HomeMy WebLinkAboutMechanical Permit 14. 0878 04 vi l°4 CITY OF PRIOR LAKE Date Rec'd
6 i',4 HEATING/AIR CONDITIONING/FIREPLACE PERMIT
a r �.Pink File PERMIT NO j 4 t t 37 ?),ffmveso� 2.Gree�3 City
(PIease type or print and sign at bottom)
3.Yellow Applicant
ADDRESS 7 8j5` ZONING(office use)
Pv'741N star �p 2 74 7430 1
LEGAL DESCRIPTION(office use only) .
LOT BLOCK ADDITION PID
OWNE41 R
(Naive) O-s r� t Phone t` i8 p 5-d;oo
(Address) 1
APPLICANT l 6 1
(Name) SIT �
M 114 N I CA-L. , "r /N C , (Phone) l q Jr 7-) 9J?- `40 ?
(Address) 676-7 0>C h a .p ST.
(Contact Person) & & I O U/VI9 (Phone) (47 S2 i '3 3-- 6 ff S
APPLICANT SIGNATURE DATE 7 tA 1 1 ( Ilf
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ['REPLACEMENT ❑ALTERATIONS ,
FURNACE-MAKE AND MODEL FUEL ,
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner-
TWaim Air Plants ❑Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water . into Required Side Yard Setbacks.
❑Mechanical ❑Radiation Fireplaces with Box Additions or
MI •it Conditioning ❑Special Devices Cantilevers to the Outside of Buildings •
•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 Constnlction) $149.50 Residential,Additions&Alterations $49.50
Residential,Heating Only(New Construction) �- $64.50 0., Residential,AC Only $49.50
Cost$ 1; f 06 ‘ Building Permit# r
HEATING PERMIT FEE $ 5"6° '....= k_1.)1-/or'
STATE SURCHARGE $ 5.00 Cts ,u2' IA
TOTAL PERMIT FEE $ 0. o' y
This A Aril'1 . : - omes Youi Building Permit Vi en Ap:roved Paid 6).3:---,,,, Receipt No12 i,1 i
Alp
4cia1Date i Dat= c,24) °14 By }lit,-( C
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
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