HomeMy WebLinkAboutMechanical Permit 10. 0907 ,c-PRI-04
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CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
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1. Pink Cite PERMIT NO GID
2. Gruen City
3. Yellow Applicant D
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
i Li Li D 1 %.V'\c\CO/e ( r WL)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) h �0``1'`e.r (Phone) 1 tP.i p�— t r 3—)-so 9
(Address) I 4b' cA.ct. C 1VL 1 Pc U,r- kk yvt1" 553-7T)--.
APPLICANT b ' W tc- -k- i l � /`� �a -RI-7
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(Name) ��yy� 0 �!� Gt.Y� 1C�(� ^(Phone) `� �U
(Address) .0V (f OC� f �rc� ,v 5535-D--
(Address)
535
(Address) 1 (City) (Zip Code)
(Contact Person) J i . _ ...e. s , (Phone) CAS3--LA '=1 a'-'/ CD
APPLICANT SIGNATURE / Clld44.0
PPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑REPLACEMENT [ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
['Gravity 0 Hot Water into Required Side Yard Setbacks.
❑Mechanical 0 Radiation Fireplaces with Box Additions or
❑Air Conditioning 0 Special Devices
OVent.System 0 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL 4t,610 St-R--8 m
os oS ip
FEE SCHE I _
Industrial,Commercial&Multi-Family 1%of job cost 'esidential,Gas Fireplace C-$.49.5-0-:)
$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 $ . 1 -"
TOTAL PERMIT FEE $ 5'1/,S
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid . .----4(:
,/ Recei t No. 6/0,6 S.—
Date/0 B
Building Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372