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AhcHEATING/AIR CONDITIONING/FIREPLACE PERMIT
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NVNESncA I.Pink File PERMIT NO. O9, 0 ?S
2.Green City
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
I 15173 Ellen Circle Se Prior lake
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
ame
OWNER Pat & Tamie Colton (Phone) 952-447-5809
(Address) 15173 Ellen Circle SE Prior lake
APPLICANT
(Name) Ron' s Mechanical Inc (Phone) 952-445-8585
(Address) 12010 Old Brick Yard Road Shakopee MN 55379
(Address) (City) (Zip Code)
(Contact Person) Linda<� (Phone)9 5 2-445-8585
[APPLICANT SIGNATURE _ lam DATE r
APPLICAN PLEASE COMPLETE BELOW
:NEW CONSTRUCTION ❑REPLACEMENT ❑ALTERATIONS
FURNACE MAKE AND MODEL U.VA� a (1 12 Loo FUEL N(--i
FLUE SIZE RETURN OPENINGS INPUT Le 01000 OUTPUT t C3
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air PlantsPLEASE NOTE: Air Conditioner
0 Steam Units and Fireplaces Cannot Encroach
EL avity 0 Hot Water into Required Side Yard Setbacks.
;�D echanical 0 Radiation q
II Air ConditioningFireplaces with Box Additions or
0 Special Devices
['Vent.System 0 Other Devices Cantilevers to the Outside of Buildings
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) $64.50 Residential,AC Only
Estimated Cost$ Building Permit '#
HEATING PERMIT FEE $ q q.
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ T.QO
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5 0. 0 0 Recei o. 7-Z0
Date
If I By
Building Official Date 1 1. 1(9/al •
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372