HomeMy WebLinkAboutMechanical Permit 14. 0738 J
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"194) CITY OF PRIOR LAKE , Date Rec'd
�� HEATING/AIR CONDITIONING/FIREPLACE PERMIT / t/-
u 7` r
r � 1.rink File PERMIT NO.
NNEso 2.Green City
3.Yellow Applicant ��c /��
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
(62q2 LakeSide P(for Ore /
LEGAL DESCRIPTION (office u e only)
LOT BLOCI I_ ► Se..., PIDO�j����. _`r
OWNER Ka f Le(")rerPhone2 20(( 7� OL
37
(Address) UQ 2 1 .2 Ore5late Gt Frbr (C/1 MO 9372
APPLeI)C• 405 Mecham
(Phone) L5 F335
(Address) 0 2 CCAUM or SV till 55-37Q
(Contact Personci.)L I (Phone) Ia �
APPLICANT SIGNATURE CVQL4 .L' " DATE
l
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTIONPLACEMENT ❑ALTERATIONS
F MAKE AND MODEL LVOW)6 I 4 ACX 030 3-l0✓) 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
0 Gravity ❑Hot Water into Required Side Yard Setbacks.
WA❑ echanical 0 Radiation Fireplaces with Box Additions or
Air 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%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��ld�jPermit#
HEATING PERMIT FEE $ ''1"l
STATE SURCHARGE $____404 _
TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When ApprovedA. f Receipt No.et] (;)Ji . 11 e7Building Official Date D to 1 25. ( L,� By ;
1
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372