HomeMy WebLinkAboutMechanical Permit 15. 0719 J
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Do ` HEATING/AIRCITY OF PRIOR LAKE
CONDITIONING/FIREPLACE PERMIT Date Recd
�f�A'NESo�� I.Pink File PERMIT NO
2.Green City .
(Please type or print and sign at bottom) I Yellow Applicant C5'- j
ADDRESS
fl .. ,^ . ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT' BLOCK ADDITION
LO
PID 25 - J
OWNS
(Name) . - 0 e • ,
4_ d - a _.f .--
{Phone q�2 13 -LiS22
(Address) 1
1 k, 1 .
APPLIC&N)< 7
(Name) IV e Y..` .
Ilk:
(Address) �' •j4, '" (Phone) 2 ,, • - eC}C�
(Contact Person) ,1.� a _
_A.I - ♦ a ` 'hone (.00 — \Qor
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION REPLACEMENT
FURNACE MAKE AND MODEL et; DALTERATIONS
FLUE SIZE DA, V • A FUEL Ua j
RETURN OPENINGS OA%I AA - iiINPUT
TYPE OF SYSTEM OUTPUT �. t
HEATING OR POWER PLANT
PLEASE NOTE:Air Conditioner
❑Wai7n Air Plants ❑Steam
❑Hof Water Units and Fireplaces Cannot Encroach
jPravity
echanicaf ❑Radiation into Required Side Yard Setbacks.
Air Conditioning ❑Special Devices Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
❑Vent. System a❑Other Devices
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial &Multi Family 1% of'ob cost
1 Residential, Gas Fireplace $49.50
Residential, Heating&A/C(New Construction)
$49.50
�49 O�niniinum
Residential, Heating Only(New Construction) $64,50 Residential,AdditionsCOnly &Alterations
Residential,AC $49.50
Cost$ Building Permit# $49.50
HEATING PERMIT FEE $ 1ilei., ` (0
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ cy ._0
This Application Becomes Your Building Permit When Approved
Receipt No. / 2
Building Official trate 13
Date t � L�, y
24 hour notice for all inspections (952)447-9850
4646 Dakota Street S.E., Prior Lake, Minnesota 55372 dr