HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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1.Pink File PERMIT NO.
41INNEsol. 2.Green City ` " &.$W
3.Yellow Applicant / �L/
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
15575 (YS1I rirt kt0Id Prior (9 K, s 6
LEGAL DESCRIPTION offir useonly)
LOT BLO DI5ITI0if .� PID
67--D4DR6
OW N)EI ho5575 ffsPhone Let67 LtObild
IT-„7-12
(Address) t ---705 P514 fI"." 0 rt
APPLICANT L� ��
(Name) r!S (icriia1 (Phone) l'E
(Address)1(11. . 14 pr 5 f ' �� �j
(Contact Person) - q I (Phone)CI✓� (-(1-(5 v 5e 9
APPLICANT SIGNATURE gA1W &9" '
DATE
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION [Q'T(EPLACEMENT 0 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 0 Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water into Required Side Yard Setbacks.
❑ echanical 0 Radiation Fireplaces with Box Additions or
MAir Conditioning 0 Special Devices Cantilevers to the Outside of Buildings
0 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 $ CI) .
STATE SURCHARGE $ 5.00 '
TOTAL PERMIT FEE $ FA. )
This Application Becomes Your Building Permit When Approved '1 5 4. 0 Receipt Not I r
Date . J By
Building Official Date 4
24 hour notice for all inspections(952)447-9850 /
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372