HomeMy WebLinkAboutMechanical Permit 14. 0810 0 CA
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of vitt% CITY OF PRIOR LAKE Date Rec'd
A�. . l rtl HEATING/AIR CONDITIONING/FIREPLACE PERMIT e g /V
i.Pink File PERMIT NO.
�NNEsoll' 2.Green City Qi
(Please type or print and sign at bottom) 3.Yellow Applicant � � U
ADDRESS ZONING(office use)
X4-1 k 'DuAuckAn 16kve-, SE R2-
LEGAL
2LEGAL DESCRIPTION(offi;a use only)
LOT - , i i - l,r PID 25- 9 " 1
(d
OWNER
(Name) 11o\ne,1 \d—S (Phone) qS2—895--1900
(Address) 2ZS25 01 R . E. 1 �,,, ,,)YYISuI k V� , m 3 ���33�
APPLIC NT
(Name) L,/-k-T- ,.-> k"\- r -tr ` - (Phone) qSZ-473 t-5g:I I
(Address)51t Uppe.6- i4-711= 54. L . 5' i t 2- 1 Aoe_ tater9 , ink) s5 z'
(Contact Person) AVIV\e e r tCf.._ (Phone) Z 43k I 1
APPLICANT SIGNATURE, ' to / i 1 f DATE S/5 I I+
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION NREPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL Q YYe,,v- 5c( 2t304SS 4 FUEL ( ^ Cc)- )-
FLUE SIZE .." RETURN OPENINGS r7 INPUT 45100 Q OUTPUT 4l i400
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
❑Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
El Gravity ❑Hot Water into Required Side Yard Setbacks.
NMechanical 0 Radiation Fireplaces with Box Additions or
KAir Conditioning ❑Special Devices Cantilevers to the Outside of Buildings
:I Vent. System 0 Other Devices Require a Building Permit.
(FIREPLACE MAKE AND MODEL 1
FEE SCHEDULE
Industrial,Commercial&Multi Family I%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 $ 4q,SO
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $ -,50
This Application Becomes Your Building Permit When Approveds., `-) , Receipt No
l j13 Cl
Date By
Building Official Date ,, i c�
(K
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372