HomeMy WebLinkAboutMechanical Permit 15. 0436 0 JQ
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CITY OF PRIOR LAKE Date Rec'd
. HEATING/AIR CONDITIONING/FIREPLACE PERMIT
1.Pink File
2.Green City PERMIT NO. ��`
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
S(`01 o Gaels ruoocjT t \ ivy .
LEGAL DESCRIPTION(office use only)
LOT ' BLOCK 1 ADDITION S4, 4;n1,e.. 3 /2. arzf PID 5. 14.- DOS,
OWNER
(Name) 'SOL—e\Lj 1�c� pK . (Phone) CIS a- a 10 tp/O /
(Address) Gip I() t a r IA)o o d NE , P rl o lr Lot,k t t
APPLICANT
(Name)_ C,p YL D I I e C1 Al 1r (Phone) lis 1 1-I(0 D - tt1') @.
(Address) g I al O Eater V) AV C.►f tit t arm 1 ng Im M N SS a�
(Contact Person) H t✓ccth-e r art 1,1 (Phone) (DSI-t4 (DO - U pa
APPLICANT SIGNATUREA/45,77:20-d"" l 9ii — DATE q-2 9- /5
APPLICANT PLEASE COMPLETE BELOW
Ac ❑NEW CONSTRUCTION NI REPLACEMENT ❑ALTERATIONS
FURNACE.MAKE AND MODEL --Trot—)e X f2-.1-5 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 ❑Hof Water into Required Side Yard Setbacks.
ID Mechanical ❑Radiation Fireplaces with Box Additions or
®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 1%of job cost Residential,Gas Fireplace $49.50
$49.50 minimum
Residential,Heating&A1C(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 $ H cl. SC)
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ S`i , S
This Application Becomes Your Building Permit When Approved Receipt No.
Building Official Date Date %. \< By
G
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372