HomeMy WebLinkAboutMechanical Permit 15. 0431 0 Q
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ov PRION CITY OF PRIOR LADE
Date Rec'd
� HEATING(AIR CONDITIONING/FIREPLACE PERMIT
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I.Pink File PERMIT NO
2.Green Apy 3L
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(Please type or print and sign at bottom) 3_Yellow Applicant
ADDRESS
ZONING(office use)
6-6 3 1 6-Ds$ek."Jvtro., S -
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (' ro..:,vs a -F-, , r i ‹..KS a u' (Phone) 9 S,2-V416--23 9/ _
(Address) Sla 31 6rb.sscik,:12: Fri or-1. J ill�.5.S ?7
APPLICAAT
(Name)_ ri or- !4 4g-gi C-
L_L,C. (Phone) l_c417-gym)
(Address) 3r. A . ) - rwK -I.- P_'O;
(Contact Person} �.,,) Ar el
(Phone) g5., --4a1 7-8l l b _
APPLICANT SIGNATURE l„ek..--,? , DATE = 6.-,2bi S---
-•III
APPLICANT PLEASE COMPLETE BELOW
QNEW CONSTRUCTION REPLACEMENT ❑ALTERATIONS
FURNACE-MAKE AND MODEL anL� FUEL
FLUE SIZE _RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
['Warm Air Plants PLEASE NOTE:Air Conditioner
❑Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water
QMechanicai into Required Side Yard Setbacks.
❑Radiation Fireplaces with Box Additions or
.fir Conditioning El 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
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 $ CI g;5v
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ _S-zl3$Q
This Application Becomes Your Building Permit When Approved Paid 1f� � Receipt No.t
4
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Building Official Date Date I '
24 hour notice for all inspections(952)447-9850
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4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
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