HomeMy WebLinkAboutMechanical Permit 09.0469 f OOO q OOOOoO � o E
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04 r Riot CITY OF PRIOR LAKE il g T I a�i
c HEATING/AIR CONDITIONING/FIREPLACE PERMI
ll
JUL 0 2 2009
`�I O2 1.Pink File
r,
ES 2.Green City PE ' - -+!!=—„
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
J04'?3 .-- (3N,k + n -T-r-1 . SF_._)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(Niam E f I I v )4 6e-re, vl tel'n► IatiS (Pho -8 1
(Address) I£i&Q -I Lr)h l (h Tr1. SE-
APPLIC T
(Name) ee.n l4_ I P_f'3 ' 1SI I4 . (Phone) ci~J' a"�,3i --Qq
(Address)&4 L-3 . 14O -L*. l ao a pplP, i 4
(Address) I (City) (Zip Code)
(Contact Person) /�� (Phone) Q5 -' f 7
APPLICANT SIGNATURE (k_ex-41-- Z _ DATE e_cr" —
APPLICANT PLEASE COMPLETE BELOW
(=NEW CONSTRUCTION REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODECNA Lid FUEL
FLUE SIZE RETURN OPENINGS INPUT---r-)�(T OUTPUT q
TYPE OF SYSTEM HEATING OR POWER PLANT
:Num Air PlantsPLEASE NOTE: Air Conditioner
0 Steam Units and Fireplaces Cannot Encroach
['Gravity 0 Hot Water into Required Side Yard Setbacks.
Mechanical 0 Radiation
m....
Air Conditioning
0 Special Devices Fireplaces with Box Additions or
Vent.System ❑Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
"rtRti MAKE AND MODEL Pli -2 Oar, — la�. —0D�
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 $49.50
Estimated Cost$ S9C1 Building Permit #
HEATING PERMIT FEE $ .
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ ®
(Office Use Only)
This Application Becomes Your Building Permit When Approved PaidFir„� pt No5031
Date
kir '
Building Official Date .,0
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372