HomeMy WebLinkAboutMechanical Permit 15. 0920 to
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PRI0 ,� f
�� '� CITY OF PRIOR LAKE Date Rec'd
AN1 HEATING/AIR CONDITIONING/FIREPLACE PERMIT
4rNNEso�� . l c� . �'
I. e;ti I PERMIT NO. 15-- ?2o(Please type or print and sign at bottom) 3. Yellow ApplicatrtIADDRESS �� ( 11
2%q - " " i d Lane/s LaN V ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name) i H a,r r 16 r v-\
� �q Z � I �S ,_ (Phone) 0152--q d 2'�114
(Address)
W �VAI Pr c (��YJ
APPLICANT '' jj � � rr6152-31-15
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(Name) A-1 Ir 1(,`S in E?L,L.h 1'1 1. (Phone) J 2-5`15 0 V 2i
(Address) LiQ n 1 W �) "B u r nS\ t I e S533-7
(A (City) (Zip Code)
(Contact Person) Il l v (,e` L/t X Cr) (Phone) UQ I Z— i66-51643
APPLICANT SIGNATURE �,(./a�/9 )3
W 3I DATE (?
APPLICANT PLEASE COMPLETE BELOW
[NEW CONSTRUCTION laREPLACEMENT O ALTERATIONS
FURNACE MAKE AND MODEL
FUEL
FLUE SIZE RETURN OPENINGS INPUT
OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants O Steam PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water
O Mechanical into
Air Conditioning / ❑Radiation Required Side Yard Setbacks.
Ca�11('f❑Special Devices Fireplaces with Box Additions or
OVent.System z AN ii 2 0 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Y 1%of job
Industrial,Commercial&Multi-Familcost Residential,Gas Fireplace $49.50
minimum
Residential,Heating&A/C(New Construction) $149.50
Residential,AdditionsC &Alterations $49.50
Residential,Heating Only(New Construction) $64.50
Residential,AC Only $49.50
Estimated Cost$ `T vl )0 Building Permit #
HEATING PERMIT FEE $ 4-01 c>0
STATE SURCHARGE $ 1.00
(Office Use Only) TOTAL PERMIT FEE $ 60 6 C)
This Application Becomes Your Building Permit When Approved Paid L5z)
Rec t
Building Official Date Date /O / B
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372