HomeMy WebLinkAboutMechanical Permit 14. 0788 J c O n 00c000 'a o »01 g Do E
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CITY OF PRIOR LAKE (i Date Ree'd
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HEATING/AIR CONDITIONING/FIREPLACE PERMITq't T
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. , 1. k ( PERMIT NO. /4 � 1
-711f 1
AJ�fiNESOK* 2.PinGreen Fate Cit)•
3.Yellow Applicant
(Please type or print and sign at bottom) ZONING(office use)
ADDRESS
j�11-1 cj\n� X1Ror c I S(.(
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER (Phone) Ci 5•(1 .__ 1:12M_
Name l __
Phone J 1,
(Address) `J 11 .'�' �D �C1�' -v )'1 l_v- cv(� JCC
(Name)
_
APPLICANT ..
( ) lis. _ i• c _ _(Phone) (1119)_i— l i_, ' -2
(Address) 7 cC'(–) v t \_i_ t 1 v \ Yl7(Contact Person)_. ( n.t'\,
-/� (Phone)
APPLICANT SIGNATURE C_____ '' DATE 1 i __t
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 1..REPLACEMENT 0 ALTERATIONS ,
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT — OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
DWarm Air Plants DSteam Units and Fireplaces Cannot Encroach
0 Gravity DHot Water into Required Side Yard Setbacks.
D► echanical ❑Radiation Fireplaces with Box Additions or
M'Air Conditioning 0 Special Devices Cantilevers to the Outside of Buildings
0 Vent. System 0 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 Permitil
HEATING PERMIT FEE $ —
STATE SURCHARGES
_SST,
TOTAL PERMIT FEE $ ...._
This Application Becomes Your Building Permit When Approved 1 Paid S- i U Re . t No.-'J(C�/Z
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Date B //
Building Official Date )-` f`�
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372