HomeMy WebLinkAboutMechanical Permit 15. 1056 I'
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PR/ CITY q
CITY OF PRIOR LAKE Date Recd
. HEATING/AIR CONDITIONING/FIREPLACE PERMIT 8 /5
�, 1.Pink File PERMIT NO /� 0
NNEso 2.Green City 'iS /
(Pleasetype orprint and sign3.Yellow Applicant �/ F
at bottom)
ADD 2S C /0 - 4
�� ZONING(office use)
3) 4-/Or La le. c--,57--) 2g2--
LEGAL
DESCRIPTION(office use only)
LOT BLOCK ADDITION / PID .5'_ 005. 012-0
OWNER C(Name) r-c)k (.J :ei 4- kid 5--. Q(Phone) -1 r e - - t{fq -fti 9 2-
(Address)(Address)
APPLICANT A
"
(Name) L.-eA,- C A Or. TJC (Phone) 6 / a-o�c(C7 -�3y,
(Address) 6v-7 ✓.`..2- (.`r SL- LonS.14 <.` IA-11,,1 f.-S-0 VA'
(Contact Person) I 1 • _ 11 o-c_. (Phone) la l -019 a -5°3(a
APPLICANT SIGNAT i DATE L t /c"--
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION t.'TiJREPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL 60 0 ct,,,,c,,a kFUEL if
FLUE SIZE c? t4 RETURN OPENINGS INPUT f‘.9440 OUTPUT S f;U"'
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
❑Warm Air Plants El Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water into Required Side Yard Setbacks.
❑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&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 Permit#
HEATING PERMIT FEE
L.-57;117-
�b
STATE SURCHARGE $ e0- .()U
TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid Receipt I�'� 6
tkij
Building Official Date Date n O7 C By �, /"
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372