HomeMy WebLinkAboutMechanical Permit 15. 0821 JQ
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HEATING/AIR CONDITIONING/FIREPLACE PERMIT 7. l 7`�,5
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1.Pins{ File PERMIT NO.
`11INNEsd°' 2.Green City / ��`
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS i ZONING(office use)
4 ,O I f i ec,,►sc,v% 1/45tree-1- 50 1-t-\1 easy
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER -r- ((\�
(Name) 11 c)`'1 r1 U i e,1r'S (Phone) 9 5 a,- 1,6-13 56
(Address)mod I + 'eaS0M 5+ -e,e+ SOUL\ecksk Pp-:10i- ,MN 553 7
APPLIC T n
(Name) � ,i` i.c,r C ) t9 o>h& Hem,\-iv (Phone) -763-1-1-7B -1551
(Address) 46,U3 I oviei- Os,\e H G,tMeA , N 5 631
(Contact Person) P t%ChGe k SGh i tecg (Phone)?l3 19 c,-159
APPLICANT SIGNATUREhiNt2/64,e2 4 japtudio DATE
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ISREPLACEMENT ID ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE 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 ❑Hot Water into Required Side Yard Setbacks.
❑Mechanical ❑Radiation Fireplaces with Box Additions or
SAir 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 Construction) $149.50 Residential,Additions&Alterations $49.50
Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50
Cost$ 1 ct ',59 Building Permit#
HEATING PERMIT FEE $
STATE SURCHARGE $ I
TOTAL PERMIT FEE $ 5o.Qv
This Application Becomes Your Building Permit When Approved Paid 5793Receipt No.Zz►e 1
Building Official Date Date ,
age�7 .`rBy
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372