HomeMy WebLinkAboutMechanical Permit 09.0840 JE. W �.,
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F P Rr0 CITY OF PRIOR LAKE Date Rec'd
°§ '�'..., HEATING/AIR CONDITIONING/FIREPLACE PERMIT /O. j¢,cq
OM
dt! Sq 1.Pink File PERMIT NO. ��i>_0
NNESV 2.Green City Oqy D
3.Yellow Applicant V
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
5661/ ME4DOWOE1^/ eater
LEGAL DESCRIPTION(office use only)
I LOT BLOCK ADDITION PID
OW(Nam)R 3o6 i )V4 ffC-V PO Lp (Phone) (,i 2-. 700. 37413
(Address) '5564 14FAp 4//EL✓ doure71 lie ior2 LAxxi km/ 65512.0
APPLICANT �a
(Name) Hoag- E J RG Y C 7�s .fed (Phone) 476 ' `o
(Address) ,2415 A/UA/A RDd 15 LN tJI 41(7o I pLVA,�,OU` i 1, MO SSI/
(Aess) (City) (Zip Code)
(Contact Person) n(.J i !Yet?, (Phone) r3- (176 - /4I4
APPLICANT SIGNATURE ii, el- DATE lL7• ' Og
•'PLICANT PLEAU COMPLETE BELOW
ANEW CONSTRUCTION I REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL t.1". E. • I. r. 2 PIG - IN,' FUEL QA5
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
I [Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
['Gravity ❑Hot Water into Required Side Yard Setbacks.
❑Mechanical ❑Radiation Fireplaces with Box Additions or
❑Air Conditioning El Special Devices Cantilevers to the Outside of Buildings
['Vent.System 0 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 $49.50
Estimated Cost$ Building Permit #
HEATING PERMIT FEE $ : °
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ 50. 00
(Office Use Only)
This Application Becomes Your Building Permit When 6-0. w Recei o 9O -3
Date/U /
lY, 0 y
Buildine Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372