HomeMy WebLinkAboutMechanical Permit 15. 0694 J
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ov PRS CITY OF PRIOR LAKE Date Rec'd
4,r �•:iiA HEATING/AIR CONDITIONING/FIREPLACE PERMI Z_
4t.rNNEsolP 1.Pink File PERMIT NO. /
2.Yellow App �S� (aq�
(Please type or print and sign at bottom) 3. Applicant
ADDRESS
ZONING(office use)
`_3trr- 79 CectvIA)on. i rJt . ki E.
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) ieci,-_ dLit -
(Phone) ‘iQ- ` L/l/S 1l `75'
Address ' '% - AIL--
APPLICANT
(Name) rik Lc,t4t, ci`d41 r,AZo, %;A,.... . (Phone)
(Address) 21 11115- A/om 1 t-to Al.
(Contact Person) 61 Pf
(Phone) ..,‘-�rt-
APPLICANT SIGNATURE 1t1�i ,, __.... DATE //q/i
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION REPLACEMENT DALTERATIONS
FURNACE-MAKEANDMODEL "-174it k -A pZgo,3O&iv3 /j FUEL Aji1,
FLUE SIZE 41" RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE:Air Conditioner
❑Warm Air Plants ❑Steam
Units and Fireplaces Cannot Encroach
❑Gravity
y Mechanical DHot Water into Required Side Yard Setbacks.
❑Radiation Fireplaces with Box Additions or
N Air 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 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 Pennit#
HEATING PERMIT FEE $ c/%,
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ 6 l(,g-0
This Application Becomes Your Building Permit When Approved Paid
S�s7.,) Rece' No. /9
.7
Building OfficialDate Z. /' By
Date - Z
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372