HomeMy WebLinkAboutMechanical Permit 14. 1071 J
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01 PR/424 CITY OF PRIOR LAKE Date Rec'd i
A HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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4INNEsolP 1.rink File PERMIT NO.
2.Green City I /44 -//02
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(Please type or print and sign at bottom) 3.Yellow Applicant i/(�i
ADDRESS
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p/ ZONING (office use)
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LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER r0 �� /
(Name) I v- // 2e.,✓ (Phone) ,
(Address) ?1 IckAi 't-c... S
APPLICANX
(Name) - a r- L,, c /( LL
(Phone) ����7 gll��
(Address)`(a -/ 7 J k gra.K Q..l.'• 12,4v,-4.4 J7l4-....
(Contact Person) c Pc.-e•ctX (Phone) 921'j1t12 JRj
APPLICANT SIGNATURE DATE 9--A20 —‘9.0/9
APPLICANT PLEASE COMPLETE BELOW
El NEW CONSTRUCTION ,[4EPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
,Warm Air PlantsPLEASE NOTE:Air Conditioner,
0 Steam Units and Fireplaces Cannot Encroach
El Gravity El Hot Water
❑Mechanical into Required Side Yard Setbacks„
❑Radiation Fireplaces with Box Additions or
fir Conditioning 0 Special Devices
Cantilevers to the Outside of Buildings
❑Vent. System ❑Other Devices
FIREPLACE MAKE AND MODEL Require a Building Permit.
FEE SCHEDULE
Industrial, Commercial&Multi Family 1%of job cost Residential, Gas Fireplace $49.50
Residential,Heating&A/C $49.50 minimum
(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 $
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ 59-co
This A licatioan B omen Your Building Permit When Approved Paid a
(Or ,� S� grirtNa.� 3
c�(i-11(y Date O 2„.,//
Building Official Date
24 hour notice for all inspections(952)447-9850 i
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
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